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Abstract: Racism is an idea and belief that some races are superior to others (Harris et al., 2006a). This belief justifies institutional and individual practices that create and reinforce oppressive systems, inequality among racial or ethnic groups, and this creates racial hierarchy in society (Harris et al., 2006a). Recent studies have emphasised the impact of racism on ethnic health inequality (Harris et al., 2006a). In this article we analyse and discuss how nurses can challenge and reduce racism at interpersonal and institutional levels, and improve Maori health outcomes by understanding and using cultural safety in nursing practice and understanding Te Tiriti O Waitangi.
Keywords: racism, discrimination, Te Tiriti O Waitangi, Maori health, cultural safety
There are two main levels of racial discrimination: interpersonal and institutional. Interpersonal discrimination refers to discriminatory contacts between individuals, that are direct and visible (Harris et al., 2006a). This includes verbal and physical racist assault, unfair treatment at health services, at work, or being refused a job, and unfair treatment when renting or buying housing (Harris et al., 2006b). Racial discrimination in New Zealand (NZ) was experienced by Maori (Indigenous people of NZ), who are about 10-fold more likely to experience discrimination than other groups (Harris et al., 2006a). Multiple studies suggest that in the Maori population a relationship exists between self-reported experience of racial discrimination and poor health outcomes, such as mental illness, cardiovascular disease, hypertension, cancer, mortality, and health-risk behaviours such as tobacco and alcohol consumption (Harris et al., 2006a, 2006b; Human Rights Commission, 2011). Racial discrimination can increase current tobacco and alcohol use, and this substance use may be an unhealthy coping method to perceived unfair treatment for some individuals (Borrell et al., 2007). Indeed, self-reported experience of discrimination is closely related with various measures of poor health for all ethnic groups (Harris et al., 2006a).
Institutional racism on the other hand refers to discriminatory policies or practices rooted in organisational systems that tend to be indirect and relatively invisible (Harris et al., 2006b).
Institutional racism is the most powerful form of racism affecting ethnic inequality in health (Jones, 2000). It occurs when whole systems of rules and practices disadvantage minority groups while at the same time providing advantages to the mainstream group (Human Rights Commission, 2011)....