Publications

2023 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

Journal Article

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.

 

Keywords

PacificPacific peoplesPasifikaEthnicityCountry of birth

  • BibTex Key
  • Authors C. Grey | J. Paynter | J. Winter-Smith | M. Harwood | V. Selak
  • Tags Pacific health
  • DOI Number https://doi.org/10.1016/j.dialog.2023.100152

    2023 Widening ethnic inequities in heart failure incidence in New Zealand

    Journal Article

    Chan DZ, Grey C, Doughty RN, et al
    Widening ethnic inequities in heart failure incidence in New Zealand
    Heart Published Online First: 03 August 2023
    Objective
    Ethnic inequities in heart failure (HF) have been documented in several countries. This study describes New Zealand (NZ) trends in incident HF hospitalisation by ethnicity between 2006 and 2018.
    Methods
    Incident HF hospitalisations in ≥20-year-old subjects were identified through International Classification of Diseases, 10th Revision-coded national hospitalisation records. Incidence was calculated for different ethnic, sex and age groups and were age standardised. Trends were estimated with joinpoint regression.
    Results
    Of 116 113 incident HF hospitalisations, 12.8% were Māori, 5.7% Pacific people, 3.0% Asians and 78.6% Europeans/others. 64% of Māori and Pacific patients were aged <70 years, compared with 37% of Asian and 19% of European/others. In 2018, incidence rate ratios compared with European/others were 6.0 (95% CI 4.9 to 7.3), 7.5 (95% CI 6.0 to 9.4) and 0.5 (95% CI 0.3 to 0.8) for Māori, Pacific people and Asians aged 20–49 years; 3.7 (95% CI 3.4 to 4.0), 3.6 (95% CI 3.2 to 4.1) and 0.5 (95% CI 0.4 to 0.6) for Māori, Pacific people and Asians aged 50–69 years; and 1.5 (95% CI 1.4 to 1.6), 1.5 (95% CI 1.3 to 1.7) and 0.5 (95% CI 0.5 to 0.6) for Māori, Pacific people and Asians aged ≥70 years. Between 2006 and 2018, ethnicity-specific rates diverged in ≥70-year-old subjects due to a decline in European/others (annual percentage change (APC) −2.0%, 95% CI −2.5% to −1.6%) and Asians (APC −3.3%, 95% CI −4.4% to −2.1%), but rates remained unchanged for Māori and Pacific people. In contrast, regardless of ethnicity, rates either increased or remained unchanged in <70-year-old subjects.
    Conclusion
    Ethnic inequities in incident HF hospitalisation have widened in NZ over the past 13 years. Urgent action is required to address the predisposing factors that lead to development of HF in Maori and Pacific people.
    • BibTex Key
    • Authors A. Kerr | C. Grey | D. Chan | K. Poppe | M. Harwood | M. Lund | MAW. Lee | R. Doughty
    • Tags heart failure
    • DOI Number 10.1136/heartjnl-2023-322795

      2023 How pharmacist-led health services are tailored to minoritized populations, their acceptability and effectiveness: A scoping literature review

      Journal Article

      Hutchings, J.L., Grey, C., Brewer, K.M. and Aspden, T.J., 2023. How pharmacist-led health services are tailored to minoritized populations, their acceptability and effectiveness: A scoping literature review. Research in Social and Administrative Pharmacy.

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        2023 Reasons for ethnic disparities in pre-hospital care pathway following an Out of Hospital Cardiac Events: protocol of a systematic review.

