Economic & Social Determinants Philippa Howden
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Transcript Economic & Social Determinants Philippa Howden
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
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
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.
A NEW APPROACH – UNDERSTANDING
“ADAPTIVE CHALLENGES”