š Lives saved by COVID vaccine; rheumatic fever prevention; decarbonisation for health gain; learning from COVID misinformation; 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
COVID Vaccination Saved Lives and Reduced Hospitalisations
Datta, S. D., Vattiato, G., Maclaren, O. J., Hua, N., Sporle, A., & Plank, M. J. (2024). The impact of Covid-19 vaccination in Aotearoa New Zealand: A modelling study. Vaccine. https://doi.org/10.1016/j.vaccine.2024.01.101
This study calculated the impact of COVID-19 vaccination in Aotearoa during the 18 months spanning 1 January 2022 to 30 June 2023. Vaccines saved an estimated 6,650 lives and prevented 45,100 hospitalisations over the 18-month period. However, due to disparities in vaccine rollout, vaccination rates among the MÄori population were lower, leading to preventable deaths. The authors calculated that if the vaccination rate among MÄori were the same as the New Zealand European population, there would have been 77 fewer deaths and 998 fewer hospitalisations. To improve health outcomes for the MÄori population, it's crucial to address inequities in vaccine coverage and ensure equitable access to vaccination. Achieving high vaccination rates, particularly among at-risk populations, can significantly reduce the health burden of Covid-19 for all communities.
Strategies for Preventing and Controlling Acute Rheumatic Fever and Rheumatic Heart Disease in Aotearoa
Wilson, N., Anderson, A., Baker, M. G., Bennett, J., Dennison, A., McGregor, R., Middleton, F., Moreland, N. J., & Webb, R. (2024). The roles of immuno-modulator treatment and echocardiographic screening in rheumatic fever and rheumatic heart disease control: research from Aotearoa, New Zealand. Journal of the Royal Society of New Zealand. https://doi.org/10.1080/03036758.2024.2306981
This article summarises crucial strategies for preventing and controlling acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Key findings include the emphasis on primordial prevention to address social determinants, primary prevention through sore throat management programs and vaccine research, and the significance of echocardiographic case detection in disease control. The article also highlights the role of immunology and immunotherapy in treating acute rheumatic fever. For health professionals and policymakers, prioritising primordial prevention efforts, supporting sore throat management programs, and advocating for increased access to echocardiographic screening can significantly improve health outcomes.
Improving Recognition and Awareness of Tamariki MÄori in Hospital
Pennell, T., Calder, N., & Glubb-Smith, K. J. (2023). A quality improvement approach to improving recognition of MÄori tamariki (children) and assessing barriers to culturally responsive care in a paediatric ward setting. Child: Care, Health and Development. https://doi.org/10.1111/cch.13176
This study focused on improving the recognition of MÄori tamariki (children) and assessing barriers to culturally responsive care in a pediatric ward setting. The research aimed to evaluate the impact of introducing a custom sticker prompt on the front cover of clinical notes to assist with correct ethnicity identification. The study found that stickers increased accuracy in identifying MÄori patients and improved awareness of ethnicity documentation. The stickers also encouraged a holistic care approach and increased engagement regarding cultural needs and ethnicity. Overall, the stickers were a useful tool for healthcare workers to improve recognition and awareness of ethnicity and to increase dialogue around cultural needs.
Enhancing Cultural Safety in Pharmacy Practice for Pharmacists
Hikaka, J., Parore, N., McIntosh, B., Haua, R., Mohi, K., & Anderson, A. (2024). Translating research into a relevant education activity to fulfil pharmacistsā continuing professional development requirements. Exploratory Research in Clinical and Social Pharmacy, 100422. https://doi.org/10.1016/j.rcsop.2024.100422
This study evaluated an educational activity for pharmacists in Aotearoa, focusing on culturally safe care for MÄori communities. The activity included a video summarising MÄori experiences of pharmacy care and reflective questions. Results showed that the activity was well-received; participants expressed actions they would take, such as providing a better understanding of medicines and making pharmacists more available to the community. Despite identifying barriers like time and staffing issues, participants highlighted the importance of addressing power imbalances in the pharmacy setting and recognising the role of whÄnau in medicine-related care for MÄori. This study demonstrates the effectiveness of using research findings to develop relevant CPD activities for pharmacists, with potential applications in other healthcare professions.
