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Walking a tightrope: Asian health research in New Zealand

Ruth DeSouza Dip Nurs Grad Dip Adv Nurs MA*

Centre Co-ordinator/Senior Research Fellow, Centre for Asian and Migrant Health Research, AUT University, Auckland, New Zealand

*Corresponding Author:
Ruth DeSouza
Centre Co-ordinator/Senior Research Fellow, Centre for Asian and Migrant Health Research, AUT University, Private Bag 92006, Auckland 1142, Aotearoa/New Zealand. Tel: +64 9 921 9999 ext 7770; fax: +64 9 921 9877;email: [email protected]

Received: 11 September 2006 Accepted: 3 December 2006

 
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Abstract

Interest in how knowledge is constructed in multiethnic, multi-lingual and multi-faith communities is gaining momentum in countries such as New Zealand as they become more diverse. In turn, this provides an opportunity for new and innovativeresearch approaches that de-centre hegemonic discourses. This paper describes some key issues and challenges that could shape the development of appropriate and effective health research frameworks for improving the health of the diverse population groups in Aotearoa/New Zealand.Drawing on health and education research policy documents, the paper highlights the complex configuration and reworking of ethnicity, nationalism and belonging in New Zealand, in both historical and modern contexts. It suggests that an ethnic research agenda can benefitfrom the experience of Ma¯ori and Pacific people’s research in terms of walking a tightrope between addressing needs and avoiding deficiency, and balancing universal and particular research agendas. Processes that can be incorporated into aresearch study, such as consultation, enhancing self-determination and building capacity, focusing on community benefits, developing cross-cultural skills and incorporating alternative indicators of research quality, can assist in developing findingsthat are robust and useful to all stakeholders. However, incorporating such strategies into research with ethnic communities requires resourcing, institutional support and strategic leadership. Lastly, this paper contributes to the growing body ofresearch on ‘decolonising methodologies’ that move beyond cultural deficit models and the building of theoretical frameworks that draw on a range of standpoints, conceptual tools and worldviews.

Key words

Asian, culture, health, Ma¯ori, New Zealand, Pacific, research, research frameworks

Introduction

Critics suggest that research has been dominated by white, male, middle-class, researchers, and that using dominant methodologies can serve to reinforce stereotypes or deficiency discourses, especially where there is no understanding of the complex racialised processes, gender issues or social contexts that can affect particular groups (Collins, 1990;N arayan, 1992; Scheurich and Young, 1997). (In this paper ‘white’ refers to a social and political space (Allman, 1992).) Within the New Zealand context, these groups are termed ethnic, meaning that their members are not Pakeha, Maori or Pacific by background. The term minority is not used. The issue of undertaking research with ethnic groups outside the dominant culture is complicated in a country that is predominantly monocultural in terms of its institutions, but is grappling with the obligations imposed by the Treaty of Waitangi, which was signed in 1840 byMaori and the British Crown, and an increasingly multicultural present and future. This paper builds on previous work about the epistemological and methodological tensions of researching ethnicity and being an outsider-within (DeSouza, 2004b).

There are many commonalities between the research agendas of Maori, Pacific peoples and the ethnic sector. New Zealand’s changing socio-demographics require the development of new forms of evidence to inform policy development. There is a growing recognition of a new dialectic in the Maori research agenda that involves achieving a balance between realising potential and remedying deficit. Te Puni Kokiri’s (Ministry of Maori Development) Maori Potential Framework focuses onMaori success (Ringold, 2005;T e Puni Kokiri, 2005;Paotonu, 2006). These and other concepts offer insights into a potential research agenda for the ethnic sector.

This paper has two aims: the first is to outline the changing demographics of New Zealand’s population, focusing onAsian communities, the largest group in the ethnic sector, and highlighting some of the tensions and opportunities. The second aim is to identify strategies for working with and developing a research agenda for New Zealand’s growing Asian communities, by reviewing developments in Maori and Pacific people’s health research. The paper begins with an outline of the socio-demographic characteristics of Asian communities, which is followed by a brief history of migration to contextualise the Asian presence in New Zealand. Tensions between the multicultural and bicultural are foregrounded with a discussion about how this tension has played out in the health research arena. An outline of Kaupapa Maori research as a decolonising methodology and Pacific health research processes that emphasise relationships follow, with some recommendations for researchers, funders and policymakers working with Asian communities. The paper concludes by arguing that a research agenda that incorporates both Asian paradigms and participants, and contributes to the wellbeing of Asian communities through capacity and capability building, will have beneficial effects not only for Asian communities but for New Zealand society as a whole. Such developments also have relevance and application in other multi-ethnic environments where interest in research on ‘decolonising methodologies’ moving beyond deficit models, and the building of theoretical frameworks that draw on a range of standpoints, conceptual tools and worldviews is growing.

