1.1 Hauora

Overview

Cultural understandings inform how we think about people and their health. In this chapter we introduce Māori cultural understandings of health and wellbeing, with specific considerations for critical health psychology. We begin by presenting Māori worldviews and knowledges and discuss how these inform Māori notions of wellbeing. We examine the historical and socio-political context in Aotearoa New Zealand, with a focus on Te Tiriti o Waitangi, and consider the ways contexts shape how we think about people and their health. Subsequently, we outline Māori models of health and then concentrate on specific dimensions of wellbeing for Māori, with relevant examples of application for contemporary health psychology.

The topics in this chapter are not new concepts, however discussing them here offers opportunities and possibilities to critically consider and re-conceptualise health psychology. These issues are equally important for all who study, teach, research, and engage with critical health psychology in Aotearoa New Zealand. Although our focus is on Māori worldviews and foundational understandings for those working in Aotearoa New Zealand, this chapter also serves a broader remit of sharing knowledge for people interested in decolonising psychology. We recognise the potential for Māori understandings to enrich and extend critical health psychology, which may in turn be influential to cultural contexts globally.

The questions we address in this chapter are: How do Māori worldviews and experiences inform their conceptualisations of health? How can critical health psychology engage appropriately with Māori knowledges and perspectives? We focus on the following learning objectives:

 

Positionality

Positionality is important from the standpoint that all knowledge and research is inherently subjective, as we all view and understand the world through our own cultural lenses. We recognise and acknowledge the cultural assumptions we hold about reality, what we deem as constituting knowledge, and how these assumptions inform the processes we use in research and in practice. Māori are not a homogenous people, and the perspectives presented in this chapter are shaped by the authors’ own worldviews and lived experiences, hapū and iwi affiliations, educational backgrounds and academic experiences, gender, socioeconomic status, and more (see positionality statements in the Introduction to the book). Therefore, based on our understandings of Māori worldviews, and drawing together various discussions from the areas of Māori psychology and Māori health, the perspectives we offer are intended to offer a broad coverage. Our aim is to encourage critical thought to shape a new, or renewed, appreciation for Māori health moving forward.

Māori notions of health and wellbeing – What is hauora?

Māori notions of health and wellbeing are holistic, relational, and grounded in Māori cultural worldviews. Sir Mason Durie, a respected leader in Māori health, emphasises cultural connection as foundational to Māori health:

Platforms for Māori health are constructed from land, language and whānau; from marae and hapū; from Rangi and Papa; from the ‘ashes of colonisation’; from adequate opportunity for cultural expression; and from being able to participate fully within society. Like other New Zealanders Māori are not immune from the effects of unhealthy policies, nor from unacceptable standards of living, but all too often Māori have encountered expectations that they should abandon a Māori base. Yet being Māori itself is a foundation for health. (Durie, 2001, pp. 35-36).

Health and wellbeing are conceptualised within several te reo Māori terms:

• Hauora describes the breath of life and spirit; it refers to a physical sense of wellbeing for an individual and it is interdependent with collective qualities such as whanaungatanga (Henare, 1988; Pihama et al., 2023).
• Mauri ora represents the life-giving essence, the spark and vitality of life that binds the spiritual and physical (Barlow, 1991; Mead, 2016).
• Waiora encompasses total wellbeing and strength of spirit, denoting flowing and life-sustaining waters, and has bases in Māori creation narratives (Pere, 1997).
• Whānau ora pertains to family and collective wellbeing and it is a term promoted in contemporary Māori health policy (Ministry of Health, 2024).

We have chosen to call this chapter Hauora, to reflect the connection between the physical, psychological, relational, and spiritual.

Māori beliefs about the universe, reality, and knowledges

Māori have distinct and unique ways of being and thinking in the world. Māori beliefs about the universe, reality, and knowledges emphasise relational and spiritual understandings; there is an inherent interconnectedness between all things. In this section we describe these worldviews and assumptions from te ao Māori and discuss how they are relevant to Māori perspectives and experiences of health.

Cosmologies and cosmogonies

Cosmologies encompass beliefs about the nature of the universe and cosmogonies are understandings of the origins of the universe. Māori cosmologies and cosmogonies are multiple and rich. Commonly they describe the creation of the universe and the emergence of life in three phases: te kore, te pō, te ao mārama.

