š Flu vaccine available; healthy diet impacts; antibiotic prescribing; digital contact tracing uptake; safer roads; and more
MÄori health research highlights from the past week
šš½ Kia ora, Iām George Gray, a public health physician doing my best to keep up with the latest health research that can help improve outcomes for MÄori. Hereās what Iāve learned this weekā¦
š¬ The Latest Research
How Can Programmes Be Successfully Implemented with MÄori Communities?
Oetzel, J., Ngawati, R., Penetito-Hemara, D., Te Puke, T., Henry, A., Sika-Paotonu, D., & Povaru-Bourne, S. (2024). Facilitators and barriers for implementation of health programmes with MÄori communities. Implement Sci Commun, 5, 26. https://doi.org/10.1186/s43058-024-00567-y
This study highlighted the critical elements that contribute to the effective implementation of health programmes within MÄori communities. The research employed a mixed-method approach and unravelled the complex interplay of factors that either facilitate or hinder the success of these health initiatives. A standout finding from this study is the paramount importance of cultural competency, alongside robust community engagement and leadership, in achieving positive health outcomes for MÄori. The study underscores the necessity of aligning health programmes with MÄori cultural values and practices as a fundamental enabler. It also highlights the challenges posed by systemic barriers, such as inadequate funding and the need for greater MÄori representation in decision-making processes. In response, the research advocates for a strategic focus on developing culturally tailored programmes that resonate with MÄori perspectives and needs. This study guides researchers, health professionals and policymakers seeking to improve health outcomes in MÄori communities.
What Contribution Can Dietary Changes Make Towards Health Equity?
Reynolds, A. N., Cleghorn, C. L., & Mann, J. I. (2024). The broader health benefits of optimised dietary thresholds proposed for type 2 diabetes prevention in Aotearoa New Zealand: Simulation modelling. New Zealand Medical Journal, 137(1592). https://doi.org/10.26635/6965.6339
In this study, the researchers modelled the health benefits that might be achieved if healthy eating guidelines for preventing Type 2 diabetes were applied to the 2011 Aotearoa population. Focusing on a diet rich in dietary fibre, whole grains, vegetables, fruit, and unsaturated fatty acids while limiting sodium and saturated fat intake, the study projects a potential gain of 1.0 to 1.5 million Quality-Adjusted Life Years (QALYs) across the population. Importantly, these dietary modifications indicated 2.5 times greater health gains for MÄori communities, indicating a significant step towards reducing health inequities. The study leverages data from the 2008/09 Adult Nutrition Survey and the Global Burden of Disease Project, acknowledging that current dietary intakes may have shifted towards more processed foods, potentially underestimating the full scope of health benefits from meeting the proposed dietary thresholds. This study quantified the benefits that might accrue with a healthier food environment. The article calls for a government commitment to develop a comprehensive national food strategy.
What Prevented People From Using Digital Contact Tracing During the Pandemic?
Elers, P., Emery, T., Derrett, S., & Chambers, T. (2024). Barriers to adopting digital contact tracing for COVIDā19: Experiences in New Zealand. Health Expectations, 27(2). https://doi.org/10.1111/hex.14013
This study explores the barriers to adopting digital contact tracing (DCT) for COVID-19 in Aotearoa, focusing on the experiences of MÄori, Pasifika, and disabled individuals. Participants expressed willingness to use DCT but highlighted challenges such as usability issues and distrust in government interventions. Barriers included limited access to technology, concerns about privacy, and historical distrust, particularly among high-risk groups. The study emphasises the importance of including diverse voices in evaluating and improving DCT and other health technology initiatives in the future to ensure equitable access and adoption.
What Are the Physical Healthcare Experiences of MÄori and non-MÄori Individuals With Mental Health Conditions?
Cunningham R, Imlach F, Haitana T, et al. Experiences of physical healthcare services in MÄori and non-MÄori with mental health and substance use conditions. Australian & New Zealand Journal of Psychiatry. 2024;0(0). doi:10.1177/00048674241238958
Poor physical health outcomes for those with mental health conditions are well documented. This study found that individuals with mental health and substance use conditions (MHSUC) experienced varying treatment across healthcare settings, with MÄori reporting less respect and fairness than non-MÄori, especially in emergency departments. Pharmacy services were rated highest for respect and fairness. MÄori patients were more likely to experience their physical health needs being subsumed by their mental health diagnoses. To address these disparities and enhance healthcare quality, tailored interventions and strategies must be implemented to combat discrimination and improve healthcare experiences for individuals with MHSUC, especially focusing on addressing institutional racism within healthcare systems. Suggestions include monitoring those with MHSUC in separate national patient experience surveys, tracking primary care quality indicators, monitoring patient experiences in the Emergency Department, and learning why pharmacy scored so positively among respondents.
