Maori Health Review

Making Education Easy Issue 52 – 2014

Maori Health Review

Are hearing losses among young Māori different to those found in the young NZ European population?

Authors: Digby JE et al.

Summary: This group of researchers analysed cases from the New Zealand Deafness Notification Database (New Zealand’s annual reporting system on hearing-impaired children from birth to 19 years of age, covering the periods 1982–2005 and 2009–2013) and children implanted by the Northern Cochlear Implant Programme (the public provider for cochlear implants for all children and young people living in areas north of Taupo), to determine whether young Māori have more permanent bilateral hearing loss, or less severe and profound hearing loss than NZ Europeans. In Chi-squared analyses, Māori are less likely to be severely or profoundly hearing impaired and are more likely to have mild-moderate hearing loss and significantly more bilateral losses as compared with their NZ European peers. Young Māori are more likely to be diagnosed with permanent hearing loss greater than 26 dB HL, averaged across speech frequencies, with 39–43% of hearing loss notifications listed as Māori. Cochlear implant data show that Māori are less likely to receive a cochlear implant.

Comment: Similar to previous papers describing the cause and extent of sight-loss, this research provides important evidence to inform and improve the ways we prevent, treat and manage hearing loss for Māori whānau.

Reference: N Z Med J 2014;127(1398):98-110


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Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

Research Review publications are intended for New Zealand health professionals.

Evaluation of the Canterbury under-18 seasonal influenza vaccination programme

Authors: Calder K et al.

Summary: Findings are reported from an evaluation of the performance of the 2013 Canterbury under-18 Seasonal Influenza Vaccination Programme (Christchurch, NZ). Overall uptake of influenza vaccination in 2013 was 32.9% (increased from 18.5% in 2012), close to the target of 40%. Overall uptake in primary care was higher than in the school-based programme (29.2% vs 19.7%). Māori students had higher uptake than NZ European students in the school-based programme. In primary care, uptake for both Māori and Pacific children was lower than overall uptake and there was a marked gradient in uptake by socioeconomic quintile, with 30.2% uptake in the least deprived quintile (richer areas) compared to 21.9% uptake in the most deprived quintile (poorer areas). Qualitative analysis of interviews held with participating schools identified that the health and education sectors need to improve partnership and communication, to improve vaccination uptake still further.

Comment: The stand-out point for me was that school-based programmes appear to be more successful for vaccinating under-18s than delivery of immunisation through primary care.

Reference: N Z Med J 2014;127(1398):19-27


Pharmacy-based screening for atrial fibrillation in high-risk Māori and Pacific populations

Authors: Walker N et al.

Summary: Outcomes are reported from a study undertaken in late 2013/early 2014 to determine the feasibility of using the AliveCor® iPhone heart monitor to screen for undiagnosed atrial fibrillation (AF) in a high-risk primary care population, using a community pharmacist in Auckland as the first point of contact for screening. The study recruited 121 Māori and Pacific people aged ≥55 years who visited the All Seasons Pharmacy in Te Atatu, Auckland. Twenty participants were found to have AF upon screening (7 Māori and 13 Pacific people). Two people screened had a new diagnosis of AF and 2 known AF cases appeared not to be receiving warfarin. The heart monitor was considered easy to use by both pharmacists and participants, and participating GPs gave overwhelmingly positive feedback on the study. A larger NZ study is planned to verify these results.

Comment: Although this paper focusses more on the feasibility of implementing a screening programme (for a significant health issue for Māori), I’ve included it here to let readers know that it will soon be fully tested and, pending those results, perhaps made more widely available.

Reference: N Z Med J 2014;127(1398):128-31


Maori Health Review
Maori Health Review

The use of interpretive description within Kaupapa Māori research

Authors: Brewer KM et al.

Summary: This paper reports outcomes from research that combined Kaupapa Māori principles and practices (an Indigenous research approach that is decolonising and transformative) with interpretive description (a qualitative methodology used to generate knowledge relevant to the applied health disciplines) to investigate the experiences of Māori with aphasia and their whānau. The paper describes how these research approaches work together in theory, and the synergies that became apparent in practice.

Comment: I’ve included this paper as it confirms the significance of Kaupapa Māori research in clinical research. Oh, and I am an author!

Reference: Qual Health Res 2014;24(9):1287-97


Neighbourhood availability of alcohol outlets and hazardous alcohol consumption in New Zealand

Authors: Ayuka F et al.

Summary: This NZ research sought to determine whether an association exists between the availability of alcohol products and individual-level alcohol consumption. Measures capturing the availability of alcohol retailers were calculated for neighbourhoods across the country and then appended to a national health survey. While at the national level there was no evidence for an association between hazardous consumption and alcohol outlet access, there was evidence of associations with neighbourhood retailing for younger Māori and Pacific peoples males; younger European females; middle-aged European men; and older men. The paper concludes that these findings demonstrate how ‘alcogenic’ environments are linked to excessive drinking in this country, within certain vulnerable populations

Comment: Further to the previous paper on ‘alcohol policy and health outcomes’, the impacts of policies will affect people to varying degrees.

Reference: Health Place 2014;29:186-99


Climate change and the right to health for Māori in Aotearoa/New Zealand

Authors: Jones R et al.

Summary: These researchers describe the impacts of climate change on health and the determinants of health for Māori, as well as the health co-benefits of climate action. Issues relating to climate change and Māori health were analysed within a right-to-health analytical framework, which encompasses all aspects of the right to the highest attainable standard of health, including the determinants of health, and articulates those obligations and responsibilities that must be met by the State. The paper considers the obligations of the NZ government, within a right-to-health framework, to address a broad range of issues at many different levels. The researchers identify a number of important areas where the government is currently failing to meet these obligations, and they go on to describe future measures that are required in order to avoid further encroaching on the right to health.

Comment: A great paper. The authors provide detailed descriptions of the implications of climate change for Māori health if current policy settings do not change; and ways in which governments should prepare for the impacts of climate change and support Indigenous communities to adapt.

Reference: Health Human Rights J 2014;16(1):54-68