Discourse, media and health in NZ (bullet points)
Society in Aotearoa is marked by major ethnic and cultural disparities in health and well-being. Inequalities between Maori and non-Maori are deep-seated and well documented in a broad range of domains, including health, wealth and income, and education. These inequalities are the result, at least part, of poltical and beureaucratic practices establishedin the colonization of the country by Britain.
Contemporary/Social Darwinist explanations emphasize the responsibility of individuals and their decisions, justifying marginalisation and exclusion of indigenous peoples.
This distracts from the critical role that contexts/environments, especiall social environments play in the establishment and maintenance of this unjust, exploitative and unsustainable status quo.
A central tenant of social epidemiology is that the health of populations and population groups are strongly influenced by the environments in which they live.
The Ottawa Charter makes building social environments that are positive and supportive of individuals and communities a cental goal of health promotion. For many ethnic and racial minorities, social environments are profoundly health demoting. Anti-racism as a public health measure.
Racism produces direct harm from violence, hazardous low-status work, poor quality housing and physical environments, and reduced opportunities. Social marginalitization -> stress. There are positive corelations between blood pressure and racial discrimination. It also -> higher rates of mental ill-health, worse physical health and risk of depression and anxiety.
There are three main paths of discrimination:
1. internalisation of racial sterotypes and negative images, which denigrates individual self-worth and damages social and physiological efficacy.
2. institutional racison- resilting in lower SES and poorer living conditions - in which poverty, crime and violence are persistent stressors.
3. societal racism
There is a need for discourse to change the social understanding, attitude, language and understanding around race, racism, and health.
The language and narratives that surround us enforce a world view. They enormously facilitate social behaviour, and how experiences are interpreted. One interesting thing to look at is how Pakeha talk about Maori in the media:
- good Maori/bad Maori dichotomy - those who conform and those who don’t
- Maori stirrers - who demand things unreasonably.
- Maori inheritance - shouldn’t be allowed if “more” Pakeha than Maori
- Maori morality - amoral. Making tough soldiers and sports people, but poor citizens and neighbors
- Maori privilege - unfair, essentially racist and akin to apartheid
- Maori sensitivity - no sense of humour around breach of protocol and preservation of culture
- Maori inferiority - when offering simple comparisons of Maori culture to entire cultural composite of Europe - and appropriate to fade away
- One people - insisting on bilcultralism as power-sharing model is divisive and dangerous.
- Ignorance - why blame Pakeha for ignorant behaviours when many Maori are also ignorant about their own culture and customs
- Rights - privilege is wrong and anti-democratic
- ToW - The Treaty is flawed document with no relevence to present day
- Moriori - if the Maori displaced the original inhabitants of the country, why complain when they’re displaced?
In Aotearoa as elsewhere, mass media - public andprivate is an extreemly well resourced and powerful cornerstone institution and wields massive influence on all areas of social life. Mass media strongly shapes our personal and collective realities. The media in Aotearoa play a major role in entrenching and maintaining particular interests at the expence of others.
- downplaying big issues (Maori language teaching)
- missing Maori implications in other issues (immigration)
- ignoring stories completely (major hui and festivals)
- quoting people who aren’t Maori authorities (Winston Peters, Bob Jones)
- neglecting those who are Maori authorities
- blowing up negative stories, getting them wrong and denying they did.
Selective reporting of negative issues, and reliance on non-Maori sources.
- Maori issues made up only 5.5% of total TV and radio sample
- 61.7% relied on Pakeha sources
- Moari sources used on only 12.8% of items
- often failing to acknowledge Maori involvement of positive development stories
“In conclusion, while there is a large body of evidence already to hand about the negative role of the media in health disparities, combined research monitoring and social transformation projects that aim for empowerment and inclusion of Maori in national and community life are crucial. A research based platform to guide media reform toward relaising its potential thru positive and holistic representations of Maori and Maori-settler relations is needed. The development of more Maori controlled media to contribute towards the imporvement of Maori health and well-being is also needed. In turn these reforms and projects are vital components of the Maori development and participantion which will constitue a socially just, productive and vibrant nation.”
“I see the faces of singer Esther Phillips, vanquished by alcoholism at age forty-six; Chicago journalist Leanita McClain, a suicide victim at thirty-two; Olympic volleyball champion Flo Hyman, felled by Marfan's disease at thirty-one; playwright Lorraine Hansberry, silenced by cancer at thirty-four; actress Dorothy Dandridge, dead at forty-one of an overdose of Tofranil, a drug used to treat psychiatric depression. The images of black women without such public personas are as compelling as the famous faces the photo evokes. For every well-known black woman whose death has been noted and marked, there are countless other black women who have died in the shadows. These are the black women in our neighborhoods and communities who suffer in silence from AIDS, hypertension, diabetes or domestic violence. They are the black women who die without anyone ever asking why death came to call so soon.”— Evelyn C. White, “Introduction” to The Black Women’s Health Book: Speaking for Ourselves
Poverty, determinism, and institutionalised murder
This week, the Office for National Statistics published data which mapped health inequalities across the UK - including the finding that baby boys born in Glasgow can expect to live 13.5 years less than baby boys born in Kensington. http://www.guardian.co.uk/society/2011/oct/19/boys-kensington-live-longer-glasgow?INTCMP=SRCH
As a sociologist, the data was hardly surprising for me. Health inequalities are pervasive, and when dominant ideology increases inequality and normalises poverty, the statistical differences in health outcomes will inevitably widen. The news that poverty damages health is hardly new - there is a long history of substantial research evidence to show the multiple ways in which this takes place including the direct impact of poor housing, damp, fuel poverty (set to rise substantially this winter), poor nutrition etc, but also the less acknowledged but equally dangerous effects of the stress caused by poverty, which include the physical suppression of the immune system as the body prioritises perceived threat (an evolutionary by-product of the “flight-or-fight” response) and the increased likelihood of harmful “coping” strategies (drink and drugs are discussed commonly but in the 21st century where fat is increasingly a class issue I would include the often female strategy of compulsive overeating, as discussed by Caitlin Moran, as a neglected issue here).