Can Lower Antibiotic Prescribing Combat Resistance Without Compromising Care?
Thomas, M. G. (2024). Improving community antibiotic prescribing to keep antibiotics working in Aotearoa New Zealand. New Zealand Medical Journal, 137(1592). https://doi.org/10.26635/6965.6389
This study highlights the balance between fighting antibiotic resistance and providing optimal care for populations based on their health needs and risks. The article mentions sore throats as a precursor to rheumatic fever as an example of this delicate balance. The article reveals that antibiotic dispensing for viral infections in Aotearoa is higher than in other nations, which doesn't benefit patients and worsens resistance. The study suggests unnecessary antibiotic use must decrease while ensuring MÄori and Pacific communities and others with particular needs receive adequate treatment for certain organisms. Recommendations include a tailored approach to prescribing, inspired by successful reductions in antibiotic use by the NgÄti Porou Hauora Charitable Trust and the Eastern Bay Primary Health Alliance, emphasising equitable health outcomes and informed healthcare practices.
Can Safer Roads Ensure a Healthier Aotearoa?
Isles, S., Kean, M., Dipnall, J. F., & Beck, B. (2024). Temporal trends of transport-related injuries on New Zealand roads. New Zealand Medical Journal, 137(1592). https://doi.org/10.26635/6965.6342
Over four years, a study in Aotearoa examined transport-related injuries, noting significant variances across transport modes, with car occupants most affected. A notable finding was reduced hospitalisations during COVID-19 lockdowns, indicating a positive impact on road safety. The research also highlighted ethnic disparities in hospitalisation rates, with MÄori experiencing a 1.7 times higher rate of transport-related hospitalisations than the European/other group in the study. The study calls for a more granular approach to data collection and analysis, emphasising the importance of understanding the nuances behind these statistics to formulate effective interventions. By prioritising the safety of vulnerable road users and addressing the ethnic disparities in road trauma, it may be possible to reduce hospitalisations, morbidity, and mortality.
š Chart of the Week
š Food Security - Recent analysis of the Programme for International Student Assessment (PISA) 2022 by the Public Health Communication Centre results reveals a stark disparity for MÄori students in Aotearoa, with 23.5% missing meals at least once a week due to financial constraints, significantly higher than the 14% average across all students. The situation worsens with 9.5% of MÄori students missing meals daily, compared to the overall 6.5%. This nutritional gap correlates with academic performance, as MÄori students facing hunger fall one to three years behind their consistently fed classmates. These findings underscore the critical link between nutrition and educational outcomes, particularly for MÄori students, emphasising the importance of addressing food insecurity to improve academic achievement among this group.
ā In Brief
š School Lunch Program Evaluation Positive - results show the Ka Ora, Ka Ako free school lunch program is highly effective across 21 criteria, such as providing nutritious meals, improving student well-being, and demonstrating economic benefits.
š Influenza vaccine available from 2 April - the latest quadrivalent vaccine for the winter will be available from Tuesday 2 April. There is no charge for those 65 years and over, along with other eligible groups. Book online here. See how WHO selected the strains here. Protection against influenza illness outcomes and hospitalisation is 55% and 61%, respectively.
š¢ Ethnicity data accuracy - Te Aka Whai Ora released a report emphasising the need for improved quality of ethnicity data in the health sector. The report outlines the current state of the data, the definition of ethnicity, and an action plan that health providers can implement to improve their data. Providers can implement the Ethnicity Data Protocols mentioned in the reports and their data. Centralised monitoring and auditing are also discussed.
š Economic challengesāBased on December 2023 quarterly data, Aotearoa entered a technical economic recession (defined as two consecutive quarters of negative GDP growth); this may reduce government revenue in the near future, putting further downward pressure on government spending.
š©ŗ Situations vacant - A recent NZMJ article stated Aoteroa is 1,700 doctors short, and we have the second highest proportion of overseas trained doctors in the OECD at 48% of our workforce - 60% of whom leave for Australia within two years. News media summary here.
š¬ End Notes
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