Barriers to older Pacific peoples’ participation in the health-care system in Aotearoa New Zealand
Stephen Neville
1 * , Wendy Wrapson 2 , Faasisila Savila 3 , Sara Napier 2 , Janis Paterson 2 , Ofa Dewes 3 , Hoy Neng Wong Soon 2 , El-Shadan Tautolo 2
1 Auckland University of Technology, Private Bag 92006, Auckland 1010, New Zealand.
2 Auckland University of Technology, New Zealand.
3 University of Auckland, New Zealand.
Journal of Primary Health Care 14(2) 124-129 https://doi.org/10.1071/HC21146
Published: 27 May 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Introduction: Participation in the health-care system is a key component of healthy ageing strategies. The number of Pacific people aged ≥65 years in Aotearoa New Zealand will increase significantly over the next decade. Addressing the considerable health inequities and unmet need for care Pacific Island people experience when compared to other ethnicities in Aotearoa New Zealand should be a priority.
Aim: To identify barriers to older Pacific people’s participation in the health-care system in Aotearoa New Zealand.
Methods: A participatory action research design was utilised. In total, 104 Pacific co-researchers contributed to focus groups using Talanoa, a traditional method of conversational dialogue deeply rooted in Pacific Island culture. Data were collected in Pacific Island languages from storytelling and conversations shared within the focus groups. Data were translated into English and analysed using a collaborative approach.
Results: Three main themes captured older Pacific peoples’ barriers to participation in the health-care system: accessing health care; relationships with health-care providers; and understanding the health-care system.
Discussion: Older Pacific people have the capacity to influence locally driven programmes to be more responsive to their needs and aspirations. Improving older Pacific peoples’ participation in health care will require a commitment to partnership and inter-sectoral collaboration identified in recent ageing strategies. The findings will inform local communities, and policy and practice aimed at improving the health and wellbeing of Pacific peoples who are ageing in Aotearoa New Zealand.
Keywords: CALD (Culturally and linguistically diverse), co-researchers, Gerontology, health equity, health-care access, healthy ageing, older people, participatory action research.
References
[1] Minister for Seniors. Better Later life: He Oranga Kaumātua 2019 to 2034. Wellington: Ministry of Social Development; 2019. Available at https://www.superseniors.msd.govt.nz [accessed 11 June 2021].[2] Ryan D, Grey C, Mischewski B. Tofa Saili: a review of evidence about health equity for Pacific peoples in New Zealand. Wellington, New Zealand: Pacific Perspectives; 2019. Available at https://www.nzdoctor.co.nz/sites/default/files/2019-09/Tofa%20Saili-%20A%20review%20of%20evidence%20about%20health%20equity%20for%20Pacific%20Peoples%20in%20New%20Zealand.pdf
[3] Statistics New Zealand. Age and sex by ethnic group (grouped total responses), for census usually resident population counts, 2006, 2013, and 2018 Censuses (RC, TA, SA2, DHB). Wellington: Statistics New Zealand; 2018. Available at http://nzdotstat.stats.govt.nz/wbos/Index.aspx [accessed 12 May 2021].
[4] Ministry of Health. Ola Manuia: Pacific Health and Wellbeing Action Plan 2020-2025. Wellington, New Zealand: Ministry of Health; 2020. Available at https://www.health.govt.nz/system/files/documents/publications/ola_manuia-phwap-22june.pdf
[5] Lotoala F, Breheny M, Alpass F, et al. Health and wellbeing of older Pacific peoples in New Zealand. N Z Med J 2014; 127 27–39.
| 25530329PubMed |
[6] Health Quality & Safety Commission New Zealand. Bula Sautu: A window on quality 2021: Pacific Health in the year of COVID-19. Wellington, New Zealand: Health Quality & Safety Commission; 2021. Available at https://www.pacificperspectives.co.nz/_files/ugd/840a69_19857561e9f54a488965ff92bffc8912.pdf
[7] World Health Organization. Decade of healthy ageing: Baseline report. Geneva: World Health Organization; 2020. Available at https://www.who.int/publications/i/item/9789240017900 [accessed 11 June 2021].
