New Zealand's taxpayer-funded research industry has once again discovered the answer to a problem that nobody was asking.
This week's breakthrough revelation? Eating disorders apparently require a "Kaupapa Māori-led" response.
Not better access to treatment.
Not more specialist clinicians.
Not faster referrals.
Not increased psychiatric capacity.
Not more specialist clinicians.
Not faster referrals.
Not increased psychiatric capacity.
No, according to the latest academic wānanga (discussion workshop), what anorexia, bulimia and binge-eating disorders have really been missing all these years is another layer of cultural bureaucracy, another set of ethnicity-specific programmes, and another round of calls for "sustained investment".
The study itself contains some observations that are entirely sensible.
- Poverty can contribute to unhealthy eating patterns.
- Trauma can contribute to mental health problems.
- People with complex needs often struggle to navigate fragmented services.
- Specialist services can have workforce shortages.
In fact, none of it is uniquely Māori either.
A struggling solo mother in Invercargill, a family in South Auckland living week-to-week, or a teenager dealing with trauma in Christchurch face many of the same challenges regardless of ancestry.
Yet somehow every road leads back to the same destination: more race-based funding.
The article highlights "DPB eating", where families experiencing periods of financial hardship may binge when money becomes available. That sounds less like a cultural issue and more like a poverty issue. The solution would seem to be helping people escape hardship, improving access to treatment, and ensuring adequate mental health support.
But in modern New Zealand academia, ordinary social problems are rarely allowed to remain ordinary social problems.
Everything must be filtered through a cultural lens.
Everything must become a Treaty issue.
Everything must require a uniquely Māori framework.
The study also complains that mainstream services focus too heavily on weight-loss interventions while overlooking emotional wellbeing and trauma.
If that's true, then improve the treatment model for everyone.
A patient suffering from an eating disorder does not suddenly require a different standard of medical care because their great-grandparents belonged to a different tribe.
Mental health professionals should already be considering trauma, family circumstances, co-existing conditions and personal history. That's simply good clinical practice.
What is perhaps most remarkable is the growing tendency to treat cultural branding as a substitute for evidence.
Terms such as "whānau-centred", "culturally grounded", "Māori-centred assessment tools" and "kaupapa Māori knowledge" sound impressive, but the article provides little evidence that ethnicity-based approaches produce superior outcomes compared with well-resourced, accessible treatment available to all New Zealanders.
The assumption increasingly appears to be that if a programme contains enough Māori terminology, questioning its effectiveness becomes almost taboo.
Meanwhile the real issue receives far less attention.
New Zealand already struggles to provide adequate mental health services across the board. Waiting lists exist. Specialist staff are in short supply. Resources are stretched.
Those problems affect patients of every ethnicity.
Perhaps before creating separate frameworks, separate assessment tools, separate commissioning pathways and separate funding streams, we should focus on ensuring that every New Zealander suffering from an eating disorder can access timely, evidence-based treatment.
Because eating disorders do not check whakapapa before causing harm.
Anorexia does not discriminate by iwi.
Bulimia does not consult Te Tiriti.
And binge eating is not cured by replacing clinical language with cultural terminology.
The tragedy of eating disorders is that they are serious illnesses deserving serious treatment.
The tragedy of modern health policy is that increasingly every challenge must first pass through the race-relations department before anyone is allowed to discuss practical solutions.
Once again, New Zealand is being asked to believe that the path to better healthcare lies not through more doctors, more specialists and better services, but through ever more cultural frameworks, advisory groups and taxpayer-funded studies explaining why everything needs to be viewed through an ethnic lens.
Apparently even eating disorders have now been colonised.
Geoff Parker is a passionate advocate for equal rights and a colour blind society.
14 comments:
Indoctrination.
Health care people, please push back .
I don't believe that poverty contributes to unhealthy eating patterns. You can't be extremely poor and be fat, because food is expensive.
It is more likely that both obesity and poverty are caused by a lesser developed rational faculty - the language-based thinking thing you call 'I' and which distinguishes humans from other animals.
A weak rational faculty results in a lack of self-control with respect of eating.
The question then becomes, is rational faculty strength due to nature or nurture?
Having maoori manage courses in eating disorder is as irrational as maori running courses on contraceptin and famiy planning, albeit with less potential political gain with manipulation of food allergies. Whenever I walk through the local shopping centre food court I sit and observe the crowd. There is a very direct relationship between the mountain on the plate and the mountain consuming. It helps me understand how I have acumulated savings.
Barrie Davis raises a very interesting question: what exactly is the relationship between poverty and unhealthy eating habits?
When A and B occur together, it may be that A causes B, or B causes A, or both are cause by a third variable, C. Barrie seems to prefer the third option. Personally, I think all three apply. Healthy eating does cost compared with cramming oneself with nutritionally deprived kilojoules, so there is a case to be made for poverty causing bad eating where cheap kilojoules are involved. At the same time, spending money on 'fancy' highly processed foods can be even more expensive, so we have bad eating causing poverty. An outside factor influencing both is a lack of effective education about food, money and health. Such education would include removing unhealthy options from school canteens - preaching about healthy eating and having a canteen that sells kids fatty pies and bags of salty crisps and sugary buns laced with artificial cream comes down to "Do as we say, not as we do". Pupils must, of course, be able to process the information they are given, which brings in their ability to think rationally.
