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Public health issues of Asian New Zealanders –
Challenges and triumphs
Ch ll           dti     h




            NZ Diversity Forum 2010
                       y
Definition of “Asian” in NZ
                    The term ‘Asian’
                    encompasses
                            p
                    people from a
                    vast area- Japan
                     in the east to
                    Afghanistan in the
                    west and of the
                     354,549 Asians in NZ,
                    248,364 were
                     born in Asia.
Who is Asian in New Zealand?
                                                      0% 2%
                                                  1%0%0%
                                                       0%
                                               1%1% 1%
                                              1%
                                         1%
                                       2%
                                     2%
                                2%
                            2%

                           2%

                       3%
                                                                            39%



                     5%




                      9%




                                                     27%




   Chinese nfd      Indian nfd                    Korean        Filipino            Japanese
   Sri Lankan nfd   Cambodian                     Thai          Fijian Indian
                                                                  j                 Taiwanese
   Vietnamese       Malay                         Indonesian    Afghani             Asian nfd
   Pakistani        Eurasian                      Bangladeshi   Malaysian Chinese   Laotian
   Other Asian
Asian population
      p p
 Asians now 9.2% of the population
   (2006)            354,549
                     354 549 people
                                 l

     16                                    9.2% f
                                           9 2% of NZ
                                           population
                                        (Statistics of New
     14                                  Zealand, 2006)

     12

     10

      8
                                      Asian NZ population size

      6

      4

      2

      0
          1991   2001   2006   2020
Demographics continued
Demographics-continued
2006 Census:
     Auckland       98,391 Chinese,
                    74,442 Indians,
      region
        g           21,351 Korean,
                    9,819 Filipino,
                    9 819 Fili i
                    5,289 Japanese
                    and 5,049 Sri Lankans

    Wellington      14,895 Chinese,
                    11,073 Indians,
      region        2,367 Filipino


    Canterbury                13,410 Chinese,
                              4,746 Koreans,
      region                  3,429 Indians,
                              1,287Filipino

   Waikato Region   7,122 Chinese,
                    5,637 Indians,
                    1,383 Koreans.
Health status of Asians living
outside Asia
 Overseas studies [ in UK] have shown
 deteriorating health amongst Asians over a
 period of time

 Generally Asians, who are largely
 immigrants, come to NZ healthy because of
 immigration medical screening-but
 because of various reasons [ genetic,
 b             f   i                  ti
 lifestyle..] over a period of time develop
 diseases
Asian health issues - sources
                 Asian Health in
                 Aotearoa in 2006
                             2006-
                 2007
                 Trends since 2002-2003 – July
                 2010




                 Asian Health Chart
                 Book- 2006
Asian health issues

 Sociodemography
 Lifestyle issues
 Chronic diseases
 Health service utilisation (access
 to health services)
Sociodemography
Asian people, along with Māori and
Pacific, were distributed more towards the
younger age-groups than Europeans

 50% of adults aged 15-34 years
compared with 29% of the Pakeha

The time lived in New Zealand increased
in all three Asian ethnic groups
Sociodemography contd..

The Asian community is highly educated,
   e s a co       u ty s g y
with all three Asian ethnicities being more
likely to have a University bachelor or
post-graduate degree (with 35% of adults in 2006-
07 having a university degree, compared to only 18% of
Europeans)



Asian people, along with Polynesian, were
distributed more towards low household
income categories than European
Lifestyle
  Chinese and Other Asian children,
along with Mā i and P ifi l
 l      ith Māori  d Pacific, less lik l
                                   likely
to have been breast-fed than European
and South Asian children

Among all Asians, lower
           Asians
proportions of people
eating the recommended
daily number of serves of
fruit and vegetables
Lifestyle contd...