• Te kore is the most distant phase in time, the beginning. Te kore is the source of all life, meaning “the void” or “nothing”. However, te kore is also understood as energetic and the space of infinite potential.
• Te pō is the second phase. Te pō, meaning “darkness”, refers to periods of time and gradations of perceptual and mental darkness. Te pō is described as the realm of becoming, with the development of earth and life. To Māori, atua are also considered to be tīpuna and during te pō, Papatūānuku and Ranginui, who are regarded as primordial atua, come into existence. They procreate many more atua, but the closeness of their embrace prevents light and growth. The children grow tired and rebel, plotting against their parents to separate them. The separation is achieved by Tāne, who let light into the world.
• Te ao mārama is the third phase and from darkness comes the world of light. This is the realm in which human life and life on earth develops. In te ao mārama there is space for growth and the pursuit of knowledges and physical and mental enlightenment is possible. Humankind comes into being when Tāne shapes the first woman, Hine-ahu-one, from the Earth.

(To read more, see our sources: Barlow, 1991; Marsden, 1992; Mead 2016; Walker 1992).

While this is a summary of extensive knowledges and a sole perspective, what it shows is that Māori creation narratives provide the basis for understanding and interpreting reality and give meaning to everyday life.

Ontologies

Ontologies refer to understandings about reality and human nature. Based on Māori narratives about the origins and nature of the universe, Māori ontologies emphasise connectedness, relationships, and a spiritual element. These are established within cultural concepts:

• Whakapapa means genealogy, although more specifically it refers to layers of genealogy. Māori narratives and whakapapa describe human life as descending from atua, and as therefore related to the natural environment. Whakapapa is the structure by which all things are connected (Barlow, 1991).
• Whanaungatanga refers to relationships and kinship. These concepts highlight connections between the natural world, atua, tīpuna, and humankind. Whanaungatanga encompasses collective interdependence (Henry & Pene, 2001).
• Wairua and recognition of the spiritual and unseen is also central to Māori assumptions about reality and human life. Wairua is described as the ultimate reality of existence for Māori (Marsden, 1992).

Taken together, Māori cosmologies and ontologies view human life as emanating and descending from the universe and from atua. These worldviews emphasise interconnectedness between everything in existence, on earth, and in the universe. Importantly, we recognise our existence as part of a whole, spanning physical and spiritual, across past, present, and future. Existence does not begin, nor does it end, with us.

Epistemologies

Epistemologies entail undertandings about the nature of knowledges. Just as whakapapa is centred in Māori ontologies, whakapapa is also significant to Māori epistemologies as a means by which Māori record, remember, and impart knowledges about the world (Barlow, 1991). In this way Māori epistemologies and ways of engaging with knowledges reinforce the connectedness between human kind, the environment, and to space, in temporal and spiritual terms (Smith, 2008).

Similarly, Māori use narratives and metaphor to preserve and communicate knowledges. These narratives are often referred to as pūrākau, and use of pūrākau encourages multiple meanings and interpretations (Lee-Morgan, 2019). Narratives and the knowledges they contain reflect a uniqueness derived from the pūrākau inherent to whānau, hapū, and iwi.

 

 

Mātauranga

With a foundational understanding of Māori beliefs about the universe, reality, and knowledges, we now focus on Māori knowledges more intently. Mātauranga is often used as a term for knowledges and it is described as:

• a contemporary phrase for a body or continuum of knowledges with age-old origins.
• referring to something unique and valuable about the Māori world (Royal, 2012).

In exploring tikanga and a range of Māori practices, Sir Hirini Moko Mead, a leading Māori scholar, emphasises the sheer breadth of mātauranga:

The term “mātauranga Māori” encompasses all branches of Māori knowledge, past, present and still developing. It is like a super subject because it includes a whole range of subjects that are familiar in our world today, such as philosophy, astronomy, mathematics, language, history, education and so on. And it will also include subjects we have not yet heard about. Mātauranga Māori has no ending: it will continue to grow for generations to come. (Mead, 2016, p. 245).

Examples of mātauranga in Māori traditions and customs include pūrākau, whakataukī, karakia, waiata, mōteatea, and rongoā. We also do not need to look far to see mātauranga as continuing to develop in our contemporary context. The growth of Māori scholarship across academic disciplines, including health psychology is one example, and in the public sphere the revitalisation of mātauranga about Matariki and associated Māori practices is another.

