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Understanding smoking – overview with a Pacific lens
Smokefree Nurses Aotearoa Fono, Auckland 2011Smokefree Nurses Aotearoa Fono, Auckland 2011
Population by Ethnicity Auckland Region, 2001 and 2006
Asian12.5%
Pacific11.9%
Maori11.1%
Other6.1%
European64.4%
Total 2001=1,172,997 Pacific people=139,308
Total 2006=1,319,232Pacific people=158,871
Asian17.2%
Pacific12.0%
Maori10.6%
Other6.4%
European64.4%
Pacific People by Culture GroupAuckland Region
Pacific Culture Groups Auckland region %
Samoan 87,987 45.5%
Tongan 40,221 20.8%
Cook Islands Maori 34,887 18.0%
Niuean 17,703 9.1%
Fijian 5,865 3.0%
Tokelauan 1,845 1.0%
Other Pacific 5,046 2.6%
Total Respondents 193,554 100.0%
Ethnic trends in Life Expectancy 1991-2006
60
62
64
66
68
70
72
74
76
78
80
1991 1996 2001 2006
Census Year
Life
exp
ecta
ncy
at b
irth
(yea
rs)
Pacific Maori European
Males Females
65
67
69
71
73
75
77
79
81
83
85
1991 1996 2001 2006
Census YearLi
fe e
xpec
tanc
y at
birt
h (y
ears
)
Pacific Maori European
Source MoH 2009
Potential Avoidable Mortality (PAM)
• One of the measures to estimate potential to improve health.• These causes of death (theoretically) can be avoided by preventive or curative intervention at the individual level.• All deaths after age of 75 are considered unavoidable!.
Potential Avoidable Mortality (PAM)3 Auckland DHBs, 2003-2007
PAM Total %
Ischaemic heart disease 2093 21.4%
Malig neoplasm trachea, bronchus, lung 1144 11.7%
Suicide 714 7.3%
Colo-rectal cancer 683 7.0%
Breast cancer 623 6.4%
Diabetes 575 5.9%
Chronic bronchitis and emphysema 566 5.8%
Intracerebral haemorrhage or occlusion 478 4.9%
Motor vehicle crashes 434 4.4%
Lip, melanoma, other skin cancer 240 2.5%
Potential Avoidable Mortality (PAM)
Pacific People, 3 Auckland DHBs, 2003-2007
PAM Pacific %
Ischaemic heart disease 385 22.6%
Diabetes 212 12.4%
Malig neoplasm trachea, bronchus, lung 161 9.4%
Intracerebral haemorrhage or occlusion 107 6.3%
Breast cancer 78 4.6%
Suicide 72 4.2%
Chronic bronchitis and emphysema 66 3.9%
Nutritional deficits including anaemia 60 3.5%
Colo-rectal cancer 50 2.9%
Motor vehicle crashes 50 2.9%
Cancer
Breast cancer commonest cancer for ALL NZ women
Lung cancer 8.4% of Pacific female cancer (7% non Maori, non Pacific, 17% for Maori)
Beware rise in Pacific female youth smoking rates
• SOIPurpose
Our job is to improve, promote and protect the health of New Zealanders… we will help ensure New Zealanders live longer, healthier and more independent lives.
VisionWe want New Zealanders to live longer, in better health, with continued and improved independence.
We will transform our health and disability system to increase quality and deliver better value for money. Our focus is on reducing waste, and improving systems, processes and culture, in order to:put the wellbeing of New Zealanders at the centre of decision-makingsupport greater clinical leadershipimprove the integration and co-ordination of services.
Service delivery is better, sooner and more convenient for Pacific people
The health system is adaptive, innovative and continually improving for Pacific peoples
‘Ala Mo’ui Goals
‘Ala Mo’ui principles
•Respecting Pacific culture
•Valuing family
•Quality healthcare
• Working together
Respecting culture and family
Relationships - family based priorities and kinship obligations, reciprocity , custom and group interaction, enduring – lasts over centuries
Spirituality – Christian and ancient tapu beliefs coexist, therefore Church and Ministers are key leaders. Role for traditional healing
Cultural values and beliefs - dynamic, diverse and evolving
Mobility of the Pacific population
Quality healthcare
Key dimensions of quality - access, equity, cultural competence, safety, effectiveness, efficiency and patient-centeredness - implicit in delivery of health and disability services to Pacific peoples.
Quality healthcare at individual, team, organisation and overall system level.
Source: Quality dimensions for the New Zealand Health and Disability System in Minister of Health. 2003. Improving Quality (IQ): A
systems approach for the New Zealand health and disability sector. Wellington: Ministry of Health
Working together
Preferred holistic perspectives rather than piecemeal approaches
Inter-sectoral development across central and local government - health, social and economic actions
Wraparound approaches to service provision, e.g. Integrated Family Health centres, Whanau ora
Community development – e.g. Pacific providers
HPV Immunisation – at Dec 2010
National Coverage by Ethnicity – (young women born during 1997) - Dose 1 Immunisation coverage by ethnicity: Maori 64% Pacific 76% - target reachedAll 51% Dose 2 Immunisation coverage by ethnicity is: Maori 61% - target reachedPacific 75% - target reachedAll 49% Dose 3 Immunisation coverage by ethnicity is: Maori 56% - target reachedPacific 70% - target reachedAll 46%
Strong and courageous Leadership for Pacific Health
Advocate and apply a Pacific lens to:
The systems
The networks
The pathways
The programmes (Prof Sir Muir Gray)