27th July 2018, Volume 131 Number 1479

Jamie-Lee Rahiri, Ashlea Gillon, Sai Furukawa, Andrew Donald, Andrew Graham Hill, Matire Louise Ngarongoa Harwood

Bariatric surgery is currently the most effective treatment for severe obesity and obesity-related disease.1–3 Public funding for bariatric surgery in New Zealand has increased in the last decade. Dame Tariana…

Subscriber content

The full contents of this page is only available to subscribers.

To view this content please login or subscribe

Summary

This study sought to analyse all print and online news articles published over the last 10 years related to Māori and bariatric surgery. This topic is of interest because Māori health, obesity and bariatric surgery are topics of contention within the media. Over all included articles, the major themes that emerged were those related to access and attitudes towards bariatric surgery. Despite Māori having disproportionately higher rates of obesity and obesity-related disease, there was limited reporting on equity of bariatric surgery for Māori.

Abstract

Aim

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.

Method

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.

Results

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.

Conclusion

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.

Author Information

Jamie-Lee Rahiri, Research Fellow, Department of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland; Ashlea Gillon, Research Fellow, Te Kupenga Hauora Māori, Tāmaki Campus, The University of Auckland, Auckland; Sai Furukawa, Medical Student, Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai‘i;
Andrew Donald MacCormick, Senior Lecturer, Department of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland; Andrew Graham Hill, Professor of Surgery, Department of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland;
Matire Louise Ngarongoa Harwood, Senior Lecturer, Te Kupenga Hauora Māori, Tāmaki Campus, The University of Auckland, Auckland.

Acknowledgements

Jamie-Lee Rahiri is supported by a Health Research Council (HRC) of New Zealand Māori PhD Scholarship. The authors declare no other conflicts of interest. 

Correspondence

Jamie-Lee Rahiri, C/- Middlemore Hospital, Private Bag 93311, Otahuhu, Auckland.

Correspondence Email

j.rahiri@auckland.ac.nz

Competing Interests

Nil.