Ma¯ori

Ma¯ori were the first inhabitants of Aotearoa/New Zealand, first arriving in about 1300 ad. The European discovery of New Zealand occurred when Tasman visited in 1642, followed by Cook landing in 1769. Britain assumed governance of its new colony in 1840, and signed a treaty with Maori tribes. Te Tiriti O Waitangi The Treaty of Waitangi is today recognised as New Zealand’s founding document, and its importance is strongly evident in healthcare and social policy. As an historical accord between the Crown and Maori, the treaty defines the relationship between Maori and Pakeha (non-Maori), and forms the basis for biculturalism, which Sullivan (1994) defined as:

• equal partnership between two groups

• acknowledging Maori as tangata whenua (‘people of the land’)

• the Ma¯ori translation of Te Tiriti O Waitangi is acknowledged as the founding document of Aotearoa/New Zealand

• being concerned with addressing past injustices and re-empowering indigenous people.

Pacific peoples

Pacific peoples are a diverse group representing over 20 different cultures. The largest group is Samoan, making up 50% of Pacific peoples, followed by Cook Islanders (23%), Tongans (16%), Niueans (9%) Fijians (4%) and Tokelauans making up2%of Pacific peoples (Ministry of Health, 2005). In this context, ethnicity is self-defined and multiple, so the total can exceed 100%. There is a youthful population concentrated in the Auckland region, with smaller numbers scattered throughout the country (Ministry of Health, 2005). Pacific peoples make up 5.6% of the New Zealand population, which is predicted to rise to 12% by the year 2051. Pacific migration to New Zealand increased after the Second World War, as a result of growing industrialisation and the demand for a manufacturing and service industry workforce (Spoonley, 2001). Large numbers of Pacific people migrated to urban areas of New Zealand, accelerating in the 1960s and early 1970s (Spoonley, 2001).

Growing diversity

Asians had been coming to New Zealand since the 1800s, but their numbers were small until after 1987. Young Chinese men from Guangdong province travelled to the goldfields of Otago in the 1860s (Ip, 2005), and Indian connections with New Zealand began in the late 1800s with Lascars (seamen) and Sepoys (soldiers) arriving after deserting their British East India Company ships (Swarbrick, 2005). The earliest refugees arrived between 1870 and 1890, and included Danes, Russian Jews and French Huguenots. Subsequently, New Zealand has taken in refugees from all over the world. In the 2001 census, Europeans/Pakeha made up 79.6% of the population, followed by New Zealand Maori 14.5%, Asians 6.6% and people from the Pacific Islands 5.6% (Statistics New Zealand, 2002b). This cultural diversity has occurred alongside linguistic and religious diversity as seen by the census of 2001, which noted a 20% increase in the number of multilingual people and an increase in the number of people whose religion was non-Christian, including Hindu 56%, Buddhist 48% and Islam 74%.

Asian communities

Asian’ is a term that has differing definitions depending on the geographical context in which it is used. In New Zealand, ‘Asian’ tends to refer to people from South East Asia and there are debates about whether such an umbrella term is useful or strategic or merely disguises disparities within groups (Rasanathan et al, 2004;Worksh op Organising Team, 2005). Asians are the fastest growing ethnic group;their numbers have increased by around 140% over the last 10 years and are predicted to increase by 122% by 2021. In comparison, Pakeha will increase by 1%, Maori 28% and Pacific people 58%.

Asians in New Zealand are a relatively young population, and are generally in good health. Most live in the Auckland region, and over half are aged between 25 and 65 years, while around 20% are aged 15–24 years and another 20% are aged below 14 years (Asian Public Health Project Team, 2003). This age distribution is similar to that of Maori and Pacific people, but Asians are younger (on average) than Europeans. This can be further broken down into particular ethnic groups as shown in Table 1 (Statistics New Zealand, 2002a). The rapid growth of the Asian population has exposed a lack of policy and structures to evaluate and address their needs (Workshop Organising Team, 2005).