Addressing Disparities in Lung Cancer Treatment for MÄori Patients
Gurney, J., Davies, A., Stanley, J., Cameron, L., Costello, S., Dawkins, P., Henare, K., Jackson, C., Lawrenson, R., Whitehead, J., & Koea, J. (2024). Access to and timeliness of lung cancer surgery, radiation therapy, and systemic therapy in New Zealand: a Universal Health care context. JCO Global Oncology, 10. https://doi.org/10.1200/go.23.00258
This study examines disparities in access to lung cancer treatment for MÄori and non-MÄori patients. The findings revealed that MÄori patients had lower odds of accessing surgery, particularly curative surgery, compared to non-MÄori patients. However, there were no disparities in the timing of surgery or systemic therapy. MÄori patients also appeared to have higher odds of accessing radiation therapy, but further investigation is needed to understand the significance of this difference. It's crucial to ensure equitable access to surgical treatment for all patients to address these disparities. Implementing targeted interventions and policies can help improve timely and appropriate treatment for MÄori patients with lung cancer.
Enhancing MÄori Health through Transport Decarbonisation
Shaw, C., Mizdrak, A., Gage, R., McLeod, M., Jones, R., Woodward, A., & Cobiac, L. (2024). Policy approaches to decarbonising the transport sector in Aotearoa/NZ: Equity, health and health system impacts. medRxiv. https://doi.org/10.1101/2024.01.29.24301894
This study explores the potential health impacts of decarbonising the transport sector in Aotearoa, particularly focusing on the MÄori population. The findings reveal that the "Behaviour Change" and "Technology Change" pathways proposed by the New Zealand Climate Change Commission lead to improvements in population health and reductions in health system costs. Notably, the Behaviour pathway shows larger health gains, especially for MÄori, and can potentially reduce health inequities between MÄori and non-MÄori. Increasing physical activity had a greater impact on population health than relying on low-emission vehicles. Decarbonising transport can reduce health inequities if implemented equitably. The study emphasises the importance of equitable implementation of decarbonisation policies and highlights the significant impact of physical activity on population health.
š Chart of the Week
Impact of the COVID vaccine in Aoteaora - The first research article summarised the impact of the COVID-19 vaccine in Aotearoa. The chart below presents those results - the horizontal axis shows 18 months of time and the vertical axis, the number of deaths. The red line shows the number of actual deaths in Aotearoa during 2022 and the first half of 2023. The green line shows the number of deaths that would have occurred without vaccines (a difference of 6,650 people). The purple line shows the number of deaths without vaccines and anti-virals. Katalin KarikĆ³ and Drew Weissman were awarded a Nobel Prize in October for their work on mRNA vaccine development.
ā In Brief
š¦ Time in nature is associated with better health outcomes. This study with a MÄori cohort showed youāll need longer than 30 minutes in nature to improve your nasal microbiome.
š«“š½ This cost-effective intervention trained kaumatua to be health advisors for other kaumatua. A range of positive health and social outcomes were experienced by service users, along with improved personal skills.
š¦ On Wednesday night (21 Feb) in Wellington, the Royal Society Te ApÄrangi is hosting a seminar, āWhat can we learn from Covid-19 misinformation?ā featuring the Prime Ministerās Chief Scientific Advisor, Professor Dame Juliet Gerrard. Tickets are here.
š This extension for the Chrome, Firefox, and Microsoft Edge internet browsers will search the web to check if there is a free version of a paywalled journal article youāre viewing.
šš½ Massive mana wave to the Pasifika Medical Association - theyāve made the New Zealand Medical Journal completely free to read; subscribe to the journal (for free) and read all past and present issues in full.
š¬ End Notes
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