Colonial Legacy and Lung Cancer Inequities Among Rural Māori Men: A Social Epidemiological Analysis

Abstract

Lung cancer remains one of the leading causes of cancer-related mortality in Aotearoa New Zealand, disproportionately affecting Māori communities. Data consistently show that rural Māori men experience pronounced inequities in lung-cancer incidence, access to timely screening, and quality of care. The enduring legacies of colonisation, systemic racism, geographic isolation, and cultural disconnection continue to shape these disparities. Yet, there is limited research examining the intersection of rurality, Māori identity, and structural determinants influencing lung-cancer outcomes.

This study is framed by a social epidemiological lens and grounded in a Kaupapa Māori paradigm. Currently, no lung-cancer care model specifically addresses the needs of rural Māori men in Aotearoa. The project involves semi-structured interviews with 50 Māori men living in rural regions across Aotearoa, with interview questions informed by a focused literature review that incorporates both peer-reviewed and grey literature.

The research questions explore equity-focused approaches to care by drawing on Māori health frameworks—Te Whare Tapa Whā, Te Pae Mahutonga, and Te Wheke—alongside international Indigenous literature and Māori-led health strategies. The project also recognises that Aotearoa’s public-health system does not need to remain solely biomedical and Western-dominated; instead, it should evolve to embrace Indigenous-led and community-driven models of care that reflect the diversity and sovereignty of Māori worldviews.

As an international postgraduate student, I position this work as a contribution to cross-cultural and equity-focused dialogue in public health. The presentation offers preliminary insights to inform future community-led interventions and culturally grounded policy reform aimed at achieving lung-cancer equity in Aotearoa.