Biculturalism and multiculturalism

diversityhealthcare-Asian-ethnic

Table 1: Summary of Asian ethnic groups

The place of visibly different migrants has always been uncertain (Kearns and Dyck, 2004). Migrants to New Zealand have been caught between two charged agendas: the colonial ideal of a homogenous society that replicates Britain, and the desire of Maori for recognition as people of the land or tangata whenua, with specific rights (Bartley and Spoonley, 2004). The Treaty of Waitangi and the social policy principle of biculturalism have become an explicit template for relationships between indigenous Maori and subsequent migrants. The racialising and ‘othering’ of migrant groups, along with past migration policy designed to keep the country white (Beaglehole, 2005), have implicitly shaped the treatment of migrants.

Bartley and Spoonley (2004) argue that the 1980s were a pivotal period in discussions of New Zealand identity, featuring biculturalism and its incorporation into social policy in New Zealand. They suggest that discussions of multiculturalism began with the arrival of Pacific peoples in the 1970s. Canada and Australia had embraced multiculturalism during the 1960s, transforming the notion of settlement into a twoway process requiring change by both migrants and the receiving society. Bartley and Spoonley suggest that attempts to address the bicultural/multicultural relationship came about with proposals that biculturalism should take precedence, and subsequent arrivals to Aotearoa needed to negotiate a primary relationshipwithMaori. Multiculturalism would then be the outcome of a network of completed bicultural negotiations. However no process was ever suggested for this to occur (Bartley and Spoonley, 2004). The bicultural/multicultural debate remains unresolved and problematic (DeSouza, 2004a;Kearns and Dyck, 2004;Mo hanram, 1998;Thak ur, 1995;Walker, 1995; Wittman, 1998);howeve r it is arguable that biculturalism has paved the way for the majority culture to consider cultural issues at large.

Invisibility in health research

Asian ethnic groups have been largely neglected by New Zealand health policies and research, despite their long history in New Zealand and recent population growth (Duncan et al, 2004). Duncan et al (2004) cite the example of the 2002 National Children’s Nutrition Survey, where both over-sampling and separate analysis of Maori and Pacific Island children occurred, while Asian children were subsumed with New Zealand Europeans. Large-scale studies are needed to determine health risk across all major ethnic groups in New Zealand, which will in turn enable development of ethnic-specific data. Even more critical is the need for data concerning ethnic variation in other areas of health, so that effective interventions can be developed and implemented (Duncan et al, 2004). This omission and exclusion is by no means a rare occurrence in national surveys and prevents the development of an understanding of the public health needs of Asian communities in New Zealand, necessary for the development of appropriate preventative health strategies. More recently two reports have provided comprehensive information on the health of Asian New Zealanders. The Asian Health Chart Book (Ministry of Health, 2006), a monitoring report on the health of Asians, and a report on the health profile of young Asian New Zealanders were derived from the findings of Youth 2000, a national secondary school youth health survey (Rasanathan et al, 2006). Despite these gains, the health of Asians remains under-researched.

The following section details policy developments and documents which incorporate Maori and Pacific people-centred processes respectively. A short analysis of the areas in which the policies for these two groups are similar as well as theways in which they differ, such as indicators of research quality, follows. The section concludes with an analysis and discussion of the impact these guidelines/approaches could have on Asian health research.

Learning from Ma¯ori processes

Tuhiwai Smith (1992) argues that dominant Western research methodologies are inextricably linked to European imperialism and colonialism and have not been sympathetic towards Maori. Consequently, Maori researchers have sought to develop and promote appropriate methodologies for research for, by and withMaori, now referred to as KaupapaMaori, which refers to the ‘practice and philosophy of living aMaori culturally informed life ... it also invokes the stance of identifying with, and pro-actively advancing, the cause of being Maori’(Smith, 1997, p. 453), or ‘Maori centred’ research (Smith, 1992). Such approaches involve having both a critical approach to Western theoretical and analytic frameworks and a commitment to using Maori conceptual tools to understand and explainMaori experiences (Scott et al, 2005). The aim of Kaupapa Maori research has been to ensure that research with indigenous peoples is more respectful, ethical, sympathetic and useful (McNicholas and Barrett, 2005). The Maori Health Committee of the Health Research Council (HRC) has produced guidelines which it hopes will be incorporated into the practices of researchers working with Maori. These aim to ‘establish research practices which ensure that the research outcomes contribute as much as possible to improving Maori health and well-being, while the research process maintains or enhances mana Maori’ (Ma¯ori authority or power) (HRC, 1998, p. 3). The relationship of researchers to Maori is defined by the Treaty of Waitangi, and in particular Articles 2 and 3. The former refers to Tino rangatiratanga (Maori control over resources), while Article 3 refers toMaori having a fair share of benefits in terms of both funding and health outcome (HRC, 1998).

