January 24, 2024

Marketing for Equity: Pioneering Culturally Competent Health Care for First Nations

First Nations people “suffer from poorer health, are more likely to experience disability and reduced quality of life, and ultimately die younger than their non-indigenous counterparts,” according to the United Nations. Here, the term “First Nations” includes Indigenous, Aboriginal, Torres Strait Islander, Native, American Indian, First Alaskans, Native Hawaiians, Māori, Metis, and Inuit peoples.

Studies show that in Australia the life expectancy of First Nations males is 8.6 years less than the general population, and the corresponding number for females is 7.8 years. Similarly, the life expectancy of North American Indians and Alaskan Natives is 4.4 years less. The healthcare sectors in countries like Canada, the United States, and Australia have long overlooked the unique needs and perspectives of First Nations people, and this oversight has resulted in significant disparities in health outcomes for these communities as compared to the general population. What can be done to bridge this gap?

In a new Journal of Marketing study, we explore the role of marketing in decolonizing healthcare. We focus on the “Birthing on Country” policy, an initiative led by First Nations Australians that encourages women to give birth on their ancestral lands by adopting traditional birthing practices—in stark contrast to the western biomedical approaches that dominate the healthcare landscape.

At the heart of our investigation is the actor-network theory (ANT), a sociological framework through which we explore the intricate web of relationships and interactions that shape social phenomena. Through ANT, we discover how various stakeholders, both human and nonhuman, come together to form networks that can either support or hinder the decolonization of healthcare.

The Power of Marketing in Decolonizing Healthcare

One of the most striking revelations is the power of marketing techniques in this decolonization process. Traditional marketing campaigns, such as those promoting handwashing or smoking cessation, have had ambiguous results in changing behavior. However, when these techniques are tailored to respect and incorporate First Nations perspectives, they can become potent tools for change.

For instance, the “Birthing on Country” policy did not gain traction simply because it was a good idea. Our research shows that creating a strong brand identity for the policy, leveraging influential opinion leaders, forging alliances with key public and private entities, and establishing formalized systems, including training, were crucial for the policy’s success. Additionally, it was not just about promoting the policy. It was about challenging the status quo, addressing resistance, and reshaping the healthcare landscape to be more inclusive of First Nations people.

Our findings underscore the importance of cultural sensitivity and inclusivity in healthcare. Western biomedical approaches, while effective in many ways, are not one-size-fits-all solutions. Different communities have different needs, and it is crucial to recognize and respect these differences. Moreover, our findings highlight the transformative power of marketing. Often dismissed as just a tool for selling products, marketing—when used ethically and creatively—can drive societal change. It can challenge entrenched beliefs, bridge cultural divides, and pave the way for more equitable healthcare systems.

A Roadmap for Rethinking Traditional Approaches to Healthcare

For healthcare professionals, policymakers, and marketers, our study offers a roadmap for rethinking traditional approaches, being more inclusive, and harnessing the power of marketing for the greater good. It is not just about improving health outcomes for First Nations people, it is about creating a healthcare system that respects and values the diversity of all its users.

This study has implications for First Nations people who wish to engage in decolonization. First Nations people can leverage marketing techniques and technologies to communicate the problem, promote the program, and design service delivery in a consistent fashion. Additionally, marketing practices might be used to advocate for developing infrastructure that supports such healthcare services. In the case of “Birthing on Country” initiatives, this included:

• birthing centers funded by the government and placed on First Nations land,
• culturally appropriate facilities, and
• community-led healthcare services.

Another critical lesson for First Nations people is that they need a network of allies. First Nations people must build relationships and partnerships with parties who share their goals of decolonizing healthcare. This includes engaging with researchers, policymakers, healthcare professionals, and community organizations to develop collaborative strategies, share knowledge, and advocate for change. Our study shows that universities and research institutes could present an argument with the same underlying rationale of “healing” but use the same scientific and healthcare discourses as the colonizer. These partnerships allow authentic representation and an ability to navigate a system designed to suppress, marginalize, and dehumanize. Without these alliances, there would only be pockets of decolonization scattered across the country.

The path to decolonizing healthcare is complex, but marketing can be a powerful ally on this journey. It is time for all stakeholders to come together and work toward a more inclusive and equitable healthcare future.