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Winter-Smith J, Grey C, Paynter J, Harwood M, Selak V. Who are Pacific peoples in terms of ethnicity and country of birth? A cross sectional study of 2,238,039 adults in Aotearoa New Zealand's Integrated Data Infrastructure. Dialogues Health 2023; 3:100152. [PMID: 38515801 PMCID: PMC10953968 DOI: 10.1016/j.dialog.2023.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/04/2023] [Accepted: 08/24/2023] [Indexed: 03/23/2024]
Abstract
Background The aggregation of Indigenous peoples from Pacific Island nations as 'Pacific peoples' in literature may mask diversity in the health needs of these different groups. The aim of this study was to examine the heterogeneity of Pacific groups according to ethnicity and country of birth. Methods Anonymised individual-level linkage of administrative data identified all NZ residents aged 30-74 years on 31 March 2013 with known ethnicity and country of birth. All participants were described according to ethnicity and country of birth. Pacific participants were also described according to the number of ethnicities they identified. Findings A total of 2,238,039 NZ residents were included, of whom 117,957 (5·0%) were Pacific. Nearly two-thirds of Pacific peoples (65·7%) were born overseas, ranging from 45·3% (Cook Islands Māori) to 82·7% (Fijian) (Māori 2·3%, non-Māori non-Pacific 28·9%). Among NZ-born Pacific peoples, 46·9% (Samoan) to 81·9% (Fijian) were multi-ethnic; the proportion was much lower for overseas-born Pacific peoples (ranging from 3·7% [Tongan] to 23·9% [Tokelauan]). Interpretation There is substantial heterogeneity among Pacific peoples in their country of birth and identification with sole or multiple ethnicities. Assumptions regarding homogeneity in the needs of Pacific peoples are not appropriate and government statistics should therefore disaggregate Pacific peoples whenever possible. Funding Supported by the Health Research Council of New Zealand and a part of Manawataki Fatu Fatu, a programme of research funded by the National Heart Foundation of New Zealand and Healthier Lives - He Oranga Hauora - National Science Challenge of New Zealand.
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Affiliation(s)
- Julie Winter-Smith
- Section of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Corina Grey
- Department of General Practice and Primary Healthcare, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Janine Paynter
- Department of General Practice and Primary Healthcare, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Matire Harwood
- Department of General Practice and Primary Healthcare, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Vanessa Selak
- Section of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
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Tupou T, Tiatia-Siau J, Newport C, Langridge F, Tiatia S. Is the Concept of Solastalgia Meaningful to Pacific Communities Experiencing Mental Health Distress Due to Climate Change? An Initial Exploration. Int J Environ Res Public Health 2023; 20:7041. [PMID: 37998272 PMCID: PMC10671233 DOI: 10.3390/ijerph20227041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/04/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023]
Abstract
The critical inquiry is how Pacific communities themselves characterize mental distress as a result of climate change. If not solastalgia, what more suitable terms might they use? This viewpoint article aims to initiate a discourse using solastalgia as the focus for the Pacific by 1. providing a definition of solastalgia; 2. examining its application in Pacific research; 3. presenting limitations of solastalgia; and 4. assessing its appropriateness for Pacific communities. There is a dearth of research using solastalgia, particularly within Pacific communities. The Pacific region's diverse contexts may already possess terms that effectively convey place-based distress that solastalgia attempts to describe. However, the authors found that solastalgia holds limited utility in the Pacific region, primarily based on a review of the literature, which involved keyword searches in Google Scholar such as solastalgia, mental health, mental distress, wellbeing, climate change, environmental distress, displacement, and Indigenous and Pacific peoples. More importantly, the concept is limited in capturing Pacific experiences of land loss due to climate change events, particularly, as the Pacific imbues land with profound significance, intertwined with culture, identity, and wellbeing. Land loss equates to a loss of culture, identity, wellbeing, and kinship in most Pacific contexts. It is apparent that broader and more holistic approaches are required.
