Economic & Social Determinants Philippa Howden

Report
PACIFIC PEOPLE IN
NEW ZEALAND
DEBBIE RYAN AND INEKE MEREDITH
MARMOT SYMPOSIUM
WELLINGTON
13 JULY 2011
PACIFIC PEOPLE IN NZ 2011
 Pacific peoples constitute 6.9% of NZ population (2006
Census)
 38% Pacific population under 15yr of age
 By 2051 , NZ student population will rise from 1 in 10 as it is
currently to 1 in 5
 Poorer life expectancy
 Highest mortality rate for cerebrovascular disease
 Mortality rate for cardiovascular disease higher than that for
non-Maori non-Pacific People
 Diabetes
 Obesity
 Amenable mortality
PACIFIC CHILD HEALTH IN NZ
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85% Pacific children completely immunised by age 2
Highest failure rates new entrant hearing tests
At 5yr of age, only 32% Pacific children caries free
Pacific children aged 5 -14yr are 6x more likely to be obese
than other children in NZ
Unintended pregnancy and longterm consequences: poor
antenatal care, obstetric complications, low birth weight
infants, poor educational attainment and child abuse (The
Best Intentions: Unintended Pregnancy and the Well -Being of
Children and Families, 2005)
Rheumatic Fever
Rheumatic Heart Disease
Meningitis
Highest hospitalisations for asthma
ACUTE RHEUMATIC FEVER IN NZ
Acute Fever Rheumatic Admissions in 0-24 Year Olds by Ethnicity, New Zealand 1996-2007
Source: New Zealand Child and Youth Epidemiology Service
SERIOUS SKIN INFECTIONS
Hospital Admissions due to Serious Skin infections in Children and Young People 0-24 years by
Ethnicity, New Zealand 1996-2006
Source: New Zealand Child and Youth Epidemiology Service
AVOIDABLE HOSPITALISATIONS
 NZHS 2006: Decreasing unmet need
 Pharmaceutical expenditure approximates that expected
based on health need
 Increasing rates of emergency care self -presentation for less
urgent conditions
ASH rates per 1000 for Counties Manukau 0-74 year olds, by ethnicity 2001-2009
Pacific
Maori
non-Maori non-Pacific
Source: CMDHB: Changes in Primary Health Care 2001 - 2009
FOCUS ON YOUTH
 Disadvantage at dif ferent stages of life af fects adult health
(Power and Kuh 2006)
 Are there circumstances which make inequality later in life
more likely?
 “Although all children gain from quality early childhood
education, society benefits most from the investment in
children from low -income or disadvantaged homes”
(Improving the Transition, May 2011)
A FOCUS ON REDUCING INEQUALITIES FOR
PACIFIC PEOPLES
SYSTEM RESPONSE
 Legislation NZ Public Health and Disability Act 2000 – “...to reduce
health disparities by improving the health outcomes of Maori and other
population groups...”
 National strategies
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New Zealand Health Strategy 2000
Primary Health Care Strategy 2001
Public Health
Pacific Health and Disability Action Plan 2002 and Pacific Provider
Development Fund
 Quality focus
 Evidence based guidelines
 Primary health care accreditation
 Performance management
 Research and evaluation
 Workforce development
DETERMINANTS OF HEALTH AND
EMPOWERMENT
 DHB Pacific community and church based programmes
 Enua Ola
 Lotu Moui
 Health Village Action Zones
HEHA
Housing programmes
Anti-smoking
Health prevention- immunisation (MenzB, childhood,
Influenza, HPV), cancer screening, early childhood health
checks
 Pacific unemployment rate in was 4.7%, (3.4%) in December
2007 compared with 26.1% (10.6%) in 1992.
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A NEW APPROACH – UNDERSTANDING
“ADAPTIVE CHALLENGES”

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