The significance of socially-assigned ethnicity for self-identified Maori accessing and engaging with primary healthcare in New Zealand

Despite increased focus in New Zealand on reducing health inequities between Maori and New Zealand European ethnic groups, research on barriers and facilitators to primary healthcare access for Maori remains limited. In particular, there has been little interrogation of the significance of social-assignment of ethnicity for Maori in relation to engagement with predominantly non-Maori primary healthcare services and providers. A qualitative study was undertaken with a subsample (n=40) of the broader Hauora Manawa Study to examine experiences of accessing and engaging with primary healthcare among adult urban Maori. Thematic analysis of in-depth interviews identified that participants perceived social-assignment as New Zealand European as an efficacious form of capital when interacting with predominantly non-Maori health professionals. Skin colour that was white' or was perceived to identify Maori as belonging to the dominant' New Zealand European ethnic group was reported as broadly advantageous and protective. In contrast, social-assignment as Maori was seen to be associated with risk of exposure to differential and discriminatory healthcare. Reducing the negative impacts of racialisation in a (neo)colonial society where White' cultural capital dominates requires increased recognition of the health-protective advantages of White' privilege and concomitant risks associated with socially-assigned categorisation of ethnicity as non-White'.