Shiloh
Editor, Senior Moderator
Source: http://www.nzdoctor.co.nz/news?article=ca283087-fd3d-4376-808e-3f4224afb66c
15 SEPTEMBER 2009
Swine flu hit Maori and Pacific people harder
Virginia McMillan
vmcmillan@clear.net.nz
DAILY NEWS: Maori and Pacific people were hospitalised with swine flu at much higher rates than European or other New Zealanders this winter
Maori and Pacific Island people?s high rates of severe swine flu this winter provide another, particularly vivid example of health inequalities, says Michael Baker of Otago University?s public health department.
The lead author of an academic review of the New Zealand experience of influenza A (H1N1), published last month in the journal Eurosurveillance, the associate professor says pandemic influenza is a good test of our system and society.
?We should take [the message from it] really seriously,? Dr Baker says.
Higher hospitalisation rates
Markedly higher rates of severe disease for Maori and Pacific peoples are reflected in their hospitalisation rates between April and August this year, which, at 43 and 94.2 per 100,000, respectively, were several times higher than the rate for Europeans and others (14.1 per 100,000), the study reports.
?Similar ethnic inequalities between Maori and non-Maori were seen for fatalities in the 1918 influenza pandemic in New Zealand,? the authors say.
Dr Baker says although general health and health services have improved since 100 years ago, ?we still have persistent inequalities that we really should be addressing?.
Household crowding and related factors, higher rates of comorbidities and, arguably, poorer access to care are likely factors in Maori and Pacific people?s more severe illness.
?It definitely isn?t acceptable,? says Wellington School of Medicine-based Dr Baker.
Crowded living conditions a factor
Papakura GP Jacqueline Allan, until recently a Te Akoranga a Maui representative on the RNZCGP executive, says the virus spread in her community from people who had visited Australia, through several households at a time because of the ?coming and going? between houses and as a result of crowded housing in high-rent areas.
Many houses aren?t suitable for the way Maori live, Dr Allan says.
According to college executive member Peter Jansen, of Mauri Ora Associates, his recent research on the Maori patient?s experience shows the importance of the relationship with the practitioner.
?Yes, Maori are more likely to live in substandard housing, and other factors put them at greater risk, but the response of the health system is patchy. There is room for improvement.
?There is now good evidence on how care can be improved ... if you do simple stuff like ask your community the best way to go.?
Dr Allan says rather than swine-flu centres, GPs are best placed for managing epidemics. They know the families and can sort out serious symptoms from the minor ones, she says.
A third of infected Kiwis hospitalised
In Dr Baker?s study, at 23 August, a total of 3179 people had the virus, 30.6 per cent of whom had been hospitalised.
General practice consultations were the equivalent of a cumulative total of 17,672 patients nationwide.
The Ministry of Health will tomorrow publish its next update on New Zealand cases and deaths from the strain.
At 11 September, the ministry reported that confirmed cases numbered 3151, just one more than on 9 September. The cumulative number of deaths was 17.
Related links
Baker M, et al. Pandemic influenza A(H1N1)v in New Zealand: the experience from April to August 2009
Jansen P, et al. Consumer Use & Experience of Health & Disability and ACC Services (he ritenga whakaaro)
15 SEPTEMBER 2009
Swine flu hit Maori and Pacific people harder
Virginia McMillan
vmcmillan@clear.net.nz
DAILY NEWS: Maori and Pacific people were hospitalised with swine flu at much higher rates than European or other New Zealanders this winter
Maori and Pacific Island people?s high rates of severe swine flu this winter provide another, particularly vivid example of health inequalities, says Michael Baker of Otago University?s public health department.
The lead author of an academic review of the New Zealand experience of influenza A (H1N1), published last month in the journal Eurosurveillance, the associate professor says pandemic influenza is a good test of our system and society.
?We should take [the message from it] really seriously,? Dr Baker says.
Higher hospitalisation rates
Markedly higher rates of severe disease for Maori and Pacific peoples are reflected in their hospitalisation rates between April and August this year, which, at 43 and 94.2 per 100,000, respectively, were several times higher than the rate for Europeans and others (14.1 per 100,000), the study reports.
?Similar ethnic inequalities between Maori and non-Maori were seen for fatalities in the 1918 influenza pandemic in New Zealand,? the authors say.
Dr Baker says although general health and health services have improved since 100 years ago, ?we still have persistent inequalities that we really should be addressing?.
Household crowding and related factors, higher rates of comorbidities and, arguably, poorer access to care are likely factors in Maori and Pacific people?s more severe illness.
?It definitely isn?t acceptable,? says Wellington School of Medicine-based Dr Baker.
Crowded living conditions a factor
Papakura GP Jacqueline Allan, until recently a Te Akoranga a Maui representative on the RNZCGP executive, says the virus spread in her community from people who had visited Australia, through several households at a time because of the ?coming and going? between houses and as a result of crowded housing in high-rent areas.
Many houses aren?t suitable for the way Maori live, Dr Allan says.
According to college executive member Peter Jansen, of Mauri Ora Associates, his recent research on the Maori patient?s experience shows the importance of the relationship with the practitioner.
?Yes, Maori are more likely to live in substandard housing, and other factors put them at greater risk, but the response of the health system is patchy. There is room for improvement.
?There is now good evidence on how care can be improved ... if you do simple stuff like ask your community the best way to go.?
Dr Allan says rather than swine-flu centres, GPs are best placed for managing epidemics. They know the families and can sort out serious symptoms from the minor ones, she says.
A third of infected Kiwis hospitalised
In Dr Baker?s study, at 23 August, a total of 3179 people had the virus, 30.6 per cent of whom had been hospitalised.
General practice consultations were the equivalent of a cumulative total of 17,672 patients nationwide.
The Ministry of Health will tomorrow publish its next update on New Zealand cases and deaths from the strain.
At 11 September, the ministry reported that confirmed cases numbered 3151, just one more than on 9 September. The cumulative number of deaths was 17.
Related links
Baker M, et al. Pandemic influenza A(H1N1)v in New Zealand: the experience from April to August 2009
Jansen P, et al. Consumer Use & Experience of Health & Disability and ACC Services (he ritenga whakaaro)
