Partnership Health CanterburyTe Kei o Te Waka

New Zealand Diversity Forum - 2010

Refugee and AsianCommunity Report

ChristchurchTotal Population: 398,801

European: 281,385

Asian: 27,438

Maori: 27,735

Pacific: 9,756

Others: 52,434

(Middle Eastern/African: 3,036)Statistics NZ 2006

Oriental Ethnic Breakdown

Ethnicity Total - Canterbury % of Population Total - Christchurch % of Population

Chinese 13,410 46.0% 12,807 46.7%

Korean 4,746 16.3% 4,611 16.8%

Indian 3,429 11.8% 3,171 11.6%

Japanese 2,580 8.8% 2,319 8.6%

Filipino 1,287 4.4% 1,059 3.9%

Thai 822 2.8% 738 2.7%

Sri Lankan 453 1.6% 435 1.6%

Cambodian 258 0.9% 255 0.9%

Other Asian Groups 2,463 8.4% 2,301 8.4%

Total 29,172 27,438

Statistics NZ 2006

Partnership Health Canterbury – Capitated Age Bands

Ethnicity 0 - 4 5 - 14 15 - 24 25 - 44 45 - 64 65+

New Zealand European

6.2% 11.6% 11.8% 25.8% 28.2% 16.3%

European (Other) 5.3% 10.7% 8.9% 31.8% 26.9% 16.4%

Maori 12.2% 21.5% 18.5% 27.3% 16.8% 4.0%

Asian 8.6% 14.5% 13.2% 36.0% 22.0% 5.7%

Pacific Island 11.5% 21.1% 17.9% 28.2% 17.2% 4.0%

Middle Eastern 9.9% 18.5% 14.4% 30.9% 22.2% 4.1%

African 13.0% 20.2% 16.0% 36.2% 12.3% 2.4%

Other 3.5% 32.4% 3.3% 11.8% 7.3% 2.4%

Total 6.7% 12.8% 12.6% 26.6% 24.5% 14.2%

PHO: Dec 2009

Service Maori Pacific Asian

GP Utilisation (rate) 61.9 52.3

B4 School Check (%) 14 31

HPV Immunisation (%)Cohort 1 (born 1990 and 1991)Cohort 2 (born 1992.93 and 97)

5956

5452

Fully Immunised 2-year-olds (%) 87 91

Flu over 65 (%) 61 48

Youth Sexual Health (rate) 11.9 4.7

PEGS Smoking Cessation (%) 1.4 0.6

Mammography Screens (%) 91 57

Care Plus (%) 4.3 4.1

Diabetes Annual Reviews (%) 4.4 7.1

Mental Health GP Liaison (%) 0.52 0.19

Ethnic Report Card

Service Maori Pacific Asian

GP Utilisation (rate) 61.9 52.3 42.8B4 School Check (%) 14 31 20HPV Immunisation (%)Cohort 1 (born 1990 and 1991)Cohort 2 (born 1992.93 and 97)

5956

5452

5550

Fully Immunised 2-year-olds (%) 87 91 83Flu over 65 (%) 61 48 66Youth Sexual Health (rate) 11.9 4.7 2.7PEGS Smoking Cessation (%) 1.4 0.6 0.3Mammography Screens (%) 91 57 69Care Plus (%) 4.3 4.1 2.2Diabetes Annual Reviews (%) 4.4 7.1 3.6Mental Health GP Liaison (%) 0.52 0.19 ?

Ethnic Report Card

Language

Every consumer has the right to effective communication in a form, language, and manner that enables the consumer to understand the information provided. Where necessary & reasonably practicable, this includes the right to a competent interpreter.

Right 5. Right to Effective Communication (1)The Health & Disability Commissioner(Code of Health and Disability Services Consumers’ Rights) Regulations 1996

Interpreters

Diabetes

9.7%92,400,000

15.5%148, 200,000

NEJM – March 2010

~6,800 people

2008 - 400

2009 - 263

New Ze

aland Eu

ropea

n

Euro

pean O

ther

New Ze

aland M

aori

Pacific Is

land

Asian

African

Middle Ea

stern

Other (La

tin America

etc)

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

12.7%BMI < 25BMI 25-30BMI > 30

New Z

ealand

Eur

opea

n

Euro

pean

Oth

er

New Z

ealand

Mao

ri

Pacific

Island

Asian

Afric

an

Mid

dle

East

ern

Other

(Lat

in A

mer

ica

etc)

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%

50.3%

BMI < 25BMI > 25BMI > 30

In the 2006/07 New Zealand Health Survey, Asian males and females had almost

2.5 (males) and over 1.5 (females) times the prevalence of diagnosed diabetes

than males and females in the total population. This placed the Asian adult

group with the second highest incidence of diagnosed diabetes behind that of

Pacific Islanders.

Health Issues - Migrant

• Lack of understanding of the NZ health system

• Language barriers

• Cultural barriers

• Low access to services

• Little knowledge of entitlements

• Inappropriate use of ED

•Number of general practices with enrolled refugees = 22

•Enrolled patients vary from 2 to 155

•Average sustainable by most general practices <20

•Practices either contracted or fee-for-service

•First three months fully covered by PHO - until capitation funding is received

Refugee Health

•After that, funding depends on patients ability to contribute – this can take weeks/months depending on language, employment, health issues

•Last financial year, the PHO received $105k for refugee primary health care.

•Currently 740 enrolled people from refugee backgrounds; Somali, Ethiopian, Afghani, Iranian, Iraqi, Kurdish, Burmese, Cambodian, Bhutanese.

Refugee Health

Changes to Canterbury's refugee and migrant mental health service will make it harder for troubled refugees to get help, the departing clinical leader fears. The Hillmorton Hospital service is changing from a dedicated assessment and treatment service to a consult-only service with the loss of its founder and clinical leader, Dr Lynne Briggs.

Canterbury District Health Board general manager of specialist mental health services Sandra Walker said patients would have access to a specialist service in the same way as in the past. She said experienced psychiatrists would continue to provide consultations that could involve some brief intervention, prescribing drugs or referring patients to a GP.

PHC Future Activities

• Providing advice on access to services & linguistically specific literature

• Roll out nutritional programmes• Advocating culturally specific services,

centrally based, affordable interpreter service & culturally appropriate mental health services. Funding is key to this.

PHC Future Activities

• Workforce development for trained migrants

• Improve PHO ethnicity data• Target funding for migrant primary

health care• Establish a PCW based in an Asian

organisation• Key liaison function with agencies

PHC Future Activities

The report recommends:

Governance:

•The development of an Asian Health Advisory Board as part of PHC•The implementation of an Asian Mental Health Governance and Management projectAdvocacy:•The creation of an Asian Health Careers Service to address current barriers to employment•The development of an Asian Health Profile for Canterbury•The improvement of ethnicity data to accurately target specific groups.

Primary Health Care Issues Amongst Asian Peoples in Christchurch

Activity:

•The development of a DVD presentation covering basic nutrition and healthy food choices.•A concerted push through the ethnic media and societies to increase the level of enrolment to general practice.•The provision of an effective, safe interpreting and translation service for Asian people•The improvement of access to appropriate health services•The improvement of the utilisation of health services•A focus on health promotion, early intervention and a reduction in risk behaviours•The development of an Asian Health Needs Analysis•Inclusion of an Asian section in the CDHB DAP

Education:

•The development of language-specific literature across all health spectra.

Primary Health Care Issues Amongst Asian Peoples in Christchurch