Physical activity - Asian people, along
  ys ca act ty       s a peop e, a o g
with Pacific, were less likely to be
physically active than European and Māori

 This trend has not changed since 2002-
2003
Lifestyle contd...
Tobacco - There was no
change in the frequency of
     g           q    y
tobacco smoking by Asian
men or women between
the two surveys
Alcohol - The frequency of
alcohol consumption
increased in Chinese and
Other Asians between the
two surveys, but remained
unchanged in South
Asians
Lifestyle contd...

Ga b g
Gambling - Asian people were less likely
            s a peop e e e ess e y
to gamble than other New Zealanders

The proportion of Asian people who
gamble remained unchanged between the
two surveys

Lotto was the most common type of
gambling by Asian people
Lifestyle contd...

Acculturation - A longer period of
 ccu tu at o       o ge pe od o
residence in New Zealand by Asian people
was associated with increased likelihood
of being an alcohol drinker and of being
overweight and obese
Chronic diseases

Adults: Ca d o ascu a disease and
 du ts Cardiovascular d sease a d
diabetes - South Asian, Pacific and Māori
people had increased prevalences of being
on treatment for hypertension compared
to European

South Asian people had double the risk of
being on t
b i      treatment for high cholesterol
             t   t f hi h h l t       l
than European
Chronic diseases contd...

  The prevalence of being on treatment for
     e p e a e ce o be g o t eat e t o
  diabetes was increased four-fold in South
  Asian and Pacific, and two-fold in Other
  Asian and Māori, compared with European

  The prevalence of obesity has significantly
  increased among Asian adults in New
  Zealand from 2002-03 to 2006-07
  Z l df       2002 03 t 2006 07
Health service utilisation
Asian adults and children were generally less
likely to have seen in the last 12 months a range
of health professionals including medical
           professionals,
specialists, pharmacists, and social workers, than
Europeans

Chinese people were more likely to have seen an
acupuncturist or Chinese medical practitioner in
the last 12 months

Asian adults were more likely to see their GP for
short-term illnesses and less likely for mental or
emotional health reasons or contraceptive
                  reasons,
advice, than Europeans
Health service utilisation contd...
  Overall parents and care-givers of Asian children
  were less likely to have used telephone helplines
  in the last 12 months than European

  South Asian children, Chinese children and overall
  Asian adults were less likely to have used a public
  hospital in the last 12 months compared to
  European

  Similar for oral health
Are you bored???
Asian health issues from Asian
Health Chartbook
H lth Ch tb k 2006
 LBW: Indian newborns are at significantly
 higer risk of low birth weight than the
 g
 general population
           p p
 Asthma: Indian boys are 1.5 times more
 likely to be hospitalised for Asthma than the
 whole population
 Cancer: St
 C        Stomach cancer rates are hi h
                   h          t    higher
 for Chinese females and other Asian males
 than the rest of the population
Asian health issues [cont..]?
  CVD: Indian males and females have significantly
  higher cardiovascular disease hospitalisation and
  mortality rates than the total population

  IHD: Ischaemic heart disease hospitalisation is
  significantly higher for Indians than the total
  population

  Duration of Residence: There is a dose-response
  relationship between duration of residence in New
  Zealand and cardiovascular disease mortality for
  the Asian ethnicity groups.
Asian health issues [cont ]?
                    [cont..]?
ACCESS RATES:

 Mammography Screening: Women of all Asian
 ethnic groups have lower mammography
 screening uptake than New Zealand European
 women

 Cervical Screening:All of the Asian ethnic groups
 have a lower rate of cervical screening than New
                                        g
 Zealand European women
Other issues
  Mental Health issues

  Sexual Health issues

  Language issues
     g g

  Family violence
       y

  Health disparities
The Journey begins....
So, what is the solution?


