Blurred in translation: The influence of subjectivities and positionalities on the translation of health equity and inclusion policy initiatives in Aotearoa New Zealand.

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Date: Nov. 2021
From: Social Science & Medicine(Vol. 288)
Publisher: Elsevier Science Publishers
Document Type: Report; Brief article
Length: 340 words

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Abstract :

Keywords Aotearoa New Zealand; Policy translation; Health equity; Cultural competency; Maori; Ethnic diversity; Hospital workplace Highlights * Health equity policy programmes distinct for Maori and culturally diverse groups. * Distinct agendas are blurred as clinical staff translate them into practice. * Intersection of personal subjectivities and positionalities influence translations. * Blurring of agendas in everyday practice compromise potential for change. Abstract Growing health inequities among the increasingly diverse population in Aotearoa New Zealand have prompted responses in the healthcare system. Diversity-related policies and programmes have been developed in some District Health Boards (DHB) to address the issues. The translation of such policy into practice is, however, convoluted by subjective interests and power differentials and thus the outcomes of policies may deviate from their original objectives. In this paper we examine how staff in one DHB translate and implement health equity and diversity initiatives in their everyday practices in hospital settings. In high-level institutional thinking, Maori health equity policy is dictated by the Treaty of Waitangi which sets it apart from the cultural competence focus of programmes for other ethnic groups. Drawing on interviews with clinical staff in the DHB, we reveal how intersecting subject positions, including personal histories and institutional roles, influence the interpretation and enactment of these policies and programmes in ways that blur their distinct agendas. As a result, the paper demonstrates how the politics that underpin agendas that distinctly address equity and diversity, as well as the potential for change in these areas, can be compromised in everyday practice on the hospital floor. Author Affiliation: (a) School of Environment, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand (b) National Institute of Demographic and Economic Analysis, University of Waikato, Private Bag 3105, Hamilton, 3240, New Zealand (c) School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, 1142, New Zealand * Corresponding author. Article History: Revised 10 June 2020; Accepted 23 July 2020 Byline: Sandy Lee [sandy.lee@auckland.ac.nz] (a,*), Francis L. Collins [fcollins@waikato.ac.nz] (b), Rachel Simon-Kumar [r.simon-kumar@auckland.ac.nz] (c)

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Gale Document Number: GALE|A679455827