        Journal Article

        Newport R, C. Dicker, B. Ameratunga, S. Harwood, M. Reasons for ethnic disparities in pre-hospital care pathway following an Out of Hospital Cardiac Events: protocol of a systematic review. JMIR Res Protoc (forthcoming). 2023

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          2023 Understanding the barriers and facilitators that influence access to quality cardiovascular care for rural Indigenous peoples: protocol for a scoping review

          Journal Article

          Understanding the barriers and facilitators that influence access to quality cardiovascular care for rural Indigenous peoples: protocol for a scoping review | BMJ Open

          Abstract

          Introduction Māori (the Indigenous peoples of New Zealand) are disproportionately represented in cardiovascular disease (CVD) prevalence, morbidity and mortality rates, and are less likely to receive evidence-based CVD healthcare. Rural Māori experience additional barriers to treatment access, poorer health outcomes and a more significant burden of CVD risk factors compared with non-Māori and Māori living in urban areas. Importantly, these inequities are similarly experienced by Indigenous peoples in other nations impacted by colonisation. Given the scarcity of available literature, we are conducting a scoping review of literature exploring barriers and facilitators in accessing quality CVD healthcare for rural Māori and other Indigenous peoples in nations impacted by colonisation.

          Methods and analysis A scoping review will be conducted to identify and map the extent of research available and identify any gaps in the literature. This review will be underpinned by Kaupapa Māori Research methodology and will be conducted using Arksey and O’Malley’s (2005) methodological framework. A database search of MEDLINE (OVID), PubMed, Embase, SCOPUS, CINAHL Plus, Australia/New Zealand Reference Centre and NZResearch.org will be used to explore empirical research literature. A grey literature search will also be conducted. Two authors will independently review and screen search results in an iterative manner. The New Zealand Ministry of Health Te Tiriti o Waitangi (Treaty of Waitangi) Framework principles will be used as a framework to summarise and construct a narrative of existing literature. Existing literature will also be appraised using the CONSolIDated critERia for strengthening the reporting of health research involving Indigenous Peoples (CONSIDER) statement.

          Ethics and dissemination Ethical approval has not been sought for this review as we are using publicly available data. We will publish this protocol and the findings of our review in an open-access peer-reviewed journal. This protocol has been registered on Open Science Framework (DOI:10.17605/osf.io/xruhy).

          • BibTex Key
          • Authors K.Eggleton | M. Harwood | T.Tane | V. Selak
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            2023 Te Whatu Ora Te Tai Tokerau – Manager – Patient Experience

            Presentation

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            • Authors T.Tane
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              Northland Research Symposium

              All types

              Taria Tane on 23/03/23
              Project introduction and Scoping Review

               

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              • Authors T.Tane
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                Cardiac Society of Auckland and New Zealand Annual Scientific Meeting June 2023

                All types

                Home | CSANZ New Zealand Annual Scientific Meeting 2023 (csanzasm.nz)

                Presentations from MFF team:

                Heart Foundation Lecture – Corina Grey
                Ethnicity/equity and CVD risk factor distribution in Aotearoa New Zealand – Matire Harwood
                Ethnicity/equity and CVD risk factor distribution in Aotearoa New Zealand – Vanessa Selak
                Manawataki Fatu Fatu: Achieving Cardiovascular Care for equity – Karen Brewer
                Cultural safety in paramedic practice: Experiences of Māori and whānau – Sarah Penney
                Achieving equitable health outcomes for Pacific people living with cardiovascular disease in Aotearoa New Zealand: exploring the contribution of community pharmacists – Jess Hutchings

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                  2023 Manawataki Fatu Fatu for ACCESS (Māori and Pacific Hearts in Unison for Achieving Cardiovascular Care in Equity StudieS). Protocol for a Mixed Methods Programme of Research

                  Journal Article

                  Available at https://doi.org/10.1177/16094069231176348

                  • BibTex Key
                  • Authors B. Dicker | C. Grey | J. Paynter | J. Winter-Smith | K. Brewer | M. Harwood | R. Newport | S. Amertunga | S. Hanchard | T. Tuaeetia-Su'a | T.Tane | V. Selak
                  • Tags
                  • DOI Number 16094069231176348
                  • Publisher SAGE Publishing
                  • Edition International Journal of Qualitative Methods

                    2023 TUTOR PHC training and conference

                    Proceeding

                    TUTOR-PHC – Taria Tane
                    27/04/23
                    Scoping Review – Poster Presentation

                    • BibTex Key
                    • Authors T.Tane | taria
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                      2022 Pacific Health Research Symposium 2022