One size does
  not fit all
     t     ll
TANI
TANI stands for:

The

Asian

Network

Incorporated
Formation of TANI?
Outcome of Asian Forum organised by Auckland
City Council in 2000

Formally incorporated in December 2002

TANI’s council included members from a range of
Asian ethnicities:
    Mainland Chinese      Bangladeshi
    Indian                Korean
    Hongkong Chinese      Philpino
    Māori/Chinese         Sri Lankan
    Thai                  Malaysian
    Burmese
Vision of TANI
Asian New Zealanders enjoy optimal
quality of life and well being
Mission of TANI
TANI’s mission is to develop strong and healthy
Asian communities in Aotearoa New Zealand by:

Networking & Connecting
Advocating for and Promoting the welfare
Ensuring participation in policy making
Liaising with other Organizations
Li i i
Identifying further opportunities of collaboration
Responding to the changing needs
Being a credible national voice
Structure
Team TANI
Activities of TANI
Activities of TANI
• Empowering Asian
  communities by:
- Working collaboratively with them
- Promoting their respective services
- Exploring & developing networks
- Organising professional
  development workshops
- Advocating
- Partnering with
    –   Several Govt and Non-Govt organisations
    –   Asian communities
    –   Educational institutes and research centres
Empowering Asian communities

       •   Expand and maintain network

           •   Build relationship
Empowering Asian communities

                       •   Invite the community by
                           Role sharing

                       •   Co-working as a team




•   Identify the
    issues and needs
Some models of working together
 “Korean Youth
 Seminar”
 in association with Korean
 Society of Auckland




                         “Korean Health and
                         Wellbeing Forum”
                         A role model of collaboration
                         with 3 parties :-

                              Asian community
                              A i         it
                              NGO
                              Government agencies
Review : Positives and Challenges

  Supporting the Asian communities to be
  more involved
  More confident
            fid t   of accessing to the
                     f       i
  resources
  Need to manage the needs
  Takes time & Long commitment
  Lack of workforce
  Funding
  various issues for each Asian group
  Other issues
Activities of TANI
Networking and connecting
up diverse Asian communities
Activities contd……
• Increasing public health knowledge
  and awareness in Asian communities
  and among policy planners

  – Seminars and Forums (8 Annual
    Asian forums, 39 General networks
    meetings and several workshops &
    collaborative seminars)
  – Raising TB awareness project
  –S b i i
    Submissions
  – Public Consultations
Activities contd……
• Increasing public health knowledge
  and awareness in Asian communities
  and among policy planners
   – Mt Roskill HEHA project
Activities contd……
• Facilitating research

  – Asian Public Health Project (2002)
  – Asian Health in Aotearoa (2005)
  – Asian Health Chart Book (2006)
  – Co-hosted two International Asian
    Health Conferences (2006 & 2008)
  – Supported & participated in PHA
    Conferences
  – Co-ordinated & participated in focus
    groups for families commission, AUT,
    UoA
    U A
What more TANI can do?
Future prospects:

• Enhance networks with Asian
Communities l
C        iti locally as well as
                 ll       ll
Nationally

• Work more closely with health
service providers of the regions
where Asian population is growing
faster

•SSupport & empower Asian
        t            A i
communities of these regions
Challenges for TANI
Vast diversity of Asian communities

Low visibility in public health planning

Lack of research and data

Community members “burn-out” (Lack of
                   burn out
volunteers)

Myth that Asians are ‘healthy and wealthy’
                      healthy     wealthy

Funding support
SWOT Analysis with Wellington
Asian communities - 2009
  Strengths:
  - Motivated
  - Family centred
  - Interested in taking ownership
  - Bring new cultural, economic and technological
               cultural
  perspectives, skills, innovations and knowledges
  - Population growth
  -GGreater awareness of the need to address Asian
                          f h        d      dd     A i
  health priorities & concerns
  - Maintain connections with their communities
  and with the countries of origin
  - Building credibility and visibility in the sector
SWOT Analysis contd……..


Weaknesses:
- Lang age & technological barriers
  Language                     ba ie s
- Social isolation (for rest of the family
members)
- Cultural resistance
- Gap between inclusive policy and practice
- Un employment and underemployment
- Lack of champions in government sector
- Healthy immigrant effect
- Institutionalised and bureaucratic exclusion
SWOT Analysis contd……..

