poses problems

Opinion

Islanders' health poses problems

The grim findings of an official report on health of Pacific islands people in New Zealand came as no surprise to the subjects of the study.

The country’s 167,000 residents of Pacific island descent already knew that the past decade’s painful, if necessary, economic restructuring had hit them particularly hard, consequently bringing worsening health.

The Public Health Commission report paint ed a sorry picture of the problems they face.

It found they suffered from inferior housing, poor diet, low incomes and high unemploy ment - all key factors affecting their health.

Although it has long been known the island community was the most disadvantaged sec tor of the population, it was the first detailed survey of its health status.

As such, it was important in identifying not only the health needs of Pacific island people, but of the nation as a whole. For, with a birth rate more than double the national level, the islanders are one of the fastest growing ethnic communities in New Zealand.

Between 1986 and the last census in 1991, their numbers grew at a rate eight times high er than the total population. By the year 2031, they are forecast to increase by 114 percent and constitute more than seven percent of the population.

The health of Pacific islanders will therefore have an increasing influence on the health of the entire New Zealand population.

It is a report that cannot be ignored by the government and health authorities - or by the island people themselves, for it is clear, their economic plight notwithstanding, there is much they can do to improve their own con dition.

The report shows three-quarters of them are overweight and do little physical exercise compared with the rest of the population.

They eat the wrong sort of foods, they tend to use abortion as a form of contraception, they

do not look after their teeth and often do not take advantage of health services available for their children.

“Some Pacific island people,” the report sug gested,“place personal health very low down in their list of priorities.

“This may be because they cannot afford health care; or there are competing demands on household income (eg. the wish to make monetary contributions to the church may override expenditure on health needs); or because they have low self-esteem and con cern about their personal well-being.”

Certainly there is evidence that, as health spe cialist Dr Colin Tiikuitionga wrote, some Pacific island families live “an underclass eco nomic existence” in New Zealand.

A survey in Manukau, an Auckland area with a big island population, found that nearly 90 percent of Pacific island households reported financial difficulties buying food (against 38 percent of Palagi (white New Zealanders) families). More than two-thirds said they could not afford “necessary things” (Palagi 29 percent) and a similar number said they often had to choose between buying food and pay ing bills (Palagi 17 percent).

About two-thirds put off visits to the doctor and dentist (Palagi 35 percent) and 48 per cent said they had not had prescriptions filled (Palagi 12 percent).

The reasons for this situation are clear.

Unemployment in the Pacific island labour force doubled to more than 20 percent between 1981 and 1991 - twice that of the population as a whole. The unemployment rate for those aged 15 to 24 topped 44 per cent.

Many Pacific island people identified unem ployment as one of the major factors affecting their health, pointing out it restricted their ability to meet health costs or access care.

Four out of five Pacific islanders had incomes under $20,000 in 1991 compared with 64 percent of New Zealanders as a whole. More than two-thirds were on benefits in 1991 so they suffered particularly when benefit pay ments were reduced at the end of last year.

Ironically the report said the mortality rate for Pacific island people between 1987 and 1991 were well below those of the population as a whole. On the other hand, they have a much

higher hospitalisation rate, especially for asth

ma, acute respiratory infections and pneumo nia - presumably because they do not seek medical attention as early as Palagi and are therefore more likely to have to go to hospital when their condition worsens.

They also have a higher incidence of diabetes and infectious and parasitic diseases (espe cially tuberculosis).The latter, the report says, possibly arising from the larger size of Pacific island households, greater over-crowding and

poorer quality of housing.

The report notes that a 1993 survey found nearly 20 percent of islanders described their health as “not so good” or “poor” compared

with only eight percent Palagi.

The situation could get a lot worse as the island population, in common with the rest of New Zealand, ages.

The report warns that deaths from cancer, heart disease, cerebrovascular disease, dia betes and pneumonia could increase more than threefold over the next 17 years, well above those for the national population as a whole.

At the other end of the age scale, the report warns that any further deterioration in the economic circumstances of Pacific island par ents, combined with poor parenting and poor employment prospects, could lead to an increase in youth offences, including areas that have an impact on health, such as sub stance abuse.

Further, the report expresses concern at the level of violence in Pacific island society. It notes that Pacific island men make up a dis proportionate share of convictions for violent offences - 12 percent in 1991 and 1992. And their women and children account for nearly 10 percent of clients admitted to refuges. This from a group that constitutes less than five percent of the population. ■

From

David Barber

in Wellington