The magazine for alumni and friends of Massey University.
Issue 14, April 2002

Associate Professor Chris Cunningham and Te Púmanawa Hauora

Dr Chris Cunningham’s academic start was in photochromic compounds, unpicking the chemistry behind sunglass-tinting compounds.

His subsequent career has been about creating lenses to see public and social policy in a new light, making sure the range of the spectrum labelled ‘Maori’ can be seen clearly by the official gaze.

Cunningham, the director of Massey’s Te Pu¯manawa Hauora Maori Health Research Centre, will ensure there is a Maori dimension – and a Maori workforce – where needed across all aspects of the new Research School of Public Health.

From Ngäti Raukawa and Toa Rangatira, Cunningham was born and raised in the Hutt Valley, entering Victoria University in 1979.

“ Back then any Maori student with aptitude was shepherded into law or medicine. I didn’t want to do that. I did science, one of few Maori to do so,” Cunningham says.

After earning his doctorate, Cunningham was “recruited into the cause” to work for Manatü Maori, the short-lived Maori policy ministry that replaced the old Department of Maori Affairs.

The Ministry contained a mix of idealistic university-educated Maori, many in their first public sector jobs, and people with some public sector experience. Public policy was still in its relative infancy, especially in the Maori area, and staff broke new ground.

“ The stuff I helped develop was a monitoring framework for the government sector, monitoring responsiveness, how do you measure outcomes for Maori.

“ When Manutu ended I shifted to the Ministry of Health and translated that to health; How do you as a provider measure Maori needs and aspirations? How you measure outcomes on Maori terms.

“ There are subtle differences. The outcomes for Maori the mainstream always measures are not the same as Maori outcomes.

“ The mainstream measures health, not hauora. It measures physical health, mental health and independence, where Maori would want to measure spiritual health and whänau health and interdependence as well.

“ Hauora is not the Maori word for health. It is a related but different concept. There are collective and social elements to it.”

In 1996 Massey’s head of Maori studies, Mason Durie, “wandered up to my desk in the Ministry and asked, ‘Are you happy in your work?’”

He wasn’t unhappy, but the opportunity to build up a leading-edge Maori research organisation was too good to pass up.

“ A PhD is not a load to carry, and if I can assist other people to get there, I will,” Cunningham says.

Much of his work involves recruiting and supervising Maori masters and doctoral candidates, which involves challenges not seen in other parts of the university.

“ The average Maori doctoral candidate is more mature, with families and mortgages, and they are likely as not in a reasonably well paid job, so the prospect of becoming a poor student is no attraction.

“ We have received help from the Health Research Council, and we augment that in the  school to allow people to spend three or four years studying.”

Cunningham says by having a research school, Massey provides much of the infrastructure needed by graduate students and gives them a collegial environment so they don’t repeat others’ mistakes.

The structure also allows the school to pass on many of the methods it has developed for ‘Maori-centred’ research.

“ We do research at the qualitative end, not the quantitative, which usually depends on good interactions with Maori respondents and maintaining good relations with communities.

“ Mason calls it research at the interface, combining orthodox methodologies with the ability to work with Maori on Maori issues,” Cunningham says.

“ Consultation is not something we see as pro forma and a necessary evil, but it is the way we work every day – so some Päkehä researchers can contribute to Maori health and Maori can and do work in the mainstream.

He says public health is the mainstream discipline that comes closest to what Maori perceive as hauora, and he wants to strengthen that approach. “Our approach is to take a true public health focus, how to maintain wellness, how to invest in keeping well, not what you do when you get crook.

“ The same conditions which kill all New Zealanders kill Maori – cancer, heart disease, stroke. You can reduce the relatively high Maori mortality level by maintaining a level of wellness.

“ That leads to questions of what Maori models can be used. It is hard to maintain a healthy diet on a low income because bad food is cheap food. The skill is how do you design good nutrition around the realities of the food we eat.

Te Pümanawa Hauora has focused on the whänau, with much of its work fed by a massive longitudinal study of Maori households.

“ The received wisdom is what distinguishes Maori is collectivity versus individuality. So what is the collective?

“ Whänau units have withstood colonialism and urbanisation much more than hapü and iwi, so that is a collective you can use. The others are possibly notional for many Maori people.”

The focus on whänau leads to questions about how well health can span generations. A lot of that has to do with expectations Maori have of health services.

“ Maori expectations around health are often humble indeed. When you go to the area of greatest need, the expectation is to see health professionals occasionally.

“ The prospects for a whänau taking a well baby to a GP for a check up to be told they have a well baby, it doesn’t figure. Rather than being seen as an investment in wellbeing, health care is something that happens in a crisis.”

He says Maori want research which suggests solutions, rather than research which describes them as victims and measures what is wrong.

“ The health system in New Zealand is so different from indigenous systems elsewhere. Maori health has always been mainstreamed, it is nothing like Australian Aboriginal or American Indian systems where people go to different places for health services.

“ Most Maori will encounter mainstream provision, so the question is how do you make mainstream more sensitive without misappropriating Maori culture? What will you do differently tomorrow than you did yesterday?”