Opportunities:
- Develop and increase Asian workforce
- To have a national pan Asian collaboration
- Partnership with OEA’s initiatives
- To support and fund multilingual DVD for
new mig ants (Cante b
ne migrants (Canterbury)   )
- Put forward credible Asian candidates for
local and central govt roles
Threats:
- Escalating health costs eg: oral health
- Change of focus and budget cuts due to
recession
- Post migration stress
“Only when all contribute their firewood can they
            build up a strong fire”
          – we all have a role to play
Acknowledgements
A big thanks to all of you
Past & current TANI council
members
Ministry of Health
Auckland District Health Board
(ADHB)
Partner organisations
          g
TANI network members
Our contact details

          www.asiannetwork.org.nz

          Ph: 09-8152338
              09 8152338

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P.h Issues of Asian Community in NZ

  • 1. Public health issues of Asian New Zealanders – Challenges and triumphs Ch ll dti h NZ Diversity Forum 2010 y
  • 2. Definition of “Asian” in NZ The term ‘Asian’ encompasses p people from a vast area- Japan in the east to Afghanistan in the west and of the 354,549 Asians in NZ, 248,364 were born in Asia.
  • 3. Who is Asian in New Zealand? 0% 2% 1%0%0% 0% 1%1% 1% 1% 1% 2% 2% 2% 2% 2% 3% 39% 5% 9% 27% Chinese nfd Indian nfd Korean Filipino Japanese Sri Lankan nfd Cambodian Thai Fijian Indian j Taiwanese Vietnamese Malay Indonesian Afghani Asian nfd Pakistani Eurasian Bangladeshi Malaysian Chinese Laotian Other Asian
  • 4. Asian population p p Asians now 9.2% of the population (2006) 354,549 354 549 people l 16 9.2% f 9 2% of NZ population (Statistics of New 14 Zealand, 2006) 12 10 8 Asian NZ population size 6 4 2 0 1991 2001 2006 2020
  • 5. Demographics continued Demographics-continued 2006 Census: Auckland 98,391 Chinese, 74,442 Indians, region g 21,351 Korean, 9,819 Filipino, 9 819 Fili i 5,289 Japanese and 5,049 Sri Lankans Wellington 14,895 Chinese, 11,073 Indians, region 2,367 Filipino Canterbury 13,410 Chinese, 4,746 Koreans, region 3,429 Indians, 1,287Filipino Waikato Region 7,122 Chinese, 5,637 Indians, 1,383 Koreans.
  • 6. Health status of Asians living outside Asia Overseas studies [ in UK] have shown deteriorating health amongst Asians over a period of time Generally Asians, who are largely immigrants, come to NZ healthy because of immigration medical screening-but because of various reasons [ genetic, b f i ti lifestyle..] over a period of time develop diseases
  • 7. Asian health issues - sources Asian Health in Aotearoa in 2006 2006- 2007 Trends since 2002-2003 – July 2010 Asian Health Chart Book- 2006
  • 8. Asian health issues Sociodemography Lifestyle issues Chronic diseases Health service utilisation (access to health services)
  • 9. Sociodemography Asian people, along with Māori and Pacific, were distributed more towards the younger age-groups than Europeans 50% of adults aged 15-34 years compared with 29% of the Pakeha The time lived in New Zealand increased in all three Asian ethnic groups
  • 10. Sociodemography contd.. The Asian community is highly educated, e s a co u ty s g y with all three Asian ethnicities being more likely to have a University bachelor or post-graduate degree (with 35% of adults in 2006- 07 having a university degree, compared to only 18% of Europeans) Asian people, along with Polynesian, were distributed more towards low household income categories than European
  • 11. Lifestyle Chinese and Other Asian children, along with Mā i and P ifi l l ith Māori d Pacific, less lik l likely to have been breast-fed than European and South Asian children Among all Asians, lower Asians proportions of people eating the recommended daily number of serves of fruit and vegetables
  • 12. Lifestyle contd... Physical activity - Asian people, along ys ca act ty s a peop e, a o g with Pacific, were less likely to be physically active than European and Māori This trend has not changed since 2002- 2003
  • 13. Lifestyle contd... Tobacco - There was no change in the frequency of g q y tobacco smoking by Asian men or women between the two surveys Alcohol - The frequency of alcohol consumption increased in Chinese and Other Asians between the two surveys, but remained unchanged in South Asians
