š MÄori provider funding, lung cancer screening, lower food prices, rangatahi mental health, 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.
This edition explores individualsā views on a potential lung cancer screening program, trends in colon cancer incidence, and patterns in rangatahi mental health. We also examine annual food price changes, and the trends in MÄori health provider funding.
š¬ The Latest Research
Exploring MÄori Perspectives on Lung Cancer Screening for Aotearoa: What Were the Key Findings?
Colhoun, S. R., Parker, K., McCook, S., Bartholomew, K., Baty, B., Maxwell, A., Pipi, K., Marama, M., & Crengle, S. (2024). Perspectives of potentially eligible Indigenous MÄori on a lung cancer screening programme: A qualitative study. *New Zealand Medical Journal*, 136(1593). https://doi.org/10.26635/6965.6335
"Lung cancer is the greatest single contributor to the gap in life expectancy between MÄori and non-MÄori."
This study explores the perspectives of potentially eligible people on a lung cancer screening programme, uncovering barriers and facilitators for participation for MÄori participants. Key findings include positivity towards screening and fear of the illness. A key barrier to participation was negative healthcare experiences in the past. Enablers included practical support for attendance at screening and culturally safe practices. To improve lung cancer outcomes for MÄori, implementing culturally safe lung cancer screening with practical support, clear communication, and GP involvement is essential. In parallel, smoking cessation efforts and the prevention of smoking initiation are essential.
Is Aotearoa's Healthcare System Responding Effectively to the Rise in Early-Onset Colorectal Cancer Among MÄori?
Waddell, O., Pearson, J., McCombie, A., Marshall, H., Purcell, R., Keenan, J. I., Glyn, T., & Frizelle, F. (2024). The incidence of early onset colorectal cancer in Aotearoa New Zealand: 2000ā2020. BMC Cancer, 24(1). https://doi.org/10.1186/s12885-024-12122-y
This study explores the incidence of early-onset colorectal cancer (EOCRC) (age < 50 years) in Aotearoa from 2000 to 2020. While overall age-standardised colorectal cancer rates declined between 2000 and 2020, there was no significant decrease for the MÄori population. In contrast, EOCRC surged by 26% per decade, with a higher increase for MÄori individuals of 36% per decade. To address these trends, timely diagnosis, educational initiatives for patients and healthcare providers, lowering the screening age, and enhancing survivorship care for EOCRC patients are crucial. Implementing these strategies can mitigate disparities and improve health outcomes for the MÄori community.
Should we adjust age-based criteria for aortic valve replacement procedures to improve health outcomes for MÄori?
Ryan, T. D., & Ryan, J. B. (2024). Differences in life expectancy within and between countries: implications for domestic TAVI guidelines in Australia and Aotearoa New Zealand. The New Zealand Medical Journal, 136(1593). DOI: 10.26635/6965.6402
This article by two Australian authors explores the need for tailored age-based criteria for aortic valve replacement procedures in Aotearoa. It highlights the disparities in life expectancy between different populations and emphasises the importance of considering sex-specific age-based recommendations. The authors suggest raising the age of consideration for Transcatheter Aortic Valve Implantation (TAVI) for women. For MÄori (and Pacific peoples, and Aboriginal and Torres Strait Islander people), the data suggest a need for earlier access to transcatheter aortic valve implantation (TAVI) due to lower life expectancy and a higher prevalence of rheumatic heart disease. Implementing sex-specific age-based criteria could improve health service access, and outcomes by addressing these disparities. For a quick refresher video on TAVI, click here.
Unlocking Better Mental Health Outcomes for MÄori Rangatahi: Are We Doing Enough?
Sutcliffe K, Wilson M, Clark TC, Crengle S, Fleming T (Theresa). Distinct profiles of mental health need and high need overall among New Zealand adolescents ā Cluster analysis of population survey data. Australian & New Zealand Journal of Psychiatry. 2024;0(0). doi:10.1177/00048674241243262
This analysis of data from the Youth19 Rangatahi Survey has unveiled useful insights into the mental health landscape of Aotearoa's young people, with implications for MÄori rangatahi. The study retrospectively analysed self-reported data from 7,721 individuals aged 13-18 years, revealing five distinct mental health clusters, including healthy (40%), anxious (28%), stressed and hurting (9%), distressed and ideating (16%), and the severe cluster (6%). The research highlighted a disproportionate representation of MÄori in higher severity clusters, suggesting a pressing need for affordable, accessible health services and culturally centred, holistic health models for these rangatahi. The study advocates for immediate, scalable mental health services tailored to the unique needs of MÄori youth, emphasising the integration of traditional practices and community support.
Uncovering Medication Dispensing Discrepancies: Are Prescription Inequities Misjudged?
Norris, P., Horsburgh, S., Waterhouse-Perry, G., & Napier, P. (2024). Inequities in medicines use are probably much worse than we thought. Journal of Primary Health Care, 16(1), 99ā100. https://doi.org/10.1071/hc23114
This article explores the complexities of medication dispensing in community pharmacies, and presents potential inaccuracies in the estimation of prescription disparities among ethnic groups. The authors challenge the common assumption that "dispensed" signifies patients leaving with their medication, revealing that prescriptions can be processed and recorded in pharmacy databases without the patient collecting it. This discrepancy may lead to an overestimation of medicine use, particularly for marginalised groups. Moreover, it complicates the evaluation of policy changes, such as the elimination of prescription charges. Understanding these intricacies is crucial for creating standardised data definitions in healthcare and accurately assessing inequities.
š Chart of the Week
š Annual food price inflation slowed to 0.7 percent in March 2024, marking the smallest increase since April 2021. The decrease was primarily driven by cheaper fruit and vegetable prices, with prices for other food groups still on the rise. Monthly food prices also fell by 0.5 percent in March 2024, with decreases in fruit and vegetable prices contributing to the decline. Read more at StatsNZ.
ā In Brief
š° MÄori health provider funding increased by 69% between 2018/19 and 2022/23 to $523.5m (2.5% of Vote Health). Other types of funding, such as for MÄori primary health organisations and general practices, showed a substantial increase of $196.1m. Overall, total funding to MÄori health providers saw a significant rise from $401m in 18/19 to $813m in 22/23.
ā¤ļøāš©¹ Co-design solutions for rheumatic fever have been collected in a recent project. ThinkPlace and three design team partners (MÄori, Samoan, and Tongan) have reported back on co-design initiatives to prevent and manage rheumatic fever in TÄmaki Makaurau.
š¦· Fluoridation summary from the ManatÅ« Hauora. The Ministry of Health recently published summary information on water fluoridation. The average ongoing cost of community water fluoridation is $2.60 per person per year for water supplies that serve populations of over 500 people; in addition, every dollar spent on water fluoridation will save around $9 in downstream dental care costs. These savings will mostly benefit individuals by preventing the need for fillings and tooth extractions. These benefits are greater for Maori and Pacific peoples.
ā ļø Risks of Marketing Smokeless Tobacco and Oral Nicotine Products to Young People were discussed in this NZMJ. It highlights concerns about tobacco companies targeting young people with marketing strategies for new smokeless tobacco and oral nicotine products, emphasising the need for stricter regulations to protect young people from nicotine addiction. This topic was covered in a Public Health Communication Centre briefing recently also.
š Maternal immunisation rates need an urgent boost - rates of vaccination among hapÅ« mÄmÄ are critically low, particularly among MÄori and Pacific communities, posing severe health risks and highlighting the need for targeted interventions. This Public Health Communication Centre briefing summarises the trends and opportunities available to address this issue.
š¬ End Notes
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