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.

‘Ala Mo’ui Vision

“Pacific people leading longer,

healthier and more

independent lives”

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%

‘It takes three’…in a family!

Through a consumer’s eyes……..

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)

Vinaka vakalevu

Malo ‘aupito

Fa’afetai lava

Meitaki maata

Faka’aue lahi

Fakafetai

Thank you