Partnership Health Canterbury

Te Kei o Te Waka

Christchurch

Christchurch

Total Population: 398,801

Asian: 27,438Maori: 27,735Pacific: 9,756

Others: 52,434(Middle Eastern/African: 3,036)

European: 281,385

Statistics NZ 2006

EthnicityTotal -

Canterbury% of

PopulationTotal -

Christchurch% of

PopulationChinese 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

Groups2,463 8.4% 2,301 8.4%

Total 29,172 27,438

Oriental Ethnic Breakdown

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

Family Health Issues

Arthritis, Osteo

BackacheHeart

DiseaseStroke Gastro

Women's Disease

Young People's

Resp. Disease

Infectious Disease

Allergic Diseases

Hearing

14% 24% 5% 1% 11% 11% 2% 4% 3% 23% 6%

DiabetesPhys.

HarassAsthma

High Blood

pressure

Maternity Pregnancy

Acute chronic

pain

Skin Disease

Vision Accidents Dental

6% 3% 10% 13% 11% 3% 18% 14% 22% 36%

TBSexual Health

Stress DepressionMental Health

CancerAutism

Learning Probs

Elderly Illness

Disabilities OtherNo

Problems

0% 0% 14% 12% 2% 2% 2% 1% 1% 0% 8%

GPsPrivate

PsychiatristsHospital Inpatient

Hospital Outpatient

Women's Health

Child's Dental Clinic

AudiologistSchool Health

Services

Children's Rehab.

Services

Child Development

Older person's

home help

79% 5% 19% 27% 15% 35% 7% 16% 0% 3% 3%

Mental Health Service

Private Specialists

A&E Day Surgery or ward

Pregnancy Maternity

Child & Family

Adult Dental Optician Optometrist

2% 27% 32% 14% 13% 5% 37% 22%

Immunisation Service

Adult Rehab.Respite

Disabled Child

Home help discharged

patients

Drug/Alcohol Service

Disabled child needs

assessment

Older people needs

assessment

23% 2% 0% 1% 0% 2% 3%

Current Use of Medical Services

Health-Related Risk Factors

Health-Related Risk Factors

Health-Related Risk Factors

Health-Related Risk Factors

Total Numbers%

Change% of total patients

% of Total Under 21 Population

2008 2009 2008 2009 2008 2009New Zealand European

12,423 13,660 10.0% 77.3% 77.2% 19.0% 13.6%

European Other 616 762 23.7% 3.8% 4.3% 0.9% 0.8%New Zealand Maori

1,485 1,791 20.6% 9.2% 10.1% 2.3% 1.8%

Pacific Island 217 261 20.3% 1.4% 1.5% 0.3% 0.3%Asian 233 280 20.2% 1.5% 1.6% 0.4% 0.3%African 31 34 9.7% 0.2% 0.2% 0.0% 0.0%Middle Eastern 15 25 66.7% 0.1% 0.1% 0.0% 0.0%Other (Latin America etc)

1,045 879 15.9% 6.5% 5.0% 1.6% 0.9%

Total 16,065 17,692 10.1% 24.5% 17.6%

Youth Sexual Health

PHO Data; on file

Although the total under 21-year-old Asian group made up 5.9% (2008) and 6.7% (2009) of the total, it was only responsible for 1.5% and 1.6% of the total number of youth sexual health patient numbers. It was also responsible for only 1.3% and 1.4% of the total number of consultations.

European 0.8%Maori 1.5%Pacific 1.7%Asian 1.6%MELAA 1.2%

Statistics New Zealand (December 2008)

Pregnancy Termination

Asian women have not previously been identified as an at-risk group in New Zealand—rates of chlamydia for Asian women were 14 times higher in this audit thanin the audit of completed pregnancies. [Done 12 months earlier]. NZMJ; March 2005

Ethnicity Numbers %

Male

New Zealand European 573 43.1%European Other 45 3.4%New Zealand Maori 21 1.6%Pacific Island 3 0.2%Asian 13 1.0%African 0 0.0%Middle Eastern 0 0.0%Other (Latin America etc) 18 1.4%

Female

New Zealand European 565 42.5%European Other 42 3.2%New Zealand Maori 20 1.5%Pacific Island 5 0.4%Asian 12 0.9%African 0 0.0%Middle Eastern 0 0.0%Other (Latin America etc) 11 0.8%

Total 1328

End-of-Life Palliative Care

The Art of Questioning

Current smoking, by ethnic group • Asian 11.2 (8.9−13.4) 31,200

Source: A Portrait of Health; New Zealand Health Survey: 2008

Source: Healthcare Needs of Asian People in the Wider Christchurch Area: 2008

Smoking

0% 20% 40% 60% 80% 100% 120%

10% 19% 71%

Most Concern Some Concern No Problem

Do you smoke?

Are you concerned about smoking?

