Position statement: Equity and racism

In New Zealand, and throughout the world, good health is not shared equally. Health outcomes are linked to factors like income, ethnicity, education, gender and sexual orientation and whether you have a disability. In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust. For example, there are worse health outcomes for Māori and Pacific peoples, refugee and migrant communities, women and girls, transgender, non-binary, gay, lesbian, queer and intersex people, rural people and people with a disability.

Health systems have been set up in a way which favours some groups. For example, when health services charge fees for visits, this disadvantages young people who are more likely to experience cost as a barrier to accessing health care. Some sexual and reproductive health policies contribute to health inequity. Policies that make long-acting reversible contraceptives (LARCs) free, while other types of contraceptives are not free, advantages people who can afford other options and may reduce contraceptive options and choice for people who cannot pay. It is essential that policies do not restrict access to services and information for certain groups. Policies should not prioritise one type of contraceptive over another and should ensure that people have equitable access to a full range of affordable contraception that is right for them. To have health equity, policies must ensure people are treated fairly, recognising that people experience different barriers to accessing services and information.

Sexual Wellbeing Aotearoa strives to make sure our services and policies promote health equity including considering how our resources are used to promote equitable access to our services and information. We also aim to promote diversity and inclusiveness at all levels of the organisation. Sexual Wellbeing Aotearoa is committed to developing staff skills, attitudes and knowledge to provide services in a way that improves health equity in Aotearoa.

One of the most common and entrenched causes of health inequity is racism. Racism, treating someone as inferior or lesser because of their race, ethnicity or where they are from, remains a driver of inequity between groups. Racism occurs at an interpersonal level between people, as well as systemically through laws and policies, such as the way health services are designed. Racism results in unequal sharing of power and resources, and in Aotearoa it privileges New Zealand European people over others including Māori, Pacific peoples, and refugee and migrant communities.

Sexual Wellbeing Aotearoa recognises that racism and colonisation have uniquely impacted sexual and reproductive health and rights. For example, controlling reproduction including forced sterilisation, preventing people from having children, or removing children from families has been a way to try to control indigenous populations and other communities experiencing racism, and has caused intergenerational harm and trauma. All people have a right to reproductive autonomy, to have children, to not have children, and parent children in safe and healthy communities.

Negative stereotypes about sexuality and reproduction based on someone’s ethnicity is a type of racism. Negative stereotyping contributes to the stigma and shame that people may feel seeking health services and information and can impact how they are provided information or services, creating barriers to realising equity in sexual and reproductive health and rights.

Sexual Wellbeing Aotearoa aims to be an actively anti-racist organisation. As an organisation, we realise we have a lot to learn, and a long way to go, but we are committed to eliminating racism. Being anti-racist is also essential to realising the principles of Te Tiriti o Waitangi.

Sexual Wellbeing Aotearoa advocates for addressing the range of social determinants of health that relate to racism and inequity, including issues like poverty and violence, alongside our work to make sure our services are equitable, accessible and inclusive.

• Te Whatu Ora - Achieving equity 
• Racism in the health system – Ministry of Health
• Social determinants of health – Healthify