Mātauranga has often been dismissed and undermined by Western science and researchers (for discussion of a recent issue, see Stewart, 2021). However, Māori worldviews and mātauranga have been, and continue to be, valid. Indeed mātauranga is relevant and drawn on in research and practice in contemporary health settings. For example, in a surgical outpatient setting a collaborative treatment approach was used by Koea et al. (2024) to implement rongoā practices alongside routine Western medical practice. Rongoā and Māori healing traditions are founded in mātauranga and this feasibility study identified factors to promote effective collaboration of knowledges and practices from Māori and Western perspectives in a health setting in Aotearoa New Zealand.

Kaupapa Māori

Kaupapa Māori is embedded in Māori worldviews, philosophies, and mātauranga. It takes for granted the validity and legitimacy of Māori knowledges, culture, and te reo Māori. Kaupapa Māori is essentially related to being Māori (Nepe, 1991; Smith, 2021). We can view mātauranga as labelling knowledges and as informing Kaupapa Māori (Pihama, 2010). However, whereas mātauranga does not infer any particular action, Kaupapa Māori indicates action based on tikanga and practices (Royal, 2012).

The eminent example of Kaupapa Māori in action is the establishment of alternative forms of education for Māori, Te Kōhanga Reo and Kura Kaupapa Māori. In the 1980s there was growing political consciousness among Māori, including increased energy to recognise Te Tiriti o Waitangi, and the revitalisation of te reo Māori. The developments in Kaupapa Māori education became a symbol of Māori efforts to embody tino rangatiratanga (Smith, 2017).

For Linda Tuhiwai Smith the implications of Kaupapa Māori are substantial:

There is more to Kaupapa Māori than our history under colonialism or our desires for self-determination. We have a different epistemological tradition, one which frames the way we see the world, the way we organize ourselves in it, the questions we ask and the solutions that we seek. It is larger than the individuals in it and the specific ‘moment’ in which we are currently living. (Smith, 2021, p. 244).

The term Kaupapa Māori theory emphasises Māori cultural ways and knowledges, and Graham Hingangaroa Smith (2017) is clear that Kaupapa Māori theory is transformative. Specifically, it is transforming praxis, which means it involves a cycle of consciousness raising, resistance, and transformative action. In other words, Smith asks, “How is your theorising work linked to tangible outcomes that are transformative?” (p. 70). To be of benefit to Māori, Kaupapa Māori theory must be connected to Māori lived experiences and be focused on practice and transformative outcomes (Pihama, 2010).

 

 

Kaupapa Māori theory challenges prevailing Western methods of defining, accessing, and creating knowledge about Māori, with Māori maintaining autonomy over the research agenda (Bishop, 1998). Māori cultural specificities, preferences, and practices warrant that Kaupapa Māori theory retains cultural relevance and reverence (Irwin, 1992). Kaupapa Māori theory is inherently critical; it critiques systems of power and unequal power relations (Smith, 2017).

A tradition within Western science and research focused on preserving colonial values and interests, that has undermined Māori knowledges and displaced Māori lived experiences. These oppressive practices have denied Māori agency, authority, and voice (Bishop, 1998). Routinely positioned as “objects” and “others” in research, Māori have been dehumanised and pathologised, where Māori knowledges have been treated as a commodity for colonial exploitation, just as natural resources have been. Decolonisation in research therefore entails centring Māori worldviews and concerns, and engaging in research from a Māori perspective, for purposes that are relevant to Māori (Smith, 2021).

 

Historical and socio-political contexts

As well as cultural worldviews, historical and socio-political contexts also play a role in how we understand and respond to hauora for Māori in contemporary settings. Like Māori approaches to health, critical health psychology also understands health as produced through wider historical, social, political, and economic contexts. Both are therefore concerned with social justice agendas.

The history of Aotearoa New Zealand and colonisation have had significant impacts on the state of Māori health today. By drawing attention to the contexts that shape hauora, we can frame and interpret health issues differently. What if we stopped seeking solutions to “fix” people, and instead shifted the focus to consider people’s environments and contexts as being “sick” and needing to be fixed? This kind of approach encourages us to critically think about health experiences as natural or understandable responses to environments and wider contexts that are harmful, rather than attributing issues solely to individuals.