DiabetesPrevalence of Diabetes among Men and Women in China

Wenying Yang, M.D., Juming Lu, M.D., Jianping Weng, M.D., Weiping Jia, M.D., Linong Ji, M.D., Jianzhong Xiao, M.D., Ph.D., Zhongyan Shan, M.D., Jie Liu, M.D., Haoming Tian, M.D., Qiuhe Ji, M.D., Dalong Zhu, M.D., Jiapu Ge, M.D., Lixiang Lin, M.D., Li Chen, M.D., Xiaohui Guo, M.D., Zhigang Zhao, M.D., Qiang Li, M.D., Zhiguang Zhou, M.D., Guangliang Shan, M.D., Ph.D., Jiang

He, M.D., Ph.D., for the China National Diabetes and Metabolic Disorders Study Group

The New England Journal of Medicine; March 25, 2010

9.7% ---- 92,400,000

15.5% ---- 148, 200,000

2008

Total Checks 6,852

Total PHC Population 1.9%

Total Asian 400

% of total Asian Consults 5.6%

% of Total Asian Population 1.9%

2009

Total Checks 5,192

Total PHC Population 1.4%

Total Asian 263

% of total Asian Consults 5.1%

% of Total Asian Population 1.2%

ANNUAL DIABETES CHECKS

PHO Data; on file

New Z

ealan

d Eur

opea

n

Europ

ean

Other

New Z

ealan

d M

aori

Pacific

Islan

dAsia

n

Africa

n

Midd

le Eas

tern

Other

(Lat

in Am

erica

etc

)0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

12.7% BMI < 25

BMI 25-30

BMI > 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 < 25

BMI > 25

BMI > 30

BMI

In the 2006/07 New Zealand Health

Survey, Asia

n males and females

had almost 2

.5 (males) a

nd over 1.5 (fe

males) tim

es the prevalence of

diagnosed diabetes than males a

nd females in th

e total population. T

his

placed the Asia

n adult group with

the second highest i

ncidence of

diagnosed diabetes behind th

at of Pacific

Islanders.

Female

New Zealand European 747

European Other 59

New Zealand Maori 69

Pacific Island 10

Asian 18

African 5

Middle Eastern 2Other (Latin America

etc)31

Male

New Zealand European 441

European Other 43

New Zealand Maori 48

Pacific Island 6

Asian 8

African 0

Middle Eastern 1Other (Latin America

etc)9

Total 1497

In the 15 months ending June 2009, 1,497 new contacts for the Brief Intervention Counselling service. Only 1.7% were for Asian peoples.

Brief Intervention Counselling

Total Asian

AgeNo.

eligible

Fully immunised for

age %

6 Months 89 76 85%12 Months 121 117 97%18 Months 127 111 87%24 Months 87 79 91%

% Vaccinated

4-year-olds 11-year-oldsNZ European 86% 81%European Other 78% 75%Maori 81% 73%Pacific Islander 72% 70%Asian 81% 69%Middle Eastern 63% 92%African 74% 95%Other 78% 72%Total 84% 79%

Immunisations

PHO Data; on file

B4 Schools Checks

At the end of December 2009, 508 4- and 5-year-old Asian children were enrolled with PHC. 17.5% of them had received a B4 School check.

PHO Data; on file

Total Checks

% Total 4/5 Population %

NZ European 1,875 78.9 6,689 28.0

European Other 81 3.4 717 11.3

Maori 137 5.8 1,079 12.7

Pacific Island 74 3.1 415 17.8

Asian 89 3.7 508 17.5

Middle East 13 0.5 40 32.5

African 12 0.5 63 19.0

Other 95 4.0 232 40.9

Language is an ability which is difficult to measure. It is the single biggest issue

facing migrants to Canterbury.

Language

LanguageLanguage

Language Line

Face-to-Face

Use of Interpreters

Culture

Culture plays an enormous – and often misunderstood – part in the ability to

communicate.

Discussion

“…pride of your parents, your immediate relatives, your extended relatives, and all your dead ancestors rolled up into this brand you will forever bear on your forehead for the rest of your life. Essentially, if you don’t excel …, then you will “lose face” and bring shame not just to yourself, but more importantly your parents, your relatives, your ancestors, and any being dead-or-alive that would bear the same last name as you.”

Dr Jane Chin

The most recent Health Needs Analysis (HNA) published by the Canterbury District Health Board (CDHB) was carried out in 2004 using data from the 2001 census. At that time the Asian population totalled 18,000. Since then, the Asian population has grown by over 10,000 people. The 2004 HNA is woefully out-of-date. That HNA highlighted several areas:

• Health-trained interpreters are essential• Increasing numbers of Chinese GPs and nurses in

Christchurch have helped ease worries for non-English speaking Chinese new immigrants.

• Instructions about taking medications are often not completely understood

• Cultural difficulties in accepting Western medicine• The lack of English language skills• Discrimination

Canterbury does not have an affordable, easily accessible interpreter service.

Worries for non-English speaking immigrants have not eased as stated

Miscommunication about medicine instructions is rife

The lack of understanding of our primary and secondary health care systems confuses most immigrants.

Discrimination continues to exist

The Brief Intervention Counselling Service is not culturally competent