Ethnic disparities in infectious disease hospitalisations in the first year of life in New Zealand

Hobbs, Mark; Morton, Stephen; Atatoa‐Carr, Polly; Ritchie, Stephen; Thomas, Mark G.; Saraf, Rajneeta; Chelimo, Carol; Harnden, Anthony; Camargo, Carlos A.; Grant, Cameron C.

doi:10.1111/jpc.13377

Cited by 23 publications

(33 citation statements)

References 37 publications

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“…Our study is cross-sectional and therefore limited in terms of attributing causality. However, experience of racism has been linked to negative health and well-being outcomes in prospective studies, both in New Zealand [ 23 , 24 ] and internationally [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Racism and health in New Zealand: Prevalence over time and associations between recent experience of racism and health and wellbeing measures using national survey data

2018

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ObjectivesRacism is an important health determinant that contributes to ethnic health inequities. This study sought to describe New Zealand adults’ reported recent experiences of racism over a 10 year period. It also sought to examine the association between recent experience of racism and a range of negative health and wellbeing measures.MethodsThe study utilised previously collected data from multiple cross-sectional national surveys (New Zealand Health Surveys 2002/03, 2006/07, 2011/12; and General Social Surveys 2008, 2010, 2012) to provide prevalence estimates of reported experience of racism (in the last 12 months) by major ethnic groupings in New Zealand. Meta-analytical techniques were used to provide improved estimates of the association between recent experience of racism and negative health from multivariable models, for the total cohorts and stratified by ethnicity.ResultsReported recent experience of racism was highest among Asian participants followed by Māori and Pacific peoples, with Europeans reporting the lowest experience of racism. Among Asian participants, reported experience of racism was higher for those born overseas compared to those born in New Zealand. Recent experience of racism appeared to be declining for most groups over the time period examined. Experience of racism in the last 12 months was consistently associated with negative measures of health and wellbeing (SF-12 physical and mental health component scores, self-rated health, overall life satisfaction). While exposure to racism was more common in the non-European ethnic groups, the impact of recent exposure to racism on health was similar across ethnic groups, with the exception of SF-12 physical health.ConclusionsThe higher experience of racism among non-European groups remains an issue in New Zealand and its potential effects on health may contribute to ethnic health inequities. Ongoing focus and monitoring of racism as a determinant of health is required to inform and improve interventions.

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Section: Discussionmentioning

confidence: 99%

Racism and health in New Zealand: Prevalence over time and associations between recent experience of racism and health and wellbeing measures using national survey data

2018

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“…SES has been correlated with the incidence of childhood illnesses, with a disproportionate burden falling on the most deprived . Beyond the already recognised increase in bronchiolitis cases requiring inpatient care, our results demonstrate that infants living in areas of high deprivation experienced more severe disease and had higher rates of re‐admission.…”

Section: Discussionmentioning

confidence: 99%

Respiratory health inequality starts early: The impact of social determinants on the aetiology and severity of bronchiolitis in infancy

Foley

Best

Reid

et al. 2018

J Paediatrics Child Health

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Aim To define the impact of demographics on the incidence, aetiology and clinical course of viral bronchiolitis in infants younger than 2 years of age. Methods Retrospective case review of all viral bronchiolitis admissions for patients aged younger than 2 years old from January 1 2014 to 31 December 2015 at Wellington Regional Hospital, New Zealand. Demographic data, second‐hand smoke exposure (SHSE) and presence of predisposing conditions were collected, along with outcome data including use of respiratory support and intensive care unit (ICU) admission. This was compared to background rates calculated from regional census data. Results There were 556 admissions included (11% of paediatric medical admissions); 49% tested positive for respiratory syncytial virus (RSV) (84% tested), and 40% of admissions received positive pressure respiratory support and 10% ICU admission. Admission rates ranged from 9.6 to 77 per 1000/year, with higher rates seen in those from areas of high deprivation. Admission rates by deprivation varied according to aetiology. RSV‐positive admission rates increased from 9.7 per 1000/year to 24.6 per 1000/year in the least to most deprived areas, whereas non‐RSV admissions showed even greater disparity, increasing from 10.1 per 1000/year to 37.5 per 1000/year (both P < 0.0001). Conclusions This study further reinforces that material deprivation contributes significantly to poor health outcomes that are apparent in infancy. SHSE is a potent risk factor for adverse respiratory outcomes in this patient population. Ongoing efforts to eradicate smoking and reduce material inequality need to continue.

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“…Racial discrimination and unfair treatment are an emergent and critical health issue for children and young people in NZ (e.g. Crengle et al, 2012;Hobbs et al, 2016;Teevale et al, 2013;Thayer & Kuzawa, 2015). For example, in the NZ Secondary School Youth Survey (n = 9,107 respondents, 19% Māori, Year 9 to Year 13), the prevalence of experiencing 'any ethnic discrimination' was higher amongst Māori (12.9%), Pacific (17.4%), and Asian students (16.7%) compared with NZ European students (5.4%) (Crengle et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…These studies have focused on documenting the detrimental health effects of direct experiences of racism on child and adolescent health. However, vicarious racism, via parent/caregiver experiences, has specific and independent effects on child health and development, including a higher likelihood of childhood illnesses (Priest et al, 2012), hospitalisation for infectious diseases (Hobbs et al, 2016), socioemotional difficulties and poorer spatial ability (Kelly et al, 2013), and more behavioural issues (Caughy et al, 2004), including internalising symptoms and lower self-esteem (Espinoza et al, 2016). The health impacts of vicarious racism for Indigenous children are poorly understood (Heard-Garris et al, 2017;Priest et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Caregiver experiences of racism are associated with adverse health outcomes for their children: a cross-sectional analysis of data from the New Zealand Health Survey

Paine

Stanley

2019

Critical Public Health

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The study aimed to investigate the association between caregiver experiences of racial discrimination and physical and emotional health outcomes for their children and to explore potential pathway variables in this relation. We analysed data from two instances of the New Zealand Health Survey that provide nationally representative data for children and adults, with high response rates for each of the major ethnic groupings (Indigenous Māori, Pacific, Asian, and European/Other). Questionnaires from the primary caregiver and their child (5 to 14 years) were linked to create n = 2,958 childprimary caregiver dyads in the 2006/07 Survey and n = 2,632 dyads in the 2011/12 Survey. Children whose caregivers reported any experience of racial discrimination had poorer mental health, self-esteem, and behaviour scores on the CHQ PF-28 scale, even after adjustment for caregiver sociodemographic variables. Multivariable models identified a worsening in child emotional health as the number of reported racism experiences increased. Caregiver experiences of racism were not associated with medicated asthma in their children. Multivariable models suggest that caregiver psychological distress may be a pathway linking vicarious racism to poorer child emotional health.

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Ethnic disparities in infectious disease hospitalisations in the first year of life in New Zealand

Abstract: Māori and Pacific children in NZ experience a high burden of ID hospitalisation. Some risk factors, for example maternal smoking, are shared, while others are ethnic-specific. Interventions aimed at preventing ID hospitalisations should address both shared and ethnic-specific factors.

Cited by 23 publications

References 37 publications

Racism and health in New Zealand: Prevalence over time and associations between recent experience of racism and health and wellbeing measures using national survey data

Racism and health in New Zealand: Prevalence over time and associations between recent experience of racism and health and wellbeing measures using national survey data

Respiratory health inequality starts early: The impact of social determinants on the aetiology and severity of bronchiolitis in infancy

Caregiver experiences of racism are associated with adverse health outcomes for their children: a cross-sectional analysis of data from the New Zealand Health Survey

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