An inconvenient truth: why evidence-based policies on obesity are failing Māori, Pasifika and the Anglo working class

ABSTRACT

Public health initiatives around obesity have generally worked well for middle class Australians and New Zealanders. This message has not had the same impact in Anglo working class areas and certain CALD communities, especially Māori and Pasifika, where obesity rates remain highest. This paper employs qualitative data from interviews with eighty-five Māori and Pasifika migrants to Australia to explore attitudes to food purchasing and consumption behaviours and associated health risks. It is evident the individual, medicalised approach to improving obesity rates has not been effective and there needs to be a new culturally responsive structural approach. This would require governments to prioritise population health over existing relationships with commercial food manufacturers – especially in relation to spatial domination of commercialised fast food outlets in low socio-economic status districts and in the areas of sports and education sponsorship. We also explore the assumptions of evidence-based health policy more generally, providing a critique of who is represented and served by the commercial solicitation and management of health research. This includes what constitutes ‘evidence’, who is conducting and funding the research, who appraises and compares the data and how is it interpreted and employed.

KEYWORDS:

• Māori
• Pasifika
• evidence-based policy

Acknowledgements

The authors would like to thank many community members who contributed. Also their special thanks to the Māori and Pasifika nurses who gave their time to be key respondents. I ore ate tuatara ka patu k waho.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 In this paper Pasifika and Pasifika peoples refer to Pacific Islanders of Tongan, Samoan, Niuean and Cook Island descent. Interview respondents are quoted using their self-identified ethnicity.

2 For this paper Aboriginal refers to the Indigenous people of Australia.

3 This included participants to be able to choose the venue for the interviews, usually their own home. Other family members who were not technically part of the interview process were able to sit in and participants could choose whether or not to disclose any relevant health information.

4 For a more detailed understanding of cultural health perspectives in relation to obesity, please see Rodriguez (2012) and Rodriguez and George (2014).

5 For more on the subject of foodscapes in relation to Māori, see Panelli and Tipa (2009).