The historical context of Aotearoa New Zealand

For a fuller appreciation of hauora and health experiences for Māori today, it is vital that we have an accurate understanding of history. Surely a basis of knowledge about the historical and social context of Aotearoa New Zealand is critical to critical health psychology.

 

He Whakaputanga – The Declaration of Independence

In 1831, in the context of unruly behaviour by Europeans who had settled predominantly in the Bay of Islands and Hokianga, leading rangatira petitioned the King of England to control British nationals and highlighted the importance of trade. Britain, too, wanted peace, trade, and control of its own disorderly subjects. In this context James Busby was appointed as British Resident, and in 1834 one of his initial acts was to meet with rangatira to select a flag.

 

On 28 October 1835 James Busby convened another significant meeting at Waitangi with 34 rangatira to sign He Whakaputanga o te Rangatiranga o Nu Tireni (He Whakaputanga), The Declaration of Independence. He Whakaputanga declared the independence of rangatira and asserted Aotearoa New Zealand as an independent state, while formalising and strengthening the relationship between Māori and Britain (Waitangi Tribunal, 2014). Importantly, He Whakaputanga was a declaration that Māori authority would endure, and it rejected any foreign authority over Māori people and territories (Walker, 2004). Furthermore, many hapū consider He Whakaputanga to be the founding document of Aotearoa New Zealand, and refer to it when exercising their independence and authority (Mutu, 2019). The context of He Whakaputanga is significant because it demonstrates Māori efforts and commitments to exercise independence and sovereignty from their earliest encounters with the British Crown.

Te Tiriti o Waitangi

He Whakaputanga and Te Tiriti o Waitangi (Te Tiriti) are both essential to the story of nationhood in Aotearoa New Zealand. Before we delve into Te Tiriti, there are important terms and details to be familiar with:

• There are two texts; Te Tiriti is the te reo Māori text and The Treaty of Waitangi (The Treaty) is the English text (these are sometimes referred to as the Māori version and the English version).
• The provisions are the specific terms of agreement, that is, what the text of Te Tiriti and The Treaty state.
• The principles are the current day consideration of the terms of agreement (there are several principles).

Te Tiriti is the founding document of Aotearoa New Zealand as a nation and representative of the relationship between the British Crown (the Government) and Māori. On 6 February 1840 at Waitangi, Te Tiriti was signed by over 40 rangatira and William Hobson as a representative of the Queen. In subsequent months more than 500 rangatira signed from around Aotearoa New Zealand (Mutu, 2011; Waitangi Tribunal, 2014).

Suffice to say there are considerable analyses and ongoing debates about the intentions, meanings, and effects of Te Tiriti and The Treaty. Here we want to highlight the significance of the provisions of Te Tiriti, because they have important implications for how contemporary health psychologists ought to think about health for Māori and Māori communities.

Professor Margaret Mutu is an expert in Te Tiriti and emphasises that in line with international law, it is Te Tiriti that is the official treaty. Furthermore, Te Tiriti was the document rangatira understood at the time and it was the document almost all rangatira signed (Mutu, 2011).

 

What does Te Tiriti mean for hauora?

So far we have focused on the provisions, however we recognise that the principles are often at the forefront in discussions about Te Tiriti, especially in health contexts. While we detail the links between provisions, principles, and implementation of such, we emphasise that knowledge of the provisions is central to contemporary understandings about Te Tiriti (Te Atakura Educators, 2023).

• Kāwanatanga, meaning governance, is a provision of Article 1 of Te Tiriti. It is related to the current day principles of good governance and partnership. What this means is working together with Māori to improve health outcomes.
• Tino rangatiratanga is a provision of Article 2, and it refers to Māori maintaining independence over their lands and all their treasures. This is interpreted in current day principles as self-determination and active protection. This means Māori have control of Māori knowledges and self-determination over their health, across policy, delivery, content, and outcomes.
• Ngā tikanga katoa rite tahi, meaning all of the rights, is a provision of Article 3. It is related to the principles of participation and equity. In health contexts, this means that Māori have equitable access and opportunities to participate in health services and delivery at all levels.
• Te ritenga Māori, referring to Māori spiritual practices, is a provision of Article 4 (often described as the “Oral Article”). This is interpreted in current day principles and implementation as honouring Māori spiritual practices (Te Atakura Educators, 2023; New Zealand Psychologists’ Board, 2009).