  • 14. Lifestyle contd... Ga b g Gambling - Asian people were less likely s a peop e e e ess e y to gamble than other New Zealanders The proportion of Asian people who gamble remained unchanged between the two surveys Lotto was the most common type of gambling by Asian people
  • 15. Lifestyle contd... Acculturation - A longer period of ccu tu at o o ge pe od o residence in New Zealand by Asian people was associated with increased likelihood of being an alcohol drinker and of being overweight and obese
  • 16. Chronic diseases Adults: Ca d o ascu a disease and du ts Cardiovascular d sease a d diabetes - South Asian, Pacific and Māori people had increased prevalences of being on treatment for hypertension compared to European South Asian people had double the risk of being on t b i treatment for high cholesterol t t f hi h h l t l than European
  • 17. Chronic diseases contd... The prevalence of being on treatment for e p e a e ce o be g o t eat e t o diabetes was increased four-fold in South Asian and Pacific, and two-fold in Other Asian and Māori, compared with European The prevalence of obesity has significantly increased among Asian adults in New Zealand from 2002-03 to 2006-07 Z l df 2002 03 t 2006 07
  • 18. Health service utilisation Asian adults and children were generally less likely to have seen in the last 12 months a range of health professionals including medical professionals, specialists, pharmacists, and social workers, than Europeans Chinese people were more likely to have seen an acupuncturist or Chinese medical practitioner in the last 12 months Asian adults were more likely to see their GP for short-term illnesses and less likely for mental or emotional health reasons or contraceptive reasons, advice, than Europeans
  • 19. Health service utilisation contd... Overall parents and care-givers of Asian children were less likely to have used telephone helplines in the last 12 months than European South Asian children, Chinese children and overall Asian adults were less likely to have used a public hospital in the last 12 months compared to European Similar for oral health
  • 21. Asian health issues from Asian Health Chartbook H lth Ch tb k 2006 LBW: Indian newborns are at significantly higer risk of low birth weight than the g general population p p Asthma: Indian boys are 1.5 times more likely to be hospitalised for Asthma than the whole population Cancer: St C Stomach cancer rates are hi h h t higher for Chinese females and other Asian males than the rest of the population
  • 22. Asian health issues [cont..]? CVD: Indian males and females have significantly higher cardiovascular disease hospitalisation and mortality rates than the total population IHD: Ischaemic heart disease hospitalisation is significantly higher for Indians than the total population Duration of Residence: There is a dose-response relationship between duration of residence in New Zealand and cardiovascular disease mortality for the Asian ethnicity groups.
  • 23. Asian health issues [cont ]? [cont..]? ACCESS RATES: Mammography Screening: Women of all Asian ethnic groups have lower mammography screening uptake than New Zealand European women Cervical Screening:All of the Asian ethnic groups have a lower rate of cervical screening than New g Zealand European women
  • 24. Other issues Mental Health issues Sexual Health issues Language issues g g Family violence y Health disparities
  • 26. So, what is the solution? One size does not fit all t ll
  • 28. Formation of TANI? Outcome of Asian Forum organised by Auckland City Council in 2000 Formally incorporated in December 2002 TANI’s council included members from a range of Asian ethnicities: Mainland Chinese Bangladeshi Indian Korean Hongkong Chinese Philpino Māori/Chinese Sri Lankan Thai Malaysian Burmese
  • 29. Vision of TANI Asian New Zealanders enjoy optimal quality of life and well being
  • 30. Mission of TANI TANI’s mission is to develop strong and healthy Asian communities in Aotearoa New Zealand by: Networking & Connecting Advocating for and Promoting the welfare Ensuring participation in policy making Liaising with other Organizations Li i i Identifying further opportunities of collaboration Responding to the changing needs Being a credible national voice