Self-determination

Self-determination in aMaori context refers to ‘chiefly control ... that is the right to determine one’s own destiny, to define what that destiny will be and to define and pursue means of attaining that destiny’ (Bishop, 2003, p. 225). Kaupapa Maori research also requires that indigenous knowledge is positioned at the centre, promotes Maori involvement in research, focuses on methodologies that are appropriate for Maori and highlights mutually beneficial outcomes for the researcher and the researched (Smith, 1999, p. 183). Kaupapa Maori research is also viewed as a mechanism for addressing historical and ongoing power imbalances (Bishop, 2003).

Building in time and resources for consultation

Appropriate consultation can serve as a buffer against claims of being ‘over-researched’ when no benefit is evident. According to the HRC, consultation can be defined as ‘a two way communication process for presenting and receiving information before final decisions are made, in order to influence those decisions’ (HRC, 1998, p. 5). The key elements are:

• setting out a proposal not fully decided upon

• adequately informing a party about relevant information upon which the proposal is based

• listening to what the others have to say with an open mind (in that there is room to be persuaded against the proposal)

• undertaking that task in a genuine and not cosmetic manner

• reaching a decision that may or may not alter the original proposal (Justice McGechan, 1993, cited in HRC, 1998).

Consultation needs to occur at all stages of the research project lifecycle. Processes and organisations to consult are clearly defined for Maori and Pacific peoples (HRC, 1998, 2004). What needs to be acknowledged is that such a process increases the workload for all parties in research, but building in such a process is more likely to lead to benefits for the community the project is being developed for, and some argue that in the case ofMaori where the criteria are ingrained into a contestable process, it can lead to more competition and better quality information (HRC, 1998).

Building capacity

There are two ways in which capacity can be increased (HRC, 1998). The first is through the training and supervision of Maori researchers, which would address the gaps in Maori health research workforce development. Provision for increasing the number of Maori researchers has been made in the availability of career development awards for Maori researchers, which means that community development can occur without increasing the size of the grant budget (HRC, 1998). The second mechanism is by providing Maori with research skills that are transferable to other projects, and funding is available through the HRC’s Rangahau Hauora Awards.

Individual versus community benefits

Western-orientated research practices are not only criticised because of the positivist tradition which dominates, but also because they contain notions of cultural superiority and have resulted in interests, agendas and methods of research remaining firmly in the control of the researcher who largely benefited at the expense of communities (McNicholas and Barrett, 2005). The HRC suggests that its guidelines and specifically consultation are there to ‘ensure that research and practices contribute to Maori health development whenever possible’ (HRC, 1998, p. 2).

Moving beyond cultural deficit models

Some Western research has produced ‘deficit theories’ which blame the victims and see the locus of the problem as either lack of inherent ability, lack of cultural appropriateness or limited resources;in short, some deficiency at best, a ‘pathology’ at worst (Bishop, 2003). Bishop suggests that research recommendations then involve getting the ‘victims’ to change, usually to become more like the researchers. Swindells (2006) suggests that there are three major changes in the Maori research and policy environment. The first is moving away from a single-dimension model of repair of deficit, disparity and dysfunction to recognising multidimensional Maori potential, strengths, and opportunities (Paotonu, 2006). Second is a move from targeting Ma¯ori as a socio-economically disadvantaged ethnic minority to investing in Maori as an integrated, but culturally distinct, indigenous community, and lastly rather than focusing on institutional responses, there is a move to investing in Maori people.

Development of cross-cultural skills

Having good consultation processes and the engagement of ethnic communities can result in learning for senior researchers who get to be involved in the development of novel research strategies, recruitment methods, dissemination strategies and research tools, not to mention broader cross-cultural skills and experiences (Paotonu, 2006).

Justifying exclusion

Exclusion of Ma¯ori participants from a general population study should only occur if it is as a result of consultation with Maori. Such an exclusion needs to be well justified, as it counteracts the potential health gain in relation to Article 3 of the Treaty (HRC, 1998). However, exclusion on the basis of perceived difficulty of working withMaori would be contrary to Article 3.