                      Proceeding

                      Pacific Health Research Symposium 2022

                      Our events – The University of Auckland

                      Date: Wednesday 30 November
                      Time: 8am – 4.40pm
                      Venue: Te Papa Ako o Tai Tonga | South Auckland Campus,  6 Osterley Way, Manukau City Centre, Auckland 2104

                      Tania Mullane & Dr Matire Harwood

                      Understanding the workforce for diabetes management with Māori and Pacific Peoples: Using tangata hourua as the framework method for analysis of qualitative research

                      Dr Corina Grey

                      Manawataki Fatu Fatu for ACCESS: a Māori and Pacific-led research programme focused on heart health equity

                      Jess Lagaluga Hutchings

                      Achieving equitable health outcomes for Pacific people living with heart disease in Aotearoa: Exploring the role of pharmacist led health services tailored to specific ethnic groups

                      • BibTex Key
                      • Authors C. Grey | J. Hutchings | M. Harwood
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                        2022 Identification of clinically relevant cohorts of people with heart failure from electronic health data in Aotearoa: potential, pitfalls and a plan

                        Journal Article

                        Authors: Vanessa Selak (Corresponding Author), Katrina Poppe (Co-author), Daniel Chan (Co-author), Corina Grey (Co-author), Matire Harwood (Co-author), Shanthi Ameratunga (Co-author), Sandra Hanchard (Co-author), Susan Wells (Co-author), Andrew J Kerr (Co-author), Mayanna Lund (Co-author), Robert Doughty (Co-author)

                        https://journal.nzma.org.nz/journal-articles/identification-of-clinically-relevant-cohorts-of-people-with-heart-failure-from-electronic-health-data-in-aotearoa-potential-pitfalls-and-a-plan

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                        • Authors
                        • Tags heart failure
                        • Publisher New Zealand Medical Journal

                          2022 Counties Manukau Research Week

                          Proceeding

                          Manawataki Fatu Fatu for CMH Research Week

                          Dr Karen Brewer

                          Whakatoohea/Ngaiterangi

                          Research title: Manawataki: Fatu Fatu for ACCESS (Māori and Pacific hearts in unison for Achieving Cardiovascular Care in Equity StudieS)

                          Karen is a speech-language therapist and kaupapa Māori researcher. She is leading the qualitative aspects of the Manawataki Fatu Fatu research programme. Karen’s main interest is in stroke and aphasia but she is quickly learning about the heart so she can keep up in team discussions and understand what the research participants are talking about.

                          Name: Julie Winter-Smith

                          Iwi or ethnic group: Tongan (`Alaki Fonua/Pelehake, Tongatapu)

                          Role title: PhD candidate

                          Short biography for introduction:  Julie Winter-Smith is a doctoral candidate based in the Section of Epidemiology and Biostatistics at the University of Auckland. She is part of the Manawataki Fatu Fatu for Achieving Cardiovascular Care for Equity StudieS (ACCESS) research programme, which is focused on achieving equity in cardiovascular disease for Māori and Pacific people. Her doctoral research is using Statistics New Zealand’s Integrated Data Infrastructure to investigate patterns of cardiovascular disease and its management among different Pacific ethnic groups, including how this differs for Pacific peoples born outside of New Zealand. Julie’s research is generously funded through the Health Research Council of New Zealand.

                          Dr Sandra Hanchard

                          Research Fellow

                          Research Title: Equity-focused discharge planning for heart failure

                          Sandra is a Pacific researcher of Tongan heritage who is researching what equity looks like for heart health services. Her current focus is discharge planning for heart failure from secondary care to long-term management in the community. She is passionate about redesigning health systems that empower Māori and Pacific patients with long-term conditions to live well and to be partners in their own care. Sandra has a research background in information and communication systems and has recently returned to Aotearoa after a decade living in South-East Asia.

