Browsing by Author "Gao, I-An"

This thesis examines the health framing strategies of the three stakeholders: the government, the media and the experts, with regard to how their assumptions and presuppositions of the notion of Taiwanese disadvantaged indigenous health overlap or diverge from each other. Taiwan is a democratic country situated in the East Asia. The ethnocultural diversity became in urgent need to be accommodated ever since the martial law was lifted in 1987. However for two decades, Taiwanese indigenous peoples have experienced health gap with the non-indigenous population in almost all health indicators. In order to complement the current literature, which has been developed with the biomedical paradigm, the health framing strategies of the three stakeholders are analysed to explore the implied factors that account for indigenous health disadvantages. The notion of health framing is utilised to refer to identifying the discourses which have been supported by institutions and influenced by cultures, produced particular understandings of the issue of Taiwanese disadvantaged health. Qualitative content analysis (QCA) is applied in all parts of the analysis. First, the government’s health framing is examined through analysing the Annual Report on Public Health from 2001 to 2012 and the health framing embedded in the media representation is examined through analysing 98 pieces of news reports on both regional and national level from 2000 to 2012. Second, the analysis of semi-structured interviews with the Taiwanese indigenous health experts offer insights into the health framing strategies in and beyond the dimensions of the coding frame. Lastly, three levels of indigenous determinants of health are introduced to structure and to highlight the hierarchy of the framing factors. The results from the analysis of the government and the media indicate that both stakeholders treat Taiwanese disadvantaged indigenous health as a structural problem of insufficiencies in medical and health resources. In addition, the media representation shows emphasis also on behavioural risk factors as explanatory factors. The health framing strategies from both stakeholders echo closely to the previous research that relied on the biomedical paradigm. Two implications are observed from the interview analysis. First, the implied problems to disadvantaged indigenous health are extended to the political, cultural, and genetic dimensions. Second, the factors that are inadequately addressed are not arbitrary and capricious, but being omitted systemically. The experts provide four explanations on the intermediate level and three explanations on the distal levels that are not addressed. For the former, they are (i) absence of access to the healthcare system, (ii) the presence in an educational system that systemically exclude their opportunities to continue education, (iii) poor access to basic infrastructure and resources to prevent economic marginalisation and (iv) the negligence of the importance of cultural continuity, especially the continuity of indigenous languages. For the latter, the implied problems are (i) the negligence of social change that were closely related to nation-building model which resulted in disassembled and deranged indigenous peoples, (ii) the role of power in the design of health institutions which manifested in the absence of cultural sensitivity and (iii) the ongoing impact of doctrine of discovery in Taiwan.