Dr Moana Jackson (2020), lawyer and renowned Te Tiriti expert, summarised the intent of Te Tiriti as a vision of a prosperous partnership and peaceful co-existence between Māori and newcomers. It is our view that this vision also encompasses promoting hauora for Māori and the wellbeing of all people in Aotearoa New Zealand.

 

Colonisation – past and present

Despite the signing of Te Tiriti, the terms agreed to were not upheld by the Crown. In the subsequent decades, Māori were dispossessed of their lands and therefore their capacity to sustain themselves, both in practical and cultural terms (Walker, 2004). The history of Aotearoa New Zealand includes several events and Crown actions, including extensive land confiscation, warfare, and prohibition of te reo Māori in schools, which were extremely detrimental to the health and wellbeing of whānau, hapū, and iwi (Smith, 2021).

The assault on Māori health and wellbeing via legislation has been wide-reaching. Oftentimes discussions of colonisation frame it as an isolated event that occurred in some distant past. But, colonisation is present and ongoing; it continues in the laws and institutions in Aotearoa New Zealand, and its legacy impacts on the lived experiences of contemporary Māori (Reid et al., 2019). A defining feature of colonisation for Māori is the undermining of mana and rangatiratanga, or rather the denial of Māori independence and rights to be self-determining (Smith, 2021). Here we outline a selection of legislation and Crown or government actions since the signing of Te Tiriti to demonstrate the mechanisms by which colonisation operates.

 

 

Our aim in giving attention to the historical and socio-political context of Aotearoa New Zealand has been to highlight events and associated narratives based in evidence. Many inaccurate retellings have proliferated over the years, perpetuating the colonial agenda by reinforcing mistaken ideas that Māori are inferior (Jackson, 2020). All of this relates to critical health psychology because historical events have long-lasting impacts on health status and colonisation affects contemporary health outcomes for Māori.

Māori health models and dimensions of hauora

The development of Māori health models grounded in Māori worldviews has provided culturally meaningful frameworks to engage in efforts towards optimal health and wellbeing for Māori. Broadly, Māori frameworks and initiatives that centre cultural understandings have contributed to significant gains in the health of Māori in the past 100 years, including improved life expectancy, lowered mortality rates, improved educational participation, and growth in te reo Māori acquisition (Durie, 2001; Tomlins-Jahnke & Mulholland, 2011).

In this section we summarise well-known and commonly used Māori health models. Then, in the subsequent section we explore core dimensions of hauora, with a focus on application. Consistent across Māori models of health and wellbeing are the themes of integration, balance, and relationality. Importantly, individual health is considered in the context of the environment and wider systems; there are no clear-cut distinctions between spiritual, psychological, physical, and collective dimensions (Durie, 2001). As we will cover, Māori health models readily use te reo Māori and metaphors derived from a Māori worldview. This provides ways of conceptualising hauora that are distinctly Māori, with solutions to uphold Māori health that are specific to Māori lived experiences.

Reflecting on your own positionality

Before we explore Māori health models, we need to revisit the ideas of positionality mentioned at the start of the chapter. We encourage you to consider your own positionality. We also bring to your attention the notion of cultural safety, a cornerstone of which is, “to produce a workforce of well educated, self-aware [practitioners] who are culturally safe to practice, as defined by the people they serve” (Ramsden, 2002 p. 94). Ongoing critical reflection of your own positionality and the ways it shapes your engagement with, and interpretation of, the world around you is essential. This necessitates cultural humility; to be open-minded, to develop awareness of your own positionality, and to learn from cultures different to your own (Christopher et al., 2014). Even with seemingly good intentions, using culturally based knowledges and health models in the absence of self-awareness and cultural humility can at best be improper, and at worst, harmful.

 

Te Whare Tapa Whā

A seminal Māori health model, Te Whare Tapa Whā, frames wellbeing as achieved through balance across four domains: te taha tinana, referring to physical wellbeing; te taha hinengaro, mental and emotional wellbeing; te taha whānau, representing family and social wellbeing; and te taha wairua, spiritual wellbeing (Durie, 1985, 2001). The whare is also conceptualised as sitting on the whenua, representing the importance of Māori connection to ancestral lands and the natural environment. Wellbeing is flourishing when all four domains are cared for and in balance, whereas illness or dysfunction develop when one or more of the domains are compromised. Te Whare Tapa Whā has been established and endorsed across psychology and health disciplines, reinforcing the importance of a holistic understanding and approach to health for Māori.