If unemployment is defines as poverty it does contribute to over eating as there is the constant time and opportunity. It becomes a time filler. The local schools, pri and sec, have a large maori/polynesian attendance. The parade to and from school always includes many eating pies etc. Apart from other factors , store bought a very expensive source of food.
"Healthy eating does cost compared with cramming oneself with nutritionally deprived kilojoules, so there is a case to be made for poverty causing bad eating where cheap kilojoules are involved."
I grew up in poverty, one of 7 children and a widowed mother. And we as young marrieds were obliged to manage on a very low income, because of mortgage and other fixed costs.
I disagree that healthy eating costs more. It may do if one buys expensive cuts of meat and out-of-season fruit and vegetables, but that isn't necessary. As children, we never went hungry. Neither was any of us fat. To be sure, our late mother was a superb manager of what little money there was. But, if she could do it, so could anyone.
Nowadays, my view is that poverty results from injudicious choices regarding food and other items such as clothing, which cost too much, not the other way about.
A family member has observed that there's no poverty in NZ, because we do not see that great marker of poverty: starvation. I tend to agree: when was the last time anyone here saw skeletal individuals tottering around?
The Maori and Pacific Island people whom we see when we're out and about tend to be fat, though not all of them, obviously. Absent evidence to the contrary, my view is unchanged.
Certainly, in light of what we see around us, the notion of a Maori -centred approach to eating disorders seems bizarre to me.
Dear Author.
With your "permission" I would like to place this article in front of the "Collective Sovereign Based Order of Polynesian People's" who congregate on a regular basis at their "Religious Center" for communal partaking of KFC.
I would also ask them to consider if -
- their eating of such food is a "disorder".
- if they feel that "Colonization" has had a greater part in creating this "Religious Order" of eating a specific food?.
Must remember this article the next time I go to get a Takeaway - any Takeaway !
D'Esterre, read the line that follows. There is cheap-and-nasty junk food and there is expensive junk food. In that sentence you quote, I was on about the former; in the sentence that follows, the latter.
BV: "...cheap-and-nasty junk food and there is expensive junk food."
My view is that all food has some nutritional value, even if some has more calories. And it's the choosing of expensive so-called "junk" food which blows people's budgets. Takeaways are always more expensive than cooking from scratch, no doubt about it. More bang for scarce bucks to be had from avoiding that takeaway stuff. But not for nutritional reasons. Lucky for us, we had access only to fish and chips. And our eating of that was strictly controlled by the cost. Otherwise we ate cheap cuts of meat, and seasonally available fruit and veg. which is cheaper.
During my employment, I was obliged to sit through seminars conducted by well-meaning women, who lectured us on which foods were nutritional. I and one or two others used to push back (much to the annoyance of the virtuous). Their adjurations were "counsel of perfection" stuff, and it used to really irritate me.
At that time, we were working with low-income people. We had to be very careful about the "counsel of perfection" problem. If healthcare providers make that mistake, people just switch off. And who is to blame them?
Were I doing that sort of work now, I'd focus on cost. Much less potential for sounding as if one is blaming people for their choices, and implying that they're harming their children.
Pak’Save has a 1.35Kg chicken for $9.99. Onions for $1 a kilo, potatoes at $2.50 a kilo and frozen peas for bugger all and pretty cheap bread.
If you can’t make 2 meals (dinner and lunch) for a family of 4 out of that for $20 you’re an idiot.
Perhaps the number of idiots in NZ is the real reason for poverty.
Supermarket chicken and pork are cost effective proteins and the addition of a few spices can turn these into a myriad of tasty dishes.
Perhaps we should reintroduce cooking and budgeting into schools along with the 3R’s (for all 53+genders)
Dreadnought talks sense.
Home Economics including culinary skills should be in the school curriculum (I suggest up to Year 11) and mandatory for both boys and girls. That's not Political Correctness on my part but the realisation that in these days of 2-income families both husband and wife work outside the home and both husband and wife should be able to do the housework including meal preparation. Anyway who said cooking was a girls'/women's thing? I am reliably informed that something like 94% of the world's top chefs are men!
Dead right, Barend. Home economics, including cooking, is a must, because those essential life skills are clearly missing from too many today. More often than not the 'poverty' they claim and poor health they endure is a result of a lack of that basic knowledge - resulting in poor choices and all abetted by a lack of personal responsibility.
There are Masters studies on a myriad topics but I wonder if anyone has fully researched how the poor actually spend. As Dreadnought observes (and as I often practice) basic meals can be quite cheap, And he did not mention inexpensive porridge and for those with the time, use of markets. I suspect only the charity budget advisory agencies have any idea of just where the money goes with the "poor". What does annoy me is the colossal expenditure on church, feasts and funerals by many of the very susbsidised supposed poor.
When I am out and about I see too many huge people, must of whom seem to be beneficiaries. I consider it to be self inflicted injury. Now there is a push to undo the effect with expensive drugs, at my expense, again.
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