Tracking Historical Trauma

Dr Borell is currently examining the health effects of historical trauma for Māori through their experiences of state welfare. Along with a small team of Whariki and SHORE researchers, we seek to do this by exploring two avenues of representation that frame Māori people and affect how health issues are understood and addressed. Poverty and Abuse in State Care are two key areas of welfare that are critical in understanding the social determinants of Māori health. Both projects offer opportunities for Dr Borell to develop new skills and methodologies, to increase the Māori research workforce and support existing and new collaborations and networking.

Poverty is one of the most important and ongoing determinants of inequitable health outcomes. Societal knowledge of poverty is often shaped by what we hear from politicians, what we read in the news and what we see on TV. These depictions tend to show particular groups as the ‘face of the poor’ with little recourse to proportional accuracy. This skew of representation increases stigmatisation of the poor, making punitive attitudes towards them more likely and precluding effective interventions that may address the causes of poverty. We hypothesise that an over-reliance on racialised representations of people experiencing poverty, while consistent across Western democracies, nonetheless hampers public support for poverty intervention. We will examine how shifts in the demographic representation of the poor may be affecting public attitudes and driving lower empathy towards those in need.

Abuse in state care is also increasingly understood as a critical element in perpetuating intergenerational trauma of which Māori have been particularly over-represented and vulnerable. Building on a pilot project funded by Nga Pae o Te Maramatanga, we are exploring how the concept of indigenous Historical Trauma may be applied to large statistical datasets like the Integrated Data Infrastructure (IDI). Impelled by the momentum of the Abuse in Care Royal Commission of Inquiry, we are examining the health and life outcomes of children placed in state care between 1950-1999. We have found marked differences in life expectancy, educational and health outcomes, mortality and causes of death, when compared with the general population. We have recently produced an article for The Conversation outlining our initial findings. As the project progresses, we will now attempt to link these children (now in their 40s and 50s) to children and descendants with the view to examine how trauma responses, but also resilience and healing, may be passed through generations.

Social Determinants of Health

Theorising ethnic privilege in Aotearoa

This research goes beyond an analysis of racism to describe the way societal privilege works as a determinant of health for dominant groups by ensuring inequitable access to power, opportunity and social status.
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Key informant understanding of privilege revolved around the notion that privilege is multi-layered, invisible (to those who benefit) and closely related to class and culture.
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This research marks an important departure from much health research that tends to focus attention on the disadvantaged groups in our society often employing “victim blaming” language.

"If we accept that there are forces in our society (other than socio-economic) that are significant in creating and maintaining disadvantage within certain populations, it is also likely that equivalent forces – environmental, cultural, societal, institutional, interpersonal – protect and perpetuate advantage in other populations groups."

Maori Health Identities

People’s understandings of their health, including deficit representations, impact through a range of mechanisms, with profound implications for health. The aims of this study are to investigate Maori health identities, examine their impacts and develop actions for better engagement and alignment of services with Maori needs and expectations. Two rounds of interviews were conducted utilising qualitative and quantitative (Q methodology) components. The study found four key groupings; a small group largely accepted the stereotypes, another group expressed varying levels of ambivalence, many resisted and challenged deficit representations of Maori health and the fourth group did so with critical insights. 

The project provided material for a case taken to the Human Rights Tribunal arguing that cartoons published in the Marlborough Express and The Press were in breach of the Human Rights Act, section 61.
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Commercial Determinants of Health

The transnational alcohol companies directly and indirectly have argued strongly for ineffective policy and to subvert the development and implementation of evidence based effective policy. Industry funded organisations have engaged in effective stakeholder marketing to try to avoid similar controls to those placed on the tobacco industry, another marketer of an addictive and hazardous substance.
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The legal high industry was active during the development of the psychoactive substances regime in New Zealand .
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More information on our Determinants of Health research here