Using the Integrated Data Infrastructure (IDI) to investigate or research various social, cultural, health, or other related outcomes is appealing and has a lot of potential. The IDI offers sufficient numbers for researchers to investigate outcomes in Pacific communities to a level of detail not available in many studies. Additionally, it allows organisations to upload their own data to supplement measures in the IDI. The overall aim of this paper is discuss the appropriate values for research projects involving Pacific communities using IDI data; issues around ownership of data from Pacific communities; consent; identification; and other ethical considerations. Although the IDI has a great deal of potential for Pacific health research, many findings based on research using IDI data have been recognised as deficit-framed and polarising for the communities they describe. Some would argue that such findings highlight discrepancies in health or social equity and point to deficiencies that should be the responsibility of governmental organisations. Most analyses stop short of investigating practical pathways for communities to find solutions that are sympathetic to the values or established infrastructure of those communities. Instead, most communities found themselves characterised by deficit and feeling solely responsible for their poor situation. This paper proposes an extension to the Tivaivai/Tivaevae research framework and shows how it incorporates values that should be reflected in Pacific research using IDI data. With applications in a range of disciplines, the Tivaivai framework, like many Pacific research models, has been applied to quantitative or small mixed-methods projects, and usually restricted to Cook Islands research. This paper shows its usefulness can be applied to a strictly quantitative research framework, making it sympathetic to wider Pacific values as well as consistent with other familiar Pacific research frameworks. These concepts will be incorporated into a research project for an HRC funded Post-doctoral study investigating the value of education to health outcomes for Pacific families. It is hoped that this paper may provide a starting point for other quantitative Pacific research projects involving administrative or other big data.

Pacific people continue to carry a disproportionately heavy social and health burden relative to their non-Pacific peers in New Zealand, and those with less formal education are experiencing social and health declines. Improving education and educational needs is seen as being central to decreasing these health inequities. While expansive, the empirical evidence-base supporting this stance is relatively weak and increasingly conflicting. Using a large birth cohort of 1,368 eligible Pacific children, together with their mothers and fathers, this study longitudinally investigates the relationship between paternal education levels and sentinel measures of their children’s physical health, mental health and health risk taking behaviours during late childhood and early adolescence. In adjusted analyses, it was found that mothers and fathers who undertook further schooling over the 0–6 years postpartum period had children with significantly lower logarithmically transformed body mass index increases at 11-years and 14-years measurement waves compared to 9-years levels than those who did not study (p = 0.017 and p = 0.022, respectively). Furthermore, fathers who undertook further schooling over this 0–6 years postpartum period also had children with significantly lower odds of risk taking behaviours (p = 0.013). These results support policy aimed at increasing educational opportunities for Pacific people in New Zealand.

ObjectivesA wide inequality in incidence and severity of childhood oral health conditions between Pasifika and non‐Pasifika in Aotearoa/New Zealand (Aotearoa/NZ) persists with some evidence that the gap is widening. To develop an evidence base for strengths‐based solutions, this study seeks to investigate the association between parental education and detected oral health conditions in Pasifika children.MethodA secondary cross‐sectional analysis of linked routinely collected national databases of children (Pasifika and Non‐Māori non‐Pasifika [NMNP]) aged 0–9 years in 2013 who completed a Before School Check (B4SC) and had their birth parents file a 2013 New Zealand census return. Parental education is represented by their self‐reported highest qualification level gained. Logistic regression models were employed to investigate childhood caries and hospitalisations related to oral health conditions after adjusting for social and economic factors.ResultsDuring the five‐year period of 2013–2017, 21 744 (10.2%) children (Pasifika and NMNP) completed the B4SC and experienced caries. Pasifika children experienced caries three times more than NMNP children (23.6% and 7.9%, respectively) and 1.8 times more dental hospitalisations (6.0% and 3.4%, respectively). Each additional level of parental education reduced their Pasifika child's odds of experiencing caries (unadjusted odds ratio [OR] = 0.83, 95% CI: 0.82–0.85) and dental hospitalization (unadjusted OR = 0.89, 95% CI: 0.87–0.91). Less than half of the reduced odds for parental education could be attributed to other covariate factors, by 43% and 25%; respectively, for caries and hospitalisations.ConclusionsOur findings show good educational achievement is associated with better oral health for offspring beyond other benefits that can be attributed to non‐education influences. Increased education for Pasifika parents is likely to directly confer better oral health for their children. The findings from this study may provide meaningful evidence for future developments in Pasifika education policy as an investment into the health of subsequent generations of Pasifika children.

Introduction: Pasifika young people of Aotearoa New Zealand are known to experience higher rates of mental health and addiction conditions (especially anxiety and depression), compared with young non-Māori/non-Pasifika (NMNP). However, there is little information about how well these issues are identified by mental health services. Aim: We compared rates of diagnosis of common mental health and substance use-related conditions between Pasifika and NMNP young people (aged 10-24 years) and examined how these diagnoses varied with deprivation. Method: This national, cross-sectional study was undertaken using 2017/18 fiscal year data from a national database known as the Integrated Data Infrastructure. Specialist mental health service use, hospitalisations and pharmaceutical dispensing for any mental health condition, emotional condition (depression and/or anxiety), substance use-related conditions, and self-harm were examined. Results: A total of 982,305 young people (12.4%, Pasifika and 63.9%, NMNP) were identified. Compared with NMNP, Pasifika young people were significantly less likely to be diagnosed by specialist mental health services with any mental health condition (adjusted Risk Ratio (aRR) = 0.77, 95% CI = 0.75 to 0.78); any emotional condition (aRR= 0.44, 95% Confidence Interval (CI) = 0.43 to 0.45); or to be hospitalised for self-harm (aRR = 0.88, 95% CI = 0.82 to 0.94). However, they were significantly more likely than NMNP to be diagnosed with substance use-related conditions (aRR = 1.68, 95% CI = 1.63 to 1.74). Although the overall rate of mental health issues remained relatively stable across deprivation levels, emotional conditions were much less frequently diagnosed in those with greater deprivation. Discussion: Discrepancies between expected and identified rates of diagnoses of common mental health and substance use-related conditions might indicate different patterns of service access by Pasifika young people, or they may reflect the bias of an inequitable and less than culturally appropriate health system.

For Pacific children in Aotearoa New Zealand under 20 years of age, this study investigates whether parental education is protective in terms of hospitalisations. For 139,686 Pacific and 659,055 other (non-Māori/non-Pacific) children, a population data extract for them and their parents was used from linked 2013 Census, health and demographic data. Binary indicators of incidence of hospitalisations between 1 March 2013 and 28 February 2018 were analysed using modified Poisson regression models with robust standard errors. The highest parental educational level of either parent ranged from 0 indicating no qualification and increased incrementally to 10 signifying a PhD. Over the study period, 1% of Pacific children were hospitalised in private hospitals and 24% with a potentially avoidable hospitalisation. Highest parental education level was protective for Pacific children, with a single level in parental qualification associated with a small but significantly lower risk of potentially avoidable hospitalisation (RR = 0.97, p < 0.0001), but a higher risk of private hospitalisation (RR = 1.25, p < 0.0001). This finding remained significant, independent from the contribution of increased socioeconomic benefits that accompanied improved education. These findings support ongoing Pacific focused initiatives for promoting continuing education as an investment for the future health of Pacific families.