Learning from the experience of Pacific peoples

The following section draws on guidelines produced by the HRC, which aim to reduce inequalities and improve the health status of Pacific peoples (HRC, 2004), the Ministry of Education (Anae et al, 2001) and the Tertiary Education Commission (TEC, 2003).

Definition of Pacific research

The HRC defines as its vision, optimal health for Pacific peoples with the best possible health outcomes for the Pacific community (TEC, 2003). Research is viewed as a significant aspect of improving the health status of Pacific peoples. The Performance Based Research Fund (PBRF) draft guidelines for assessing evidence portfolios that include Pacific research suggest that Pacific research can be undertaken by both Pacific and non-Pacific people, and needs to not only be original investigation undertaken in order to gain knowledge and understanding but also ‘demonstrate some, or all, of the following characteristics, and should show a clear relationship with Pacific values, knowledge bases and a Pacific group or community’ as shown in Box 1 (TEC, 2003, p. 3).

diversityhealthcare-research-characteristics

Box 1: Pacific research characteristics

Alternative indicators of research quality

Other than the traditional forms of quality assurance, such as peer review and refereeing processes, the TEC suggests that indicators of research quality for Pacific research can include:

• endorsement by community leadership, prior to wider dissemination

• endorsement through fono (community meetings) or Pacific media (recognising that these may be community, national, regional or Pan-Pacific), prior to wider dissemination

• evidence of dissemination and uptake of research findings by Pacific regional media, and Pacific research communities

• endorsement and uptake across Pacific communities (TEC, 2003).

Building in inclusionary strategies is also another quality indicator. Anae et al (2003) suggest that one of the ways of keeping researchers accountable is to have advisory committees or reference groups that are specific to projects. Anae et al (2003) also recommend that the researchers have team members who are proficient in the appropriate language, so that this does not prove a barrier to participation in research for Pacific peoples.

Inter- and intra-ethnic differences

Like Asian communities, Pacific peoples are not a homogeneous group;they are striated by inter- and intra-ethnic variations and therefore there is a need for Pacific statistical data and research to be disaggregated (Anae et al, 2001). In addition, the authors note the need for acknowledging differences between New Zealand-born people and Island-born or recent arrivals.

Need for both universal and particular research

Anae et al (2001) argue that there is a growing move from Pan-Pacific research towards in-depth ethnicspecific studies. The authors suggest a Pan-Pacific approach provides generic data about Pacific groups, but there are logistical problems in terms of managing multi-ethnic research teams and providing ethnic matching and gender matching of interviewers. Pacific language translations and consultation and dissemination issues mean that research becomes expensive. Equally while ethnic-specific approaches provide more Box 1 Pacific research characteristics Paradigm . Is informed by and embedded within the continuum of Pacific worldviews, knowledge, practices and values . Is conducted in accordance with Pacific ethical standards, values and aspirations, such as responsiveness and reciprocity . Involves research processes and practices that are consistent with Pacific values, standards and expectations . Includes methods, analysis and measurements that recognise Pacific philosophy, spirituality and experience . Includes data derived from the broad range of Pacific knowledge and experience Participation . Involves the active participation of Pacific people (as researchers, advisors and/or stakeholders) . Demonstrates that Pacific people are more than just subjects of research . Pacific research demonstrates communal contact;that is, it recognises and validates the relationships between the researcher and the ‘researched’ . Engagement of the Pacific community in the initial stages of the research Contribution . Has a demonstrable impact on Pacific communities . Contributes to and enhances the Pacific knowledge base in all subject areas . Contributes to a greater understanding of Pacific cultures, experiences and worldviews . Is relevant and responsive to the needs of Pacific peoples . Protects Pacific knowledge . Contributes to Pacific knowledge, spirituality, development and advancement . Is responsive to changing Pacific contexts Capacity and capability . Builds the capacity and capability of Pacific researchers . Enhances the capacity of relevant Pacific communities to access and use the research

depth and specificity, they don’t allow for broader application. Anae et al (2001) argue that while there are over-arching similarities among Pacific peoples, there are also distinct traditions, languages, histories and so on, which researchers need to be aware of.