References

  1. Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007; 357:741–52. 
  2. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004; 292:1724–37. 
  3. Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am. J. Med. 2009; 122:248–56.
  4. Campbell Live. Turia still pushing for Govt funded stomach stapling. Auckland: New Zealand. [Updated 9 February 2010; cited 1 December 2017]. Available from: http://www.3news.co.nz/Turia-still-pushing-for-Govt-fundedstomach-tapling/tabid/817/articleID/140955/Default.aspx
  5. Ministry of Health. Understanding Excess Body Weight: New Zealand Health Survey. [Updated 30 September 2015; cited 8 May 2017]. Available from: www.health.govt.nz/publication/understanding-excess-body-weight-newzealand-health-survey
  6. Ministry of Health. Annual Data Explorer 2016/17: New Zealand Health Survey [Updated 14 December 2017; cited 25 April 2018]. Available from: http://minhealthnz.shinyapps.io/nz-health-survey-2016-17-annual-update
  7. Rahiri J, Lauti M, Harwood M, et al. Ethnic disparities in rates of publicly funded bariatric surgery in New Zealand (2009–2014). ANZ. J. Surg. 2017; DOI: 10.1111/ans.14220.
  8. Taheri S, Kumar H, Bridgwater S, Barnett A. Bariatric surgery – not to be taken lightly. J. R. Soc. Med. 2009; 102:2–3.
  9. Chamberlain K, Hodgetts D. Social psychology and media: critical considerations. Soc. Personal. Psychol. Compass. 2008; 2(3):1109–25. 
  10. McGannon KR, Spence JC. Speaking of the self and physical activity participation: What discursive psychology can tell us about an old problem. Qual. Res. Sport Exercise Health. 2010; 2:17–38.
  11. McCreanor T, Rankine J, Barnes A, et al. The association of crime stories and Māori in Aotearoa and New Zealand print media. SITES. 2014; 11(1):121–44. 
  12. Puhl RM, Heuer CA. The stigma of obesity: a review and update. Obesity. 2009; 17:941–64.
  13. Glenn NM, McGannon KR, Spence JC. Exploring media representations of weight loss surgery. Qual. Health Res. 2012; 23(5):631–44.
  14. Williamson JML, Rink JA, Hewin DH. The portrayal of bariatric surgery in the UK print media. Obes. Surg. 2012; 22(11):1690–4. 
  15. Braun V, Clarke V. Using thematic analysis in psychology. Qual. Res. Psych. 2006; 3(2):77–101.
  16. Fairfax New Zealand Limited. Doctor’s Notes: Surgery Vital in Morbid Obesity. The Dominion Post. Wellington: New Zealand. [Updated 15 February 2012; cited 1 December 2017]. Available from: http://ezproxy.auckland.ac.nz/login?url=https://search-proquest-com.ezproxy.auckland.ac.nz/docview/921764565?accountid=8424
  17. Scoop Media. Media release: Access to Obesity Surgery Hampered by Lack of Understanding. Wellington: New Zealand. [Updated 17 November 2014; cited 1 December 2017]. Available from: http://www.scoop.co.nz/stories/GE1411/S00091/access-to-obesity-surgery-hampered-by-lack-of-understanding.htm 
    http://www.scoop.co.nz/stories/GE1411/S00091/access-to-obesity-surgery-hampered-by-lack-of-understanding.htm
  18. Scoop Media. Press release: Bariatric surgery numbers up. Wellington: New Zealand. [Updated 29 September 2011; cited 1 December 2017]. Available from:
  19. Sunday Star Times. I’m fitter now at 43 than I was 12. The world is my oyster. Wellington: New Zealand. [Updated 21 March 2010; cited 1 December 2017]. Available from: http://ezproxy.auckland.ac.nz/login?url=https://search-proquest-com.ezproxy.auckland.ac.nz/docview/314129411?accountid=8424
  20. The Dominion Post. Big gains in weight loss procedures – surgeons. Wellington: New Zealand. [Updated 3 May 2014; cited 1 December 2017]. Available from: http://www.stuff.co.nz/national/10004128/Big-gains-in-weight-loss-procedure-surgeons
  21. The Dominion Post. Surgery offers new life. Wellington: New Zealand. [Updated 10 February 2010; cited 1 December 2017]. Available from: http://ezproxy.auckland.ac.nz/login?url=https://search-proquest-com.ezproxy.auckland.ac.nz/docview/338416269?accountid=8424
  22. The New Zealand Herald. The doctor at the cutting edge of our obesity crisis. Auckland New Zealand. [Updated 14 February 2016; cited 1 December 2017]. Available from: http://www.nzherald.co.nz/lifestyle/news/article.cfm?c_id=6&objectid=11589216
  23. The Manawatu Standard. Acceptable cost of lowering obesity. Palmerston North: New Zealand. [Updated 28 January 2010; cited 1 December 2017]. Available from: http://ezproxy.auckland.ac.nz/login?url=https://search-proquest-com.ezproxy.auckland.ac.nz/docview/314412072?accountid=8424 
  24. Sunday Magazine. ‘I lost 65kg on the operating table and now I’m really flying’. Wellington: New Zealand. [Updated 9 October 2016; cited 1 December 2017]. Available from: http://www.stuff.co.nz/life-style/well-good/inspire-me/84665234/i-lost-65kg-on-the-operating-table-and-now-im-really-flying 
  25. The New Zealand Government. Weight loss surgery meet and greet: Hon Tariana Turia. Wellington: New Zealand. [Updated 22 November 2010; cited 1 December 2017]. Available from: http://www.scoop.co.nz/stories/SP1011/S00001/weightloss-surgery-meet-and-greet-hon-tariana-turia.htm 
  26. The New Zealand Government. Tariana Turia’s Beehive Chat: Weekly Column. Wellington: New Zealand. [Updated 14 November 2011; cited 1 December 2017]. Available from: http://www.scoop.co.nz/stories/PA1111/S00256/tariana-turias-beehive-chat-weekly-column.htm
  27. The New Zealand Herald. Patient calls for more obesity surgery. Wellington: New Zealand. [Updated 31 January 2015; cited 1 December 2017]. Available from: http://ezproxy.auckland.ac.nz/login?url=https://search-proquest-com.ezproxy.auckland.ac.nz/docview/1649142982?accountid=8424
  28. Atanasova D, Koteyko N, Gunter B. Obesity in the news: directions for future research. Obes. Rev. 2012; 13(6):554–9.
  29. Meleo-Erwin ZC. “A beautiful show of strength”: Weight-loss and the fat activist self. Health. 2011; 15(2):188–205.
  30. Murray S. Pathologizing “fatness”: Medical authority and popular culture. Sociol. Sport. 2008; 25(1):7–21.
  31. Puhl RM, Heuer CA. The stigma of obesity: A review and update. Obesity. 2009; 17(5):941–64.
  32. LeBesco K. Neoliberalism, public health, and the moral perils of fatness. Crit. Pub. Health. 2011; 21:153–64. 
  33. Robson B, Harris R. Hauora: Māori Standards of Health IV. Otago: Te Rōpu Rangahau Māori, 2007. 
  34. Māori Affairs Select Committee. Briefing on bariatric surgery and its benefit for Māori. [PDF on Internet]. Wellington: New Zealand. [Updated 24 March 2010; cited 1 December 2017]. Available from: http://www.parliament.nz/en/pb/sc/reports/document/49DBSCH_SCR4663_1/briefing-on-bariatric-surgery-and-its-benefits-for-maori 
  35. Ministry of Health. Assessment of the business case for the management of adult morbid obesity in New Zealand. Wellington: Ministry of Health, 2008.
  36. Nairn R, Barnes A, Rankine J, et al. Mass media in Aotearoa: an obstacle to cultural competence. NZJ Psychol. 2011; 40(3):168–75.
  37. Nairn R, Barnes A, Borell B, et al. Māori news is bad news: That’s certainly so on television. MAI Journal. 2012; 1(1):38–49.
  38. Cooper CP, Roter DL. “If it bleeds it leads”? Attributes of TV health news stories that drive viewer attention. Pub. Health Rep. 2000; 115:331–8.
  39. Schwitzer G, Mudur G, Henry D, et al. What are the roles and responsibilities of the media in disseminating health information. PLoS Medicine. 2005; 2:576–82.
  40. Holder HD, Treno AJ. Media advocacy in community prevention: news as a means to advance policy change. Addiction. 1997; 92:89–99.
  41. Nairn R, Pega F, McCreanor T, Rankine J, Barnes A. Media, Racism and Health Psychology. J Health Psych. 2006; 11(2):183–96. 

Download

The downloadable PDF version of this article is only available to subscribers.

To view this content please login or subscribe