There are two forms of conservative excusism which inevitably come in to play whenever stark statistics like this appear. Firstly, you get the “nice” conservative argument, which will suggest that social inequality is in fact facilitated by the psychological dependency normalised by socialism, that there will be some initial pain but neo-liberal removal of the nanny state will inevitably empower the poor to the point where inequalities are naturally removed by the re-ignition of the suppressed “go-getting” element of the human psychology. I call this “nice” because however naive and lacking in any empirical support it may be, it does not involve intrinsic hatred of the poor.
More unpleasantly, there is the argument that the poor deserve their lot - that we live in a meritocracy (again, clearly no strong evidence for this) and that poor people are simply lazy scroungers who choose to piss their lives away. This is the argument fed out to the masses by the tabloids, an argument which is entirely non-sensical when met with the reality that a baby, born today and with no free will exercised whatsoever, will be significantly restricted (or enabled) by the household and area he or she has been born in to. Exceptions to the rule are taken, with little understanding of how probability works, to suggest anyone COULD achieve social mobility, if only they had the strength of character. It is an argument presented so widely it is generally accepted without question, often and most tragically by the very people it denigrates.
Lastly, I suspect from various conversations/arguments I have had with certain people from public school backgrounds over the years, that eugenics is alive and kicking as an ideology amongst our elite. There is a hidden belief, probably tracing its way back to the old bastions of aristocracy, that the poor remain poor because they are genetically inferior - losers breed losers, and the social system merely reproduces the genetic hierarchy. The psychological advantages for someone of a wealthy background to believe in this are fairly clear - if extreme wealth is a consequence of breeding, there is no real necessity to challenge inequality, as there is the comforting illusion of inevitable success. Of course, disgusting and evidentially unsubstantiated as eugenics arguments are, there is an inconsistency in that, unpick them a little, and they give no moral support to the extremes of poverty they uphold in the existing poor - if there really was a biological difference between the rich and poor, this would if anything support an old paternalist liberal line of thinking, as we do not choose our genes therefore the poor cannot be accused of choosing or even having much influence over their destinies. However, there is of course the more pressing and foul suggestion of sterilisation which generally seems to be of much greater interest to any lineage obsessed elitist.
The real problem, as I see it, is that extremes of conservatism lack analytical understanding of either society or the individual, and are utterly unsupported by science. For conservatism to be anything other than spiteful, it has to insist on meritocratic effects of market forces, and this in itself requires a strong argument for free will in the individual. Lock up, hang and flog, because criminals choose to violate society. Reward the very wealthy with more wealth, because they have made choices to get a brilliant education (or their parents made choices to work hard to pay for it), chosen time and again work over leisure, dedicated themselves to the pursuit of money through their own industrious spirit. Take away every possible support from the poor, axe sure-start, slash welfare, get the disabled and the mentally ill back into the workplace, pull the ladder up, because if these people really wanted to succeed in life they could, and it is their parasitic choices which lead them to depend on the rest of us.
Except, where is the evidence? Look back over the years to the history of psychology, and one of the few things that the giants agree on is that free will is at best a minor and inhibited force in human behaviour, and more often an illusion. I have already mentioned the biological influence on behaviour - there is of course no strong evidence that poverty is biological, but there is plenty of evidence to show that a lot of the choices we make are framed by our level of activity of neurochemicals at any one time, which are in turn mainly influenced by genetics. Which we don’t choose. Sigmund Freud believed free will was an illusion, in that forces in the unconscious mind pushed us constantly, and that these in turn were down to innate drives (which we don’t choose) and early childhood influences (which we have little or no control over). Skinner famously asserted that the illusion of free will is an inevitable consequence of the experience of consciousness - because we experience ourselves in situations with numerous possible outcomes, we falsely perceive that our decisions at any one time have their origin in the consciousness of the moment rather than the learning environment of the past - which we don’t choose. In reality, there is strong evidence that biology affects our outcomes, early childhood affects our outcomes, the learning environment and the cultural norms we are exposed to affect our outcomes, and certainly the interaction of these makes it difficult to narrow down a cause to any one thought or behaviour, but to suggest that a thought or behaviour does not have a cause is the antithesis of science, and the evidence for free will as a real force unrestrained by any of these factors is very thin on the ground (or in fact, does not exist).
There are a couple of points to make here. Firstly, the illusion of free will is not the sole property of the right. Any time the left shouts about evil bankers, capitalist monsters or eating the rich, the same issues are occuring - those at the top are not restrained by poverty or the class system, but their thinking and actions are as much a product of cultural norms and values as those at the bottom. However, this is not to say that the values that they uphold should not be challenged, that we should not declare war on a system where so few have power over so many, that that 13.5 year life expectancy gap does not indicate institutionalised murder in black and white.
Secondly, you could philosophically extend the point to argue that if all human behaviour is determined, then work to remove one of the key determining factors (social inequality) will not lead to freedom, merely the triumph of the other determining factors such as biology and the family environment. This takes the premise that freedom from determined behaviour is the goal, however, whereas a socialist ideology should generally involve the view that equality is best experienced as a freedom from want rather than a freedom from destiny. Alongside this, there is the mundane reality that social inequality will almost certainly never be neutralised. This may be the case, but a utilitarian viewpoint would suggest that even if social inequality can never be fully tackled, a successful political battle to improve the health outcomes and experiences of a huge sector of society can only be a good thing. It may be old news, but the reality that poverty condemns should be on the front page.