This thesis examines the dual roles of social class and cultural practice in understanding obesity–related disease and the personal experiences of chronic illness in the Polynesian migrant community in Australia, using social constructionist concepts and addressing issues of Cultural Safety in health practice. New Zealand Maori and other Polynesians from Samoa, Tonga, the Cook Islands and Niue (Pacific Islanders), comprise one of Australia’s fastest growing migrant groups. People from these communities are in the highest percentiles of obesity–related illnesses such as heart disease, type 2 diabetes, renal failure and respiratory problems in the world. Despite the public health messages regarding the implications of obesity, Polynesians appear not to be responding to recommendations of health care providers as intended. This thesis explores the socio–centric nature of Polynesian families and kinship structures that are enacted within a network of reciprocities and understandings that do not privilege the individual. It examines how the cultural identities created and re–iterated by these practices inform relational notions of belonging and well–being. It is argued that without addressing such cultural understandings, health promotion messages derived from the biomedical position that regards obesity as the result of poor individual choices, are unlikely to be adopted by Polynesians. As Polynesian migration to Australia is steadily rising, this issue will be of increasing significance as it impacts on Australian mainstream health services.

The research employs qualitative methods and epistemologies based on Kaupapa Maori, a theoretical model designed by Maori scholars, to elucidate participants’ discursive constructions of their bodies, health and wellness. Kaupapa Maori encompasses an examination of the cultural dynamics that are influential in how health and ill–health are conceived and experienced in this population group. This also allows for an exploration of socio–economic factors that exacerbate the likelihood of poor health outcomes in Polynesian communities. Qualitative interviews were conducted with sixty–seven interview participants from Sydney and the Hunter region of New South Wales. This included extended interviews with three key informants who are Polynesian nurses practising in Australia. For an Australian or non–Polynesian readership, this thesis is intended to bring a broader cultural understanding of the Maori/Pacific Islander communities, and the strengths and the challenges it faces in relation to obesity–related illness. It is also intended to have resonance for Maori and Pacific Islanders in Australia in regard to their perceptions of health, well–being and identity in their adopted country.