Capacity building

Capacity-building research and processes that enhance Pacific peoples and communities are also signalled by Pacific researchers (Anae et al, 2001). It is recommended that research builds on and enhances Pacific communities’ strengths. In addition, mentorship and training of younger Pacific researchers with the building of positive collegial relationships across sectors is recommended. Building research capacity and capability has been the main focus of the HRC’s Pacific Health Research Committee (HRC, 2004).

Development of a research strategy

The Pacific Team at the HRC also has a focus on capacity and capability of the Pacific Health Research Workforce: offering scholarship opportunities for Pacific peoples in health and health research;adm inistering the promotion, assessment and contractual agreements of Pacific awards;promoting Pacific health research in New Zealand and in the wider Pacific region;develo ping Pacific health research networks; improving the access of Pacific peoples to HRC funding opportunities;developi ng Pacific health research policy;providing guidelines on Pacific health research; building funding partnerships with other agencies for Pacific health research;and maximising funding opportunities for research that will improve the health outcomes for Pacific peoples (HRC, 2004, p. 15).

Focus on relationships

In consultation with Pacific peoples, the HRC proposes ten essential principles for guiding ethical research relationships: respect;cultural competency;me aningful engagement;reciproci ty;utility;rights ;balance; protection;capacity building, and participation (HRC, 2004).

Levels of indicators

TheHRC(2004) has developed a continuum model to ascertain the level of Pacific involvement and benefit from Pacific research. It can be seen from Table 2 that research which moves from relevance to governance across the table provides more opportunity for capacity and capability development of Pacific researchers and their communities. Having reviewed policy developments and documents which incorporate Maori and Pacific people-centred processes respectively, the ways in which policies for these two groups are similar (such as consultation and involvement, empowerment models, and the rejection of cultural deficiency models) as well as the ways in which they differ (such as indicators of research quality) are discussed.

diversityhealthcare-Pacific-relevance

Table 2: Levels of indicators to define Pacific relevance, Pacific partnership and Pacific governance

Culturally safe research

There is one significant difference between the population groups, firstly in terms of the unique status of Maori as tangata whenua and treaty obligations,which means that the frameworks and strategies have legislative power. However, there are far more similarities. Kearns and Dyck (2004, p. 79), recommend that the following are necessary for research to be culturally safe:

• respect for the cultural knowledge, values and practices of others

• an awareness of one’s own way of seeing and doing

• analysis of the effect of our actions on the knowledge that is produced.

Culturally safe research is supported by Maori- and Pacific-centred frameworks that value not only the content of knowledge but the process through which research is conceived, produced and justified as knowledge (DeSouza, 2004b). This is because research is ‘an active process, engaged in by embodied subjects, with emotions and theoretical and political commitments’ (Gill, 1998, p. 24) that impact on the research process. Methodology and research design are far from neutral and ‘we inevitably bring our biographies and our subjectivities to every stage of the research process, and this influences the questions we ask and the ways in which we try and find answers’ (Cameron et al, 1992, p. 5).

Researchers also have a pivotal role in shaping the research encounter through the theoretical, ontological, personal and cultural frameworks that they hold (Luttrell, 2000), which makes it vitally important for the researcher to reflect on their multiple positionings and identification with groups, the political implications of their work and the context of unequal power relations, so that they can produce research that is both plausible and reflects better the voices of those being researched (Easterby-Smith and Malina, 1999).

The Ma¯ori- and Pacific-centred frameworks go further, emphasising communal rather than individual benefits, and the need for not just inclusion but empowerment. These involve going beyond the individual researcher’s career and professional development, to the development and wellbeing of the larger community. Although by no means exhaustive, Table 3 highlights the similarities and differences between Maori- and Pacific-centred processes with the status of ethnic research included.

Both population groups are priority populations in the HRC’s policy framework, which is focused on identifying and addressing needs and issues for these groups through research investment. Both Maori and Pacific frameworks argue for self-determination and the use of insiders of the community being studied;for example, ‘While it is preferable to use Pacific researchers, where there is a limited pool of Pacific researchers available, it may be necessary to use non-Pacific researchers’ (Anae et al, 2001, p. 10). This essentialist position, where the ‘insider’ is privileged, does not mean that stereotyping or other exclusionary processes will not occur, particularly if the researcher is working within a Eurocentric paradigm. Hence it is necessary for all researchers to avoid the reinforcement of prevailing and widely accepted patterns of domination and colonial practices that can be embedded in institutions. The notion of insider rests on an essentialist construction of identity leaving little room for multiple and shifting identities (DeSouza, 2004b), but Bishop (2003) argues that it is a strategic position to occupy as long as it allows for an ongoing fluid and dynamic process of cultural reference and reconstruction.