[8] Associate Minister of Health. Healthy Ageing Strategy. Wellington: Ministry of Health; 2016. Available at https://www.health.govt.nz/system/files/documents/publications/healthy-ageing-strategy_june_2017.pdf
[9] Tamasese TK, Parsons LT, Waldegrave C. Pacific perspectives on ageing in New Zealand. Wellington, New Zealand: The Family Centre; 2014. Available at https://www.massey.ac.nz/massey/fms/Colleges/College% 20of% 20Humanities% 20and% 20Social%20Sciences/Psychology/HART/publications/reports/Pacific_Elders_NZLSA_2014.pdf
[10] Wiles J, Wild K, Kerse N, et al. Resilient ageing in place project: recommendations and report. Auckland, New Zealand: The University of Auckland; 2011. Available at https://www.fmhs.auckland.ac.nz/assets/fmhs/soph/sch/ageing/docs/Resilient-Ageing-in-Place-Recommendations-and-Report.pdf
[11] Baldwin JN, Napier S, Neville S, et al. Impacts of older people’s patient and public involvement in health and social care research: a systematic review. Age Ageing 2018; 47 801–809.
| Impacts of older people’s patient and public involvement in health and social care research: a systematic review.Crossref | GoogleScholarGoogle Scholar | 29939208PubMed |
[12] Blair T, Minkler M. Participatory action research with older adults: key principles in practice. Gerontologist 2009; 49 651–662.
| Participatory action research with older adults: key principles in practice.Crossref | GoogleScholarGoogle Scholar | 19491353PubMed |
[13] Tautolo E-S, Wrapson W, Paterson J, et al. Healthy Pacific grandparents: a participatory action research project exploring ageing well among Pacific people in New Zealand. Self & Society 2017; 45 134–148.
| Healthy Pacific grandparents: a participatory action research project exploring ageing well among Pacific people in New Zealand.Crossref | GoogleScholarGoogle Scholar |
[14] Vaioleti TM. Talanoa research methodology: a developing position on Pacific research. Waikato J Educ 2006; 12 21–34.
| Talanoa research methodology: a developing position on Pacific research.Crossref | GoogleScholarGoogle Scholar |
[15] Braun V, Clarke V, Hayfield N, et al. Thematic analysis. In: Handbook of research methods in health social sciences. P Liamputtong, editor. Singapore: Springer; 2019. pp. 843–860.
[16] Southwick M, Kenealy T, Ryan D. Primary care for Pacific people: A Pacific and health systems approach. Report to the Health Research Council and the Ministry of Health Wellington: 2012. Available at https://www.health.govt.nz/system/files/documents/publications/primary-care-pacific-people-pacific-health-systems-approach.pdf
[17] Cowley ET, Paterson J, Williams M. Traditional gift giving among Pacific families in New Zealand. J Fam Econ Issues 2004; 25 431–444.
| Traditional gift giving among Pacific families in New Zealand.Crossref | GoogleScholarGoogle Scholar |
[18] Davis P, Suaalii-Sauni T, Lay-Yee R, et al. A comparison of Pacific and all patient visits to doctors: The National Primary Medical Care Survey. Wellington, New Zealand: Ministry of Health; 2005. Available at https://www.health.govt.nz/system/files/documents/publications/natmedcareport7pacificdec2005.pdf
[19] Ryan D, Southwick M, Teevale T, et al. Primary care for Pacific people: A Pacific and health systems view. Wellington, New Zealand: Pacific Perspectives; 2011. Available at https://www.fmhs.auckland.ac.nz/assets/fmhs/som/sacs/integrated-care/docs/primary-care-2011.pdf
[20] Sherrington C, Tiedemann A. Physiotherapy in the prevention of falls in older people. J Physiother 2015; 61 54–60.
| Physiotherapy in the prevention of falls in older people.Crossref | GoogleScholarGoogle Scholar | 25797882PubMed |
[21] Wylie G, Torrens C, Campbell P, et al. Podiatry interventions to prevent falls in older people: a systematic review and meta-analysis. Age Ageing 2019; 48 327–336.
| Podiatry interventions to prevent falls in older people: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 30615052PubMed |