Te Wheke

Another well-recognised Māori model of health, Te Wheke, affirms that individual wellbeing is inseparable from whānau wellbeing (Pere, 1997). Represented as an octopus, the head symbolises whānau and the eyes represent waiora, which in the model is understood as the overall wellbeing of whānau. Each of the eight tentacles represent a dimension fundamental to Maōri wellbeing, including those encompassed in Te Whare Tapa Whā (wairuatanga, hinengaro, tinana, and whanaungatanga) as well as a further four dimensions: mauri, referring to life essence; mana ake as unique identity; hā a koro mā, a kui mā, representing breath of life from ancestors; and whatumanawa as healthy expression of emotions.

Meihana Model

The Meihana Model provides a practical guide for clinical assessment and treatment and is represented as a waka hourua traversing the ocean (Pitama et al., 2007, 2017). The Meihana Model places whānau at the centre, alongside the individual, and similarly includes the four core dimensions of Te Whare Tapa Whā. It also extends to account for the historical and social context of Aotearoa New Zealand, represented as ngā hau e whā, the four winds, and in so doing recognises the ongoing impact of colonisation, migration, marginalisation, and racism for whānau. In addition, the Meihana Model identifies components from te ao Māori that may influence a person and their whānau. These are depicted as ngā roma moana, ocean currents, and comprise: āhua, referring to personalised indicators; tikanga; whānau, specifically roles and responsibilities within families; and whenua, representing spiritual and ancestral connections to land.

 

Te Pae Māhutonga

The fourth model we share uses a star constellation and brings together elements of health promotion. Te Pae Māhutonga represents charting a course towards Māori health and wellbeing (Durie, 1999). It is a significant constellation in ocean navigation and voyaging, aiding the traditional migrations to Aotearoa New Zealand from the Pacific. The constellation consists of four central stars that symbolise the key tasks of health promotion: mauriora, reflecting access to te ao Māori; waiora, representing environmental protection; toiora, denoting healthy lifestyles; and te oranga, indicating participation in society. There are two additional pointer stars, which are named in the model as ngā manukura, referring to leadership, and te mana whakahaere, as autonomy. Just as Te Pae Māhutonga as a constellation has served as a guide for successive generations, likewise Te Pae Māhutonga as a model of health promotion provides a map to integrate elements of health promotion as related to Māori health.

How are dimensions of hauora applied?

We use the term “dimensions of hauora” to encompass what Māori health models describe as taha, domains, tasks, and so on. Although we discuss the dimensions of hauora as distinct concepts, bear in mind the interdependent nature of Māori worldviews. All of these dimensions are connected, fluid, and often overlapping, with no clear lines separating one from another. Linking back to our discussion of historical and socio-political contexts, it is also important to acknowledge the wider contexts that impact on understandings and practices related to the application of Māori knowledges and Māori health models.

Drawing on examples from research and professional practice in psychology, mental health, and broader literature pertaining to hauora and Māori wellbeing, we demonstrate the implications of Māori health models and dimensions of hauora for critical health psychology. We begin by discussing the four taha within Te Whare Tapa Whā, which are mirrored in many Māori health models, and we then explore additional dimensions of hauora that have particular relevance in contemporary settings.

Wairua

We begin with wairua, because this is a central to a Māori way of being and therefore foundational to hauora. Reverend Māori Marsden, who was a tohunga regarded for his expertise on Māori divinity and an ordained Anglican minister, describes wairua as the ultimate reality of existence for Māori (Marsden, 1992). Similarly, from Māori psychological perpsectives wairua is described as the fundamental, boundless, and connective aspect of Māori life and ways of being (Valentine, 2009; Valentine et al., 2017). Wairua is a connection to that which is sacred, which is all-encompassing from a Māori standpoint (Brittain, 2022). Therefore wairua can be understood as spirituality, the unseen, divine, connectedness, and is also much more; it permeates Māori views and experiences of the world. Given this, wairua is an essential dimension to hauora for Māori.