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Affiliation(s)
- Trish Tupou
- Crawford School of Public Policy, Australian National University, Canberra, ACT 2601, Australia;
| | - Jemaima Tiatia-Siau
- School of Māori Studies and Pacific Studies, University of Auckland, Auckland 1010, New Zealand; (C.N.); (S.T.)
| | - Christina Newport
- School of Māori Studies and Pacific Studies, University of Auckland, Auckland 1010, New Zealand; (C.N.); (S.T.)
| | - Fiona Langridge
- Paediatrics, Child and Youth Health, University of Auckland, Auckland 1023, New Zealand;
| | - Suelaki Tiatia
- School of Māori Studies and Pacific Studies, University of Auckland, Auckland 1010, New Zealand; (C.N.); (S.T.)
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Baker MG, Gurney J, Moreland NJ, Bennett J, Oliver J, Williamson DA, Pierse N, Wilson N, Merriman TR, Percival T, Jackson C, Edwards R, Mow FC, Thomson WM, Zhang J, Lennon D. Risk factors for acute rheumatic fever: A case-control study. Lancet Reg Health West Pac 2022; 26:100508. [PMID: 36213134 PMCID: PMC9535428 DOI: 10.1016/j.lanwpc.2022.100508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain an inequitable cause of avoidable suffering and early death in many countries, including among Indigenous Māori and Pacific populations in New Zealand. There is a lack of robust evidence on interventions to prevent ARF. This study aimed to identify modifiable risk factors, with the goal of producing evidence to support policies and programs to decrease rates of ARF. METHODS A case-control study was undertaken in New Zealand using hospitalised, first episode ARF cases meeting a standard case-definition. Population controls (ratio of 3:1) were matched by age, ethnicity, socioeconomic deprivation, location, sex, and recruitment month. A comprehensive, pre-tested questionnaire was administered face-to-face by trained interviewers. FINDINGS The study included 124 cases and 372 controls. Multivariable analysis identified strong associations between ARF and household crowding (OR 3·88; 95%CI 1·68-8·98) and barriers to accessing primary health care (OR 2·07; 95% CI 1·08-4·00), as well as a high intake of sugar-sweetened beverages (OR 2·00; 1·13-3·54). There was a marked five-fold higher ARF risk for those with a family history of ARF (OR 4·97; 95% CI 2·53-9·77). ARF risk was elevated following self-reported skin infection (aOR 2·53; 1·44-4·42) and sore throat (aOR 2·33; 1·49-3·62). INTERPRETATION These globally relevant findings direct attention to the critical importance of household crowding and access to primary health care as strong modifiable causal factors in the development of ARF. They also support a greater focus on the role of managing skin infections in ARF prevention. FUNDING This research was funded by the Health Research Council of New Zealand (HRC) Rheumatic Fever Research Partnership (supported by the New Zealand Ministry of Health, Te Puni Kōkiri, Cure Kids, Heart Foundation, and HRC) award number 13/959.
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Affiliation(s)
- Michael G. Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
- Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
| | - Jason Gurney
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nicole J. Moreland
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
| | - Julie Bennett
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jane Oliver
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Victoria, Australia
| | - Deborah A. Williamson
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Reference Laboratory at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Nevil Pierse
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nigel Wilson
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Starship Children's Hospital, Auckland, New Zealand
- Green Lane Paediatric and Congenital Cardiac Services, Auckland, New Zealand
| | - Tony R. Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, United States of America
| | - Teuila Percival
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Moana Research, Auckland, New Zealand
| | | | - Richard Edwards
- Department of Public Health, University of Otago, Wellington, New Zealand
| | | | | | - Jane Zhang
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Diana Lennon
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Mairs RA, Bekker MJ, Patolo T, Hopkins SA, Cowley-Malcolm ET, Perese LM, Sundborn GB, Merry SN. Gamifying Parenting Education Using an App Developed for Pacific and Other New Zealand Families (Play Kindly): Qualitative Study. JMIR Serious Games 2020; 8:e15647. [PMID: 32519973 PMCID: PMC7315361 DOI: 10.2196/15647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 03/17/2020] [Accepted: 04/08/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Play Kindly is a gamified animated app designed to address common behavioral problems in childhood. The interface is designed to appeal to Pacific people, a population group with a higher risk of developing clinically significant behavioral problems than most other ethnic groups in New Zealand. OBJECTIVE The aim of this study is to explore the opinions of parents and professionals about the acceptability, usability, and content of Play Kindly. METHODS We used qualitative and Pacific and Māori research methodologies. A