2.4.5. • Racial discrimination from healthcare providers (e.g., outward and subtle racism towards ethnic minority patients, privileging Western medical knowledge over Indigenous/ethnic minority understandings of health) • Lack of culturally appropriate services (e.g. appointment systems, waiting rooms, reception areas, communications, health promotion, education and services) • Barriers to accessing healthcare (e.g., lack of information provided to improve understandings of how the Aotearoa New Zealand health system works, language barriers, etc.) • These barriers can be alienating for Māori and tauiwi, which can reduce their willingness to engage in the healthcare system and, therefore, their overall health outcomes. Community and neighbourhood discrimination Migrants in Aotearoa New Zealand may also experience discrimination within their local communities. Research in this area is very limited; however: 2.4.6. • Martin Jenkins (2018) conducted consultations with recent migrants to explore their experiences of settling and adjusting to life in Aotearoa New Zealand. They found that while most migrants felt included and welcomed in their communities, a small proportion (12%) frequently experienced discrimination and did not know how to access support in this area. • An older study gathered qualitative information from migrants and former refugees (Butcher et al., 2006) and found their experiences of discrimination within their neighbourhoods were variable – while New Zealand-born neighbours were positive in one-off interactions, migrants perceived them to be aloof, reticent to interact with them, lacking knowledge or understanding about how to interact with migrants. Culture and identity Racism can have a variety of impacts on migrants’ cultural identity, including reexamination of cultural identity; assimilating into the host culture while rejecting original ethnic identity; rejecting the host culture, and internalised racism (Stuart, 2014). 2.4.7. Belonging, safety and social cohesion/inclusion Unfair/biased behaviour from others in their community can lead to migrants feeling a lack of belonging and safety in Aotearoa New Zealand (Ward et al., 2018). Aotearoa New Zealand research has shown that discrimination can cause migrants to feel unsafe from crime in their neighbourhoods (Ministry of Business, Innovation & Employment, 2018). www.malatest-intl.com Drivers of racism – March 2021 32