Implications for an ethnic framework

Guidelines produced by the Office of Ethnic Affairs offer a starting point for consulting ethnic communities, including Asian communities (Bishop, 2003). An example of good practice is the recently launched Creative New Zealand research project looking at Asian participation in and access to the arts, where members of Asian communities have been recruited into their advisory groups to guide the research process, and consulted on the research process. Capacity is being enhanced through the Building Research Capacity for the Social Sciences (BRCSS) New Settler research development. This is a cross-institutional research network of around 30 major funded social science research programmes in New Zealand. This development is promising, and a key aim is to ‘enhance the capability and capacity of the national social science research community, especially for new emerging researchers and with particular attention to the research needs of Maori, Pacific and New Settler communities’ (Spoonley and Thorns, 2006, p. 1).

Recently completed research projects have identified the need for universal (umbrella) and particular (ethnic-specific) research. The needs of long-term settled communities have been brought into focus with the launch of the Asian Health Chart Book (Ministry of Health, 2006), which demonstrated the need to focus not only on new migrants but also on longer term settled migrant Asian communities. Major differences in health and health service use between recent migrants and longstanding migrants show that that recent or first-generation migrants have better health status than longstanding migrants or the New Zealand born, demonstrating the acculturative effects of the dominant culture and the dissipation of the selection effect (McDonald and Kennedy, 2004). The Asian Health Chart Book (Ministry of Health, 2006) stratified within the ‘Asian’ grouping along two axes – ethnicity and settlement history – and analysed three ethnic groups separately – Chinese, Indian and ‘Other Asian’. However, as seen in Table 3, an ethnic research framework is in need of development, for despite the gains outlined, ethnic research remains at the level of relevance rather than partnership or governance.

diversityhealthcare-research-frameworks

Table 3: Summary of strategies used in research frameworks.

Conclusion and recommendations

Now that the Asian population has overtaken that of the Pacific peoples and is predicted to continue to increase, there is a need to ensure that a more strategic research response to New Zealand’s changing demographics is developed for an Asian health agenda. Research outcomes and processes must contribute to the wellbeing and development of Asiancommunities. Consideration needs to be given to how research is made culturally safe and, from a more strategic perspective, how research responds to New Zealand’s changing demographics. Future developments in ethnic health research need to heed the unique status of Maori and learn from the experiences of both Maori and Pacific peoples, thereby minimising the risk of reproducing deficiency discourses.

Clearly, research with Asians must benefit Asian communities, not just researchers, academic institutions and government. Incorporating an Asian perspective and team members in expert research teams benefits not only Asian communities but also communities of researchers. Pan-Asian research can provide advocacy and numbers for system change, while more specific information can benefit the diverse needs of the different communities within this group. Mentoring, training and capacity building of Asian researchers require institutional support and leadership. A balance must be struck between addressing needs and pathologising and marginalising groups. A shift from a deficit-based approach to a strengthsbased one holds promise. For all of this to occur, research design and methodology need to include mechanisms for building relationships, culturally appropriate methodologies, and development of researchers who are culturally safe and competent, and develop ways in which research findings can be fed back to communities in ways they can utilise and endorse and ensure reciprocity and partnership.

Based on the foregoing discussion, it is recommended that research projects be transformed from being relevant or about Asian communities to being conducted in partnership with Asian communities. Asian community governance and co-ownership of research projects should be encouraged. Such a shift requires resourcing, leadership and strategic development within an emerging Asian health research agenda. In summary this paper recommends that researchers, funders and policymakers consider:

• incorporating sound consultationprocesses throughout the lifecycle of the research

• identifying ‘Asian’-appropriate methodologies that position Asian worldviews at the centre, thus providing an opportunity for new and innovative methodologies to emerge

• including Asian participants in general population research to a greater extent than currently occurs

• maintaining accountability and integrity by utilising alternative indicators of research quality, such as endorsement and dissemination by Asian advisory groups, communities and media

• developing a national Asian health research strategy that promotes networking and partnership rather than competition for scarce funding, and which works towards minimising gaps and duplication

• creating guidelines for developing ethical researchbased relationships with Asian communities.

Acknowledgment

The author would like to thank the reviewers for their helpful contributions to the development of this paper.

CONFLICTS OF INTEREST

None.

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