                          Pablo A. Callejas

                          Clinical Support Officer with the Clinical Audit and Research Team, Hato Hone (St John)

                          Iwi or ethnic group: Latin American

                          Research Title: Ethnicity findings from the 2020/21 Out-of-Hospital ST-segment Elevation Myocardial Infarction Registry

                          Pablo has over 10 years’ experience working as a Paramedic. Pablo started with the New York City EMS and has held a variety of Clinical positions. Currently, Pablo holds a Clinical Support position within Hato Hone (St John) as one of the team leading the focused audit portfolio. In his role as a focused auditor, he has authored the inaugural annual STEMI report.

                          • BibTex Key
                          • Authors J. Winter-Smith | K. Brewer | P. Callejas | S. Hanchard
                          • Tags Equity

                            2022 U21 Health Sciences

                            Proceeding

                            U21 Health Sciences Group

                            Award to Manawataki Fatu Fatu, PhD candidate, Jess Hutchings

                            • BibTex Key
                            • Authors J. Hutchings
                            • Tags Pharmacy

                              2022 Understanding the barriers and facilitators that influence access to quality cardiovascular care for rural indigenous peoples: a scoping review

                              Proceeding

                              National Rural Healthcare Conference: Home | NRHC 2022 (nationalruralhealthconference.org.nz)

                              Presentation by Taria Tane

                              Background: Māori are disproportionately represented in cardiovascular disease (CVD) prevalence, morbidity, and mortality rates, and are less likely to receive evidence-based CVD healthcare. Rural Māori in Aotearoa New Zealand experience additional barriers to treatment access, poorer health outcomes, and a greater burden of CVD risk factors, compared to Non-Māori and Māori living in urban areas. Despite these inequities in access and outcomes, little is known about the barriers and facilitators that may influence rural Māori accessing quality CVD healthcare. Importantly, inequities in CVD outcomes and access to quality CVD healthcare in Aotearoa New Zealand are similar to those experienced by Indigenous Peoples, in other nations impacted by colonisation. 

                              Aims/ objectives: To explore the barriers and facilitators in accessing quality CVD healthcare for rural Māori and international Indigenous Peoples in nations impacted by colonisation.  

                              Methods: A scoping review will be performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. A thematic analysis approach, underpinned by Kaupapa Māori Research principles, will be used to describe the literature. In addition, literature will be appraised according to the Consolidated Criteria for Strengthening Reporting of Health Research Involving Indigenous Peoples (CONSIDER) statement. 

                              Findings and implications: We will describe the extent of research available and gaps in research, key barriers and facilitators, and recommendations for future research to benefit of healthcare access for rural Māori and other rural Indigenous Peoples.  

                              • BibTex Key
                              • Authors T.Tane | taria
                              • Tags rural care

                                2022 Paramedicine Research Day

                                Proceeding

                                Paramedicine Research Day 2022 Registration, Thu 20/10/2022 at 9:00 am | Eventbrite

                                Hear from our Paramedicine Academic Staff, Postgraduate and Undergraduate students, who will present the latest research from their research projects. 

                                Manawataki Fatu Fatu will be represented by Rochelle Newport, Sarah Penney and Aroha Ormsby-Brett

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                                • Authors A. Ormsby-Brett | R. Newport | S. Penney
                                • Tags Paramedicine

                                  2022 Pasifika Medical Association Conference

                                  Proceeding

                                  Pasifika Medical Association Conference

                                  4 – 6 September, 2022

                                  Te Papa Museum, Wellington

                                  Conference programme: PMA Conference 2022 – Programme Booklet ONLINE.pdf (pacifichealth.org.nz)

                                  Julie Winter-Smith

                                  Who Are Pacific People In Aotearoa New Zealand? Findings From A Pacific-Led Analysis Of National Health And Non-Health Datasets In The Idi

                                   Julie Winter-Smith

                                  Is It Appropriate To Homogenise Pacific People When Considering Their Need For Cvd Health

                                  Services? A Systematic Review Of The Epidemiology and Management Of CVD Among Pacific People

                                  • BibTex Key
                                  • Authors J. Winter-Smith
                                  • Tags Pacific health