total of five focus groups with 45 parents and 12 individual interviews with professionals were conducted. The five focus groups consisted of 2 pan-Pacific groups, 1 Māori group, 1 open group, and 1 group of young Pacific adults or prospective parents. The professionals were from a range of disciplines, and the majority had expertise in early childhood, parenting interventions, or research in this field. RESULTS Play Kindly appealed to both parents and professionals. Participants related to the scenarios, which were created in collaboration with a playwright and animator. Although most participants liked the Pacific feel, there was some disagreement about how culturally specific the app should be. A range of issues with usability and gamification techniques were highlighted, likely attributed to the low budget and lack of initial co-design with parents as well as professionals with specific expertise in parenting. A number of parents and professionals felt that the parenting strategies were overly simplified and did not take into account the context in which the behavior occurred. Professionals suggested narrowing the focus of the app to deliver two important parenting messages: playing with your child and positively reinforcing desired behaviors. CONCLUSIONS Play Kindly is the first culturally adapted parenting app of its kind designed for Pacific parents and other New Zealanders with children 2-5 years of age. This app has potential in Pacific communities where there are limited culturally specific parenting resources. The results of this study will guide improvements of the app prior to testing it in an open trial.
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Affiliation(s)
- Rebecca A Mairs
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Marthinus J Bekker
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Tony Patolo
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Sarah A Hopkins
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | | | | | - Gerhard B Sundborn
- Department of Pacific Health, University of Auckland, Auckland, New Zealand
| | - Sally N Merry
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
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Disney G, Teng A, Atkinson J, Wilson N, Blakely T. Changing ethnic inequalities in mortality in New Zealand over 30 years: linked cohort studies with 68.9 million person-years of follow-up. Popul Health Metr 2017; 15:15. [PMID: 28446238 PMCID: PMC5406924 DOI: 10.1186/s12963-017-0132-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 04/12/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Internationally, ethnic inequalities in mortality within countries are increasingly recognized as a public health concern. But few countries have data to monitor such inequalities. We aimed to provide a detailed description of ethnic inequalities (Māori [indigenous], Pacific, and European/Other) in mortality for a country with high quality ethnicity data, using both standard and novel visualization methods. METHODS Cohort studies of the entire New Zealand population were conducted, using probabilistically-linked Census and mortality data from 1981 to 2011 (68.9 million person years). Absolute (standardized rate difference) and relative (standardized rate ratio) inequalities were calculated, in 1-74-year-olds, for Māori and Pacific peoples in comparison to European/Other. RESULTS All-cause mortality rates were highest for Māori, followed by Pacific peoples then European/Other, and declined in all three ethnic groups over time. Pacific peoples experienced the slowest annual percentage fall in mortality rates, then Māori, with European/Other having the highest percentage falls - resulting in widening relative inequalities. Absolute inequalities, however, for both Māori and Pacific males compared to European/Other have been falling since 1996. But for females, only Māori absolute inequalities (compared with European/Other) have been falling. Regarding cause of death, cancer is becoming a more important contributor than cardiovascular disease (CVD) to absolute inequalities, especially for Māori females. CONCLUSIONS We found declines in all-cause mortality rates, over time, for each ethnic group of interest. Ethnic mortality inequalities are generally stable or even falling in absolute terms, but have increased on a relative scale. The drivers of these inequalities in mortality are transitioning over time, away from CVD to cancer and diabetes; such transitions are likely in other countries, and warrant further research. To address these inequalities, policymakers need to enhance prevention activities and health care delivery, but also support wider improvements in educational achievement and socioeconomic position for highest need populations.
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Affiliation(s)
- George Disney
- University of Otago, 23a Mein Street, Wellington, New Zealand.
| | - Andrea Teng
- University of Otago, 23a Mein Street, Wellington, New Zealand
| | - June Atkinson
- University of Otago, 23a Mein Street, Wellington, New Zealand
| | - Nick Wilson
- University of Otago, 23a Mein Street, Wellington, New Zealand
| | - Tony Blakely
- University of Otago, 23a Mein Street, Wellington, New Zealand
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