Rahiri Jamie-Lee, Gillon Ashlea, Furukawa Sai, MacCormick Andrew Donald, Hill Andrew Graham, Harwood Matire Louise Ngarongoa
Research Fellow, Department of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland.
Research Fellow, Te Kupenga Hauora Māori, Tāmaki Campus, The University of Auckland, Auckland.
N Z Med J. 2018 Jul 27;131(1479):72-80.
Media constructs in Aotearoa, New Zealand naturalise the dominant Western culture. Conversely, mainstream news about Māori is rare and prioritises negative stereotypical constructs that are often centred on Māori as economic threats via resource control and political activism. These narratives influence continued discrimination against Māori in New Zealand. Media representations of bariatric surgery in New Zealand are not widely understood. We explored the portrayal of Māori and bariatric surgery in print and online news media articles in New Zealand using an inductive approach to thematic analysis.
An electronic search of two databases (Proquest Australia/ New Zealand Newsstream and Newztext) and two New Zealand news media websites (Stuff and the New Zealand Herald) was performed to retrieve news articles reporting stories, opinion pieces or editorials concerning Māori and bariatric surgery published between January 2007 to June 2017. Articles were scored using a five-point scale to assess the level of reporting as either very negative, negative, neutral, positive or very positive. Included articles were then subjected to inductive thematic analysis using the NVIVO 11 to identify and explore common themes surrounding Māori and bariatric surgery.
Of 246 articles related to bariatric surgery over the 10-year study period, 31 (13%) were representative of Māori. Articles were scored as 'neutral' to 'positive' with a mean reporting score of 3.7 (Kappa score of 0.72 [95% CI, 0.66-0.78, p<0.0001]). Five main themes were identified, these were: Attitudes towards bariatric surgery; complexity of obesity and weight loss; access to bariatric surgery; Māori advocacy and framing of Māori. Of the five themes, access to bariatric surgery and attitudes towards bariatric surgery were most prevalent. Māori advocacy was another common theme that arose largely due to the support of public funding of bariatric surgery championed by Dame Tariana Turia. Aside from this, narratives describing equity of bariatric surgery provision and equitable outcomes following bariatric surgery for Māori were sparse.
There was limited reporting on Māori health inequalities and equitable access to publicly funded bariatric surgery in New Zealand. We argue that this lack of coverage may work against addressing disparities in obesity prevalence and access to publicly funded bariatric surgery for Māori in New Zealand.
在新西兰的奥特亚罗瓦地区，媒体构建使占主导地位的西方文化自然化。相反，关于毛利人的主流新闻很少，且优先报道负面刻板印象，这些报道往往将毛利人视为通过资源控制和政治行动主义构成经济威胁的群体。这些叙事影响了新西兰对毛利人持续存在的歧视。新西兰媒体对减肥手术的报道并未得到广泛理解。我们采用归纳主题分析法，探究了新西兰印刷和在线新闻媒体文章中毛利人和减肥手术的描绘。
对两个数据库（Proquest澳大利亚/新西兰新闻流和Newztext）以及两个新西兰新闻媒体网站（Stuff和新西兰先驱报）进行电子搜索，以检索2007年1月至2017年6月期间发表的有关毛利人和减肥手术的新闻报道、评论文章或社论。文章使用五点量表进行评分，以评估报道水平为非常负面、负面、中性、正面或非常正面。然后使用NVIVO 11对纳入的文章进行归纳主题分析，以识别和探索围绕毛利人和减肥手术的共同主题。
在为期10年的研究期内，与减肥手术相关的246篇文章中，31篇（13%）涉及毛利人。文章评分从“中性”到“正面”，平均报道评分为3.7（卡帕评分0.72 [95%可信区间，0.66 - 0.78，p<0.0001]）。确定了五个主要主题，分别是：对减肥手术的态度；肥胖和体重减轻的复杂性；获得减肥手术的机会；毛利人的倡导以及对毛利人的框架构建。在这五个主题中，获得减肥手术的机会和对减肥手术的态度最为普遍。毛利人的倡导是另一个常见主题，主要是由于塔里亚娜·图里亚女爵士支持为减肥手术提供公共资金。除此之外，描述减肥手术提供的公平性以及毛利人减肥手术后公平结果的叙事很少。
新西兰关于毛利人健康不平等以及获得公共资金资助的减肥手术的公平机会的报道有限。我们认为，这种报道不足可能不利于解决新西兰毛利人肥胖患病率差异以及获得公共资金资助的减肥手术的问题。
