Occupants' Health and Their Living Conditions of Remote Indigenous Communities in New Zealand

Assessing Disparities in Asthma and Respiratory Health in Indigenous People

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Asthma exacerbations in New Zealand 2010-2019: A national population-based study

INTRODUCTION

Asthma is one of the most common long-term conditions in the world, with New Zealand (NZ) having one of the highest rates of asthma symptoms. Despite the significant burden of asthma in NZ, there is a lack of data on asthma exacerbation rates in NZ and how these have varied over time. This study is a national population-based study of asthma exacerbation rates in NZ between 2010 and 2019, and explores how these rates vary amongst different demographic groups.

METHODS

A retrospective population-based observational cohort study covering the ten years 2010-2019 to determine asthma prevalence, and asthma exacerbation and hospitalisation rates, using de-identified data from five national healthcare datasets. Exacerbations were defined based on hospital discharge diagnoses or oral corticosteroid dispensing.

RESULTS

Total number of patients with asthma was 447,797 in 2010 to 512,627 in 2019, equating to approximately 10% of the population. Of these 19.4% experienced an exacerbation in 2010 (a population rate of 376.2 per 1000 patient-years); this exacerbation rate increased to 25.1% in 2019 (438.3 per 1000 patient-years). Exacerbations rates were consistently higher for females than males, and among Pacific peoples and Māori. In contrast, hospital admissions 25% lower in 2019 than 2010, decreasing from 1.4% to 0.9%, however over 50% of these admissions were in Māori and Pacific peoples.

CONCLUSION

Asthma exacerbation rates in NZ have increased over 2010-2019, however hospitalisation rates have decreased. This potentially suggests a move away from secondary to primary care management of exacerbations and provides important information for asthma care planning.

Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021

PURPOSE OF REVIEW

The volume of public health environmental justice (EJ) research produced by academic institutions increased through 2022. However, the methods used for evaluating EJ in exposure science and epidemiologic studies have not been catalogued. Here, we completed a scoping review of EJ studies published in 19 environmental science and epidemiologic journals from 2018 to 2021 to summarize research types, frameworks, and methods.

RECENT FINDINGS

We identified 402 articles that included populations with health disparities as a part of EJ research question and met other inclusion criteria. Most studies (60%) evaluated EJ questions related to socioeconomic status (SES) or race/ethnicity. EJ studies took place in 69 countries, led by the US (n = 246 [61%]). Only 50% of studies explicitly described a theoretical EJ framework in the background, methods, or discussion and just 10% explicitly stated a framework in all three sections. Among exposure studies, the most common area-level exposure was air pollution (40%), whereas chemicals predominated personal exposure studies (35%). Overall, the most common method used for exposure-only EJ analyses was main effect regression modeling (50%); for epidemiologic studies the most common method was effect modification (58%), where an analysis evaluated a health disparity variable as an effect modifier. Based on the results of this scoping review, current methods in public health EJ studies could be bolstered by integrating expertise from other fields (e.g., sociology), conducting community-based participatory research and intervention studies, and using more rigorous, theory-based, and solution-oriented statistical research methods.

Thermal Performance of School Buildings: Impacts beyond Thermal Comfort

Based on field study data regarding the winter indoor thermal environment of three classrooms with different building envelopes, this study compared and evaluated these environments, not only related to students' thermal comfort but also to their health. The inadequacy of the conventional New Zealand school building for maintaining a comfortable and healthy winter indoor thermal environment has been identified. A classroom with thermal mass had 31%, 34% and 9% more time than a classroom without thermal mass when indoor temperatures met 16 °C 18 °C and 20 °C respectively and has 21.4% more time than the classroom without thermal mass when indoor relative humidity was in the optimal range of 40% to 60%, in a temperate climate with a mild and humid winter. Adding thermal mass to school building envelopes should be considered as a strategy to improve the winter indoor thermal environment in future school design and development. Adding thermal mass to a school building with sufficient insulation can not only increase winter indoor mean air temperature but can also reduce the fluctuation of indoor air temperatures. This can significantly reduce the incidence of very low indoor temperature and very high indoor relative humidity, and significantly improve the indoor thermal environment.