Risk factors
Obesity
Pacific people are disproportionately affected by chronic diseases caused by smoking, poor diet and physical inactivity. Several studies have shown that more than 65% of Pacific people are obese. Obesity is one of the major causes of poor health, especially diabetes, for adult Pacific people. It is also a growing problem among Pacific children and young people. Results from the 2014/15 New Zealand Health Survey showed that 10.8% of New Zealand children aged 2–14 were overweight or obese. The figures were worse for Māori and Pacific children – 14.8% and 29.7% respectively. A major cause of obesity is the consumption of unhealthy food and sugar-sweetened beverages, and lack of regular physical activity.
Extremely obese kids
A 2007 Otago University study found almost 11% of New Zealand Pacific Island children were extremely obese, compared to just 0.8% of European and other non-Māori children. Researcher Dr Alisa Goulding said, ‘Most parents probably didn’t realise their children are so heavy and so fat.’ 1 Their size posed health threats like Type 2 diabetes. Goulding said that more research was needed to discover the reasons for the ethnic differences and find ways to prevent severe obesity in children.
Alcohol
The drinking patterns of Pacific people are also more harmful, with higher reported rates of violence associated with drinking than for the general population. A 2003 study found that 57% of Pacific people drank alcohol, compared to 85% of the total population. However, Pacific people had a greater average annual consumption of alcohol (21 litres) than the New Zealand average (11 litres). Moreover, 33% of Pacific drinkers consumed enough to feel drunk at least weekly – as against 9% of drinkers nationally.
This general pattern was confirmed in the 2014/15 New Zealand Health Survey. Fifty-six per cent of Pacific people 15 and over had consumed alcohol in the past year, compared to a national figure of 79.5%, but they had higher rates of hazardous drinking.
Tobacco
While tobacco use in New Zealand has declined, the prevalence of smoking remains higher among Pacific people, especially men. In 2014/15, 24.7% of Pacific people smoked, compared with 16.6% of all New Zealanders.
Health service delivery
Hospital admissions
Hospital admissions for preventable conditions such as asthma and diabetes are two to three times as high among Pacific people as other New Zealanders. Pacific people with asthma are seen more often in hospital emergency departments and are less likely to receive preventive therapy. Pacific people with diabetes develop more complications as a result of their disease. Children of Pacific origin are six times as likely to be admitted to hospital with pneumonia as other New Zealand children. These problems probably stem from delays in seeking care that are compounded by traditional beliefs about health and illness, poor access to primary care providers and lack of confidence in hospital services.
The Pacific touch
Teuila Percival, an Auckland paediatrician of Samoan descent, commented that ‘[a] Samoan nurse once explained to me about “the Pacific touch.” What is the Pacific touch? It is taking the time to stop and pray with a family. It is taking the time to teach a young mother to cook. It is being committed and dedicated and passionate about our people. The Pacific touch is that quality that sets a special few of our nurses and health workers apart.’2
Pacific primary health-care providers
Pacific people were less likely to go to doctors’ surgeries and medical centres, leading to more of them being admitted to hospital than the general population. From the late 20th century this began to change, as Pacific-owned primary health care services were set up. The first was West Auckland’s Pasifika Healthcare, in 1989.
By 2000 there were 30 Pacific-owned health-provider organisations around New Zealand. They were a response to ongoing problems with access to primary health care which was market-driven, medically focused and sometimes unresponsive to the needs and expectations of Pacific people. There was also no provision for public input into primary health-care service delivery, and a severe shortage of doctors who could speak a Pacific language. Pacific-owned health services have improved choices for Pacific people, but the majority of the Pacific population continue to be served by mainstream providers.
In the 2010s Pacific people in New Zealand continued to be low users of health-care services despite having high health needs. Targeted health initiatives for Pacific people were developing, but more substantial changes were needed to make health services more accessible.