 

 

Whānau

Whānau is commonly translated as family, although the modern use of whānau to refer to the parent-child family unit is a contemporary development. In te reo Māori, when whānau is used as a noun it refers to children of the same parents, a family group, extended family, and can be applied to friends. Whānau can also be a verb, meaning to give birth or to be born. Whānau traditionally were the basic social unit, typically comprising an extended family unit spanning three generations (Walker, 2004). Throughout Māori models of health, whānau and collective wellbeing are prioritised, and working with whānau in health psychology settings can enhance hauora for whānau and individuals alike.

 

Hinengaro

The next dimension of hauora is hinengaro. Of interest to psychology in general, hinengaro encompasses the mind, thoughts, emotions, and intellect (Durie, 2001). Rangimarie Pere, who developed Te Wheke and is regarded as a tohunga, conceptualises hinengaro as comprising the conscious and subconscious aspects of mind (Pere, 1997). Furthermore, Māori worldviews maintain that thought, awareness, and understanding are not solely activities of the mind, but are deeply connected with bodily or embodied experiences (Marsden, 2003). For example, ngākau represents the heart and seat of emotions, and is attuned to hinengaro and wairua. Similarly ate referring to the liver, and puku to the stomach are also regarded as emotional centres within the body (Smith, 2008).

 

Tinana

Tinana refers to the physical body and as a dimension of hauora caring for physical wellbeing can include; regular exercise, eating a balanced and nutritious diet, and healthy sleep habits. Equally it can entail understanding and managing chronic illnesses and health conditions, as well as reducing harms associated with substance use. Physical wellbeing is often framed in terms of individual health behaviours and lifestyle choices. Individuals, particularly Māori, are blamed for making poor choices for their health in ways that disregard context, and instead ethnic or cultural identities are misconstrued as risk factors. Ethnicity is certainly important to consider for physical wellbeing, however, a more constructive perspective is to consider Indigeneity as an indication of exposure to risk factors (Huria et al., 2019).

A widely circulated framing of health connects physical health to lifestyle choices and an individual’s responsibility to participate in recognised health behaviours, such as eating a nutritious diet. This individualism disregards the social determinants of health, the circumstances and environment of people’s lives that determine their health. Social determinants of health for Māori contribute to severe inequities across all levels of health (Reid et al., 2019). (For further discussion of dominant discourses that construct health as an individual responsibility, see Riley et al. Chapter 1.4.)

 

 

Furthermore, the wellbeing of tinana is closely linked with wairua, hinengaro, and whānau health. As we highlighted earlier, the dimensions of hauora are interconnected. At times, what may present as a physical or mental illness from a Western medical perspective could have a spiritual basis, or reflect disharmony in whānau circumstances. From a Māori perspective, while issues may manifest physically, explanations may be spiritual or non-physical, therefore necessitating different treatment or healing practices.

 

Culture and te reo Māori

Access to culture and te reo Māori is well established as foundational to Māori wellbeing. A positive sense of Māori identity cultivated through cultural and social connection provides a strong base for wellbeing. Māori identity is also considered to be a protective factor for Māori health, as it can be a source of grounding that enables a person respond to challenges in a resilient manner (Durie, 2001).

As discussed earlier, Te Kōhanga Reo and Kura Kaupapa Māori were established as alternative forms of education for Māori in the 1980s, in the context of revitalisation efforts for te reo Māori and recognition of Te Tiriti. Te reo Māori education has provided a crucial pathway for Māori to be connected to Māori worldviews and knowledges and through this, to strengthen cultural identities (Durie, 2003). Māori culture and te reo Māori are also embraced and celebrated in kapa haka, a form of Māori performing arts that is significant to Māori culture and has become a unique part of national identity in Aotearoa New Zealand. Notably, Te Matatini is an acclaimed national Māori performing arts festival held every two years, providing an incentive for individuals and communities to increase their knowledge and understanding of Māori culture and te reo Māori (Durie, 2017).

