Like all New Zealanders, Pacific peoples desire good health and wellbeing (Tamasese et al 2010). At the same time, many Pacific people have beliefs about individual health, family and community needs and realities that are different from those of other New Zealanders (Southwick et al 2012). These beliefs can influence health choices and behaviours. For instance, the financial priorities of many Pacific individuals centre on maintaining relationships, meeting their immediate family needs, donating to church, and making contributions to family, both in New Zealand and in Pacific Island countries of origin (Tait 2009). Such financial obligations can impact on families’ ability to pay for health services. Their use of traditional Pacific medicine and healing can also influence the way that Pacific peoples use health care services in New Zealand (Ministry of Health 2008).
Pacific peoples appear to be more connected socially than many other population groups in New Zealand (Tait 2009). For example, many Pacific families are strong participants in church and community activities, which create and reinforce strong social connections and therefore resilience (Tait 2009). A number of recent health initiatives have successfully built on the strengths of Pacific communities, such as the immunisations campaigns for Pacific children, and Pacific church initiatives to promote physical activity and healthy eating.
Because of these unique Pacific factors and strengths, it is important that Pacific peoples are more strongly engaged in identifying and developing effective approaches that will work for them. Pacific participation helps to spread knowledge, awareness and understanding of Pacific health issues and encourages collective ownership of and action on health issues.
While there are complex barriers that impact on the health status of Pacific peoples, health professionals are in a position to better support them to be healthy. For instance, many Pacific people are unaware of the services available to them through government agencies (Koloto 2007), or from health professionals and providers (Pacific Health Research Centre 2003; Paterson et al 2004). Some groups of Pacific peoples face particularly complex barriers in accessing information and support. Many of these groups are among those most in need, including Pacific peoples with disabilities and Pacific informal caregivers (Goodhead and McDonald 2007; National Health Board 2010).
Poor health literacy is a significant barrier to accessing health care (Ministry of Health 2010a) and results in poor health outcomes (Kickbusch et al 2005). Ethnic minorities, particularly people who speak English as a second language, tend to have lower health literacy (Zanchetta and Poureslami 2006). Evidence suggests that having a workforce that reflects the population it serves improves the delivery of culturally competent care (Cohen et al 2002).
What are we seeking to achieve?
The Ministry of Health wants to enable Pacific peoples to get the most benefit from the health system, through:
improving the health literacy of Pacific peoples so that they can make healthy choices and gain better access to the health and disability system – which we will achieve by supporting research on effective approaches to strengthen health literacy; ensuring that health programmes work for people with low levels of health literacy and raising health literacy awareness; and strengthening the practice of health literacy in the health workforce through cultural competency education
working with lead providers of the Healthy Families New Zealand initiative to implement programmes that enable Pacific families and communities to live healthier lives.
How are we going to measure this?
The Ministry of Health will use the following indicators to measure whether the actions identified above achieve the intended outcomes.
1. Improve the health literacy of Pacific peoples so that they can make healthy choices and gain better access to the health and disability system, by supporting research on effective approaches to strengthen health literacy.
A qualitative survey to measure the health literacy of Pacific peoples in New Zealand.
2. Ensure that health programmes work for people with low levels of health literacy and raise health literacy awareness.
3. Strengthen the practice of health literacy in the health workforce through cultural competency education (Pacific Analysis Framework Training, Ministry of Pacific Island Affairs).
4. Work with lead providers of the Healthy Families New Zealand initiative to implement programmes that enable Pacific families and communities to live healthier lives.
Decrease the number of Pacific children aged 2–14 years who are obese.
BMI> = cole cut-offs (2–14 years) Performance as at 1 May 2014
Improve management of diabetes by increasing ‘More heart and diabetes checks’. The target is that 90 percent of the eligible adult population will have had their cardiovascular disease (CVD) risk assessed in the last five years.
As at December 2013, over 28,000 or 9.0 percent of Pacific peoples are estimated to have diabetes compared to 5.7 percent of all New Zealanders.