  • 34. Activities of TANI • Empowering Asian communities by: - Working collaboratively with them - Promoting their respective services - Exploring & developing networks - Organising professional development workshops - Advocating - Partnering with – Several Govt and Non-Govt organisations – Asian communities – Educational institutes and research centres
  • 35. Empowering Asian communities • Expand and maintain network • Build relationship
  • 36. Empowering Asian communities • Invite the community by Role sharing • Co-working as a team • Identify the issues and needs
  • 37. Some models of working together “Korean Youth Seminar” in association with Korean Society of Auckland “Korean Health and Wellbeing Forum” A role model of collaboration with 3 parties :- Asian community A i it NGO Government agencies
  • 38. Review : Positives and Challenges Supporting the Asian communities to be more involved More confident fid t of accessing to the f i resources Need to manage the needs Takes time & Long commitment Lack of workforce Funding various issues for each Asian group Other issues
  • 40. Networking and connecting up diverse Asian communities
  • 41. Activities contd…… • Increasing public health knowledge and awareness in Asian communities and among policy planners – Seminars and Forums (8 Annual Asian forums, 39 General networks meetings and several workshops & collaborative seminars) – Raising TB awareness project –S b i i Submissions – Public Consultations
  • 42. Activities contd…… • Increasing public health knowledge and awareness in Asian communities and among policy planners – Mt Roskill HEHA project
  • 43. Activities contd…… • Facilitating research – Asian Public Health Project (2002) – Asian Health in Aotearoa (2005) – Asian Health Chart Book (2006) – Co-hosted two International Asian Health Conferences (2006 & 2008) – Supported & participated in PHA Conferences – Co-ordinated & participated in focus groups for families commission, AUT, UoA U A
  • 44. What more TANI can do? Future prospects: • Enhance networks with Asian Communities l C iti locally as well as ll ll Nationally • Work more closely with health service providers of the regions where Asian population is growing faster •SSupport & empower Asian t A i communities of these regions
  • 45. Challenges for TANI Vast diversity of Asian communities Low visibility in public health planning Lack of research and data Community members “burn-out” (Lack of burn out volunteers) Myth that Asians are ‘healthy and wealthy’ healthy wealthy Funding support
  • 46. SWOT Analysis with Wellington Asian communities - 2009 Strengths: - Motivated - Family centred - Interested in taking ownership - Bring new cultural, economic and technological cultural perspectives, skills, innovations and knowledges - Population growth -GGreater awareness of the need to address Asian f h d dd A i health priorities & concerns - Maintain connections with their communities and with the countries of origin - Building credibility and visibility in the sector
  • 47. SWOT Analysis contd…….. Weaknesses: - Lang age & technological barriers Language ba ie s - Social isolation (for rest of the family members) - Cultural resistance - Gap between inclusive policy and practice - Un employment and underemployment - Lack of champions in government sector - Healthy immigrant effect - Institutionalised and bureaucratic exclusion
  • 48. SWOT Analysis contd…….. Opportunities: - Develop and increase Asian workforce - To have a national pan Asian collaboration - Partnership with OEA’s initiatives - To support and fund multilingual DVD for new mig ants (Cante b ne migrants (Canterbury) ) - Put forward credible Asian candidates for local and central govt roles Threats: - Escalating health costs eg: oral health - Change of focus and budget cuts due to recession - Post migration stress
  • 49. “Only when all contribute their firewood can they build up a strong fire” – we all have a role to play
  • 50. Acknowledgements A big thanks to all of you Past & current TANI council members Ministry of Health Auckland District Health Board (ADHB) Partner organisations g TANI network members
  • 51. Our contact details www.asiannetwork.org.nz Ph: 09-8152338 09 8152338