Abstract
Indigenous peoples have poorer health outcomes than their non-indigenous counterparts and this applies to cancer outcomes for Māori in Aotearoa/New Zealand. Differential access to and quality of healthcare contributes to poorer survival rates for Māori. This research provides insight into some of the mechanisms that hinder and facilitate care access. Thirty four people who had undergone cancer treatment (19 Māori and 15 non-Māori) were interviewed by two Māori researchers. The analysis of the interview transcripts was informed by membership categorization analysis. This form of analysis attends to the categories that are used and the activities and characteristics associated with those categories. From this analysis it is argued that the classical patient role, or sick role, inadequately captures the kind of role that some Māori take in relation to their healthcare. Māori can also have culturally specific family (whānau) influences and a greater draw towards alternative approaches to healthcare. Dissonant roles contribute to a different experience for Māori. A better understanding of the categories and roles that are relevant to those who have cancer provides opportunities to attenuate the monocultural impacts of healthcare.
• New Zealand Māori have poorer cancer outcomes than non-Māori New Zealanders.
• Health services play an important role in responding to inequity in cancer outcomes.
• Māori with cancer can have different responses to their healthcare than non-Māori.
• Role dissonance provides an important explanation for these different responses.
• Understanding role dissonance may improve the experience of cancer care for Māori.