Indigenous Voices on Measuring and Valuing Health and Illness

Dr Esther Willing - IIRC20
Friday, November 20, 2020

Economic measures of health are considered important tools for guiding decisions about resource allocation within our health systems - but the values and philosophical assumptions that underpin them are rarely made explicit. The Western philosophical positions that inform economci measures of health that are used within our health system view health in a very different way to Indigenous understandings of health and illness and this creates tension when measuring health outcomes and making policy decisions as they fail to capture the experiences of Indigenous peoples.

This qualitative research project was conducted alongside a broader cost of illness study that explored the economic ‘Cost of Doing Nothing’ to reduce health inequities between Māori and non-Māori New Zealanders. The qualitative study involved six in-depth interviews with Māori individuals who had experienced illness or cared for whānau (family) members through long-term illness. These interviews explored their perspectives on health and illness and created space for them to consider how these health and illness states might be measured and valued when underpinned by Indigenous concepts and values.

An Indigenous measure of health and illness would need to capture a much broader understanding of health and wellbeing than current Western measures of health are able to. For Indigenous people, the health and wellbeing of the individual is located within the health and wellbeing of the collective. This requires an Indigenous measure of health to consider the impact of health and illness of the wider whanau (family), hāpu (wider family network) and iwi (tribe) as well as the lands and waters of the natural environment that we are connected to.

In contrast to current Western economic measures of health that utilize units of dollars to compare different health states, an indigenous measure of health might be able to use time as a unit of measurement. This requires further research as the concept of time has very different meanings for Indigenous peoples compared to the European concept of time.

This research sets out to start a conversation around developing an Indigenous measure of health that might better meet the needs of Indigenous people than the current Western economic measures of health that are used in decisionmaking and funding allocation processes.