An Interdisciplinary Assessment of the Heart Health Environment

2025

Authors

Daniels, N., McGowan, R., Smith, S., Cotter, J., Reihana, K., Bullen, C., Matthews, K., Burton, N., Berning, H., Roxburgh, B., Davies, L., Rolleston, A.

Abstract

Background

Heart health and the approach to its management in Australasia reflect our dominant cultural contexts i.e., of western values, knowledge, and systems — which have strengths but also limitations and unaccounted costs. Western systems regard people and their health as somewhat autonomous, intra-generational and independent from the biosphere, thereby contrasting Indigenous perspectives. Herein lies inequity that may amplify greatly for future generations. We, therefore, undertook an interdisciplinary assessment of the heart-health environment (HHE).

Methods

As an interdisciplinary research team, we (a) identified categories that shape the HHE for current and future generations (e.g., treatment, education); (b) compiled and summarised research, clinical guidelines and public policy sourced from subject matter experts; (c) filled gaps therein and incorporated relevant Te Ao Māori frameworks; (d) categorised NZ Health Research Council (HRC) funding; and (e) discussed key evidence and messages via dialogic conversations in a 3-day wananga.

Outcomes

Western and Te Ao Māori emphases on heart health differ starkly. Western (knowledge) systems emphasis is overwhelmingly on medical and biological factors and treatment, which receive 95% of HRC funding for cardiovascular health (cf. 4% on public health), and focusses on maximising lifespan within the current generation(s). It is disconnected from nature and contributes to unsustainability, thereby acting directly and indirectly against the HHE of future generations. Therefore, we need to braid different approaches. Te Ao Māori emphasises whenua and mauri, connection to whenua and whānau, living a full life while accepting its limits, and with clear concern for future generations and non-human life.

Conclusion

The HHE lacks but requires Indigenisation.

Publication Link

https://www.heartlungcirc.org/article/S1443-9506(25)00335-X/fulltext