 

Whenua and te taiao

As a final dimension of hauora, whenua and te taiao are important for hauora in multiple ways. Māori worldviews maintain that people are connected to the natural world and land through whakapapa. Connectedness to whenua and te taiao is essential to cultural identity and belonging. This is reflected in key te reo Māori terms that depict Māori relationships with the land:

• Whenua refers to land and it is also the term for placenta. These dual meanings are similar in reflecting a source of sustenance.
• Tangata whenua, meaning people of the land, is used to describe Māori as Indigenous in Aotearoa New Zealand.
• Tūrangawaewae describes a standing place and belonging granted through whakapapa. It is usually used to refer to ancestral lands where one has rights of belonging.
• Ūkaipō refers to origins or homelands. It also has a dual meaning, describing a mother as a source of sustenance.

Whenua is also closely connected to wairua and whakapapa, therefore efforts toward hauora for Māori must acknowledge relationships with the wider environment (Mark & Lyons, 2010; NiaNia et al., 2017). The significance of te taiao is denoted in Māori creation narratives. Māori view the lands, sky, winds, seas, waterways, forests, and the natural environment as atua and as tīpuna. Given this relationship, a Māori worldview also maintains that Māori have obligations and responsibilities to te taiao. The concept of kaitiakitanga encompasses the responsibilities of guardianship and caretaking of the natural environment, to protect and preserve te taiao for future generations (Marsden, 2003). Māori wellbeing across the dimensions of hauora is understood as deeply intertwined with, and dependent upon, the state of te taiao. The impacts of climate change and widespread degradation of the natural environment in the contemporary context therefore pose significant issues for Māori.

 

 

In discussing the dimensions of hauora and examples of application we have endeavoured to demonstrate the ways these dimensions and Māori models of health can be translated from conceptual to practical. An expanding body of Māori research and approaches to wellbeing employs knowledges and practices originating in te ao Māori. Across the dimensions of wairua, whānau, hinengaro, tinana, culture and te reo Māori, as well as whenua and te taiao, there are many avenues for Māori understandings to enrich health psychology.

In pracitical terms, appropriate integration of tikanga, use of karakia and te reo Māori, active whānau involvement, use of whanaungatanga to develop relationships, and facilitating access to rongoā are experienced positively by Māori accessing health services (Pere, 2006; Waitoki et al., 2015). Such efforts underpin models of practice within Māori health services and are means by which the principles of Māori models of health are incorporated to enhance outcomes and hauora for Māori.

Conclusion – hauora in a changing world

We  conclude by emphasising that contexts influence health experiences and outcomes. Hauora for Māori exists in a changing health landscape, with implications for contemporary health psychology. The contexts we live in are constantly evolving, therefore our thinking and practices must also continually develop and adapt. The challenge for critical health psychology in Aotearoa New Zealand is to not only be aware of contexts and structures, but to respond constructively, with a commitment to benefitting hauora and Māori communities.

The critical health psychology pou have emerged throughout  this chapter. The pou of valuing theoretical and conceptual thinking was relevant to our discussion of Māori worldviews, knowledges, and understandings of health and wellbeing. In reviewing the historical and socio-political context in Aotearoa New Zealand and Te Tiriti, the pou of challenging taken–for–granted understandings and paying attention to issues of power and equity were important. Māori models of health, dimensions of hauora, and links to application and practice offer exemplars of the pou of moving beyond individualistic psychology and considering knowledge as produced in context.

We hope this chapter offers conceptual, historical, and practical foundations to rethink Māori and Indigenous health and wellbeing. Our coverage of Māori knowledges and understandings is intended to ignite thought and reconceptualisation of ideas within health psychology. To this point, Reid et al. (2010) implore Māori and Indigenous peoples alike regarding the importance of creative and critical thought for the future:

Indigenous knowledges are not solely ancient wisdoms but necessarily include processes for the creation of new Indigenous knowledge that have the potential to contribute to well-being of all peoples, our environment and our planet. […] This Indigenist approach to research and science holds important answers for the critical questions we currently face in collective well-being.

Māori working in health psychology have a significant responsibility, to both draw on existing Māori knowledges and to also create Māori knowledges to contribute to hauora. The health and wellbeing of Māori is a pressing issue that must be informed and led by Māori scholars and practitioners, and Māori worldviews and practices. The task for all involved in health psychology in Aotearoa New Zealand begins with cultural humility, to be aware of positionality, to be open-minded, and to learn. These issues are equally important for all who study, teach, research, and engage with health psychology in Aotearoa New Zealand. There is abundant potential for Māori knowledges and practices to enrich and expand health psychology, so that hauora for Māori can flourish.

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