Deconstructing Whiteness in Health and Diabetes: A Pacific Cultural and Communal Approach

The purpose of this chapter is to critically deconstruct Whiteness in the health sector and the approaches to diabetes diagnosis. There is existing bias in the clinical approaches to diabetes diagnosis, including the use of body mass index (BMI), New Zealand diabetes quiz and individualistic approach to healthcare. These processes tend to value Eurocentric ideas without any consideration of Pacific people and other indigenous communities, who genetically have different body mass. These influence the way healthcare is provided from the early stage of assessment and public healthcare mechanisms. To this end, the paper will examine literature on diabetes diagnosis and the hidden bias that exists and is adopted into the global health system. It will also use a case study to evaluate how a collective approach to healthcare is more realistic in mitigating modifiable risk of diabetes as a response. This chapter examines how diagnostic tools and criteria that are promoted through global health institutions such as World Health Organization, have subconscious Eurocentric bias that influence framing of the health and wellbeing of Pacific peoples and indigenous communities. Historically, people who do not fit into the system and structures tend to face serious challenges in the endless “maze passage” to better health and wellbeing. The question of cultural relevance and people-based approaches to health assessment and healthcare is a critical one today. This will be explored through the use of case studies. The paper will explore alternative health approaches from an indigenous collective perspective that could be useful and appropriate for Pacific peoples as opposed to the dominant individualistic (Whiteness) approach. This chapter will be useful in the context where Pacific people in Aotearoa, New Zealand, have a risk of diabetes that is three times higher than other ethnicities in the country. Similarly, Pacific Island countries also have a high prevalence of the disease.