Li-Chia Yeh

The pervasive effects of racism: experiences of racial discrimination in New Zealand over time and associations with multiple health domains.

Self-reported experience of racial discrimination has been linked to a range of health outcomes in various countries and for different ethnic groups. This study builds on previous work in New Zealand to further investigate the prevalence of self-reported experience of racial discrimination by ethnicity, changes over time and associations with multiple health measures. The study uses data from the 2002/03 (n=12,500) and 2006/07 (n=12,488) New Zealand Health Surveys, nationally representative population-based surveys of adults (15+ years). Reported experience of racial discrimination was measured in both surveys and covered 5 items: experience of an ethnically motivated physical or verbal attack; and unfair treatment because of ethnicity by a health professional, in work, or when gaining housing. Ethnicity was classified as Maori, Pacific, Asian or European. Health indicators included measures of: mental health (SF36 mental health scale, psychological distress, doctor diagnosed mental health condition); physical health (self-rated health, SF36 physical functioning scale, cardiovascular disease); and health risk (smoking, hazardous drinking, excess body fat). Logistic regression was used to examine changes in prevalence of reported experience of racial discrimination over time and associations with health. Reported experience of racial discrimination increased between 2002/03 (28.1% ever) and 2006/07 (35.0% ever) among Asian peoples but remained largely unchanged for other ethnic groupings (Maori 29.5%, Pacific 23.0%, European 13.5%). Experience of racial discrimination was associated with all negative health measures except excess body fat. Where there were significant associations, a dose-response relationship was also evident. We conclude that racial discrimination experienced across a range of settings has the potential to impact on a wide range of health outcomes and risk factors. While ongoing research is needed to understand the multifarious nature of racism and the pathways by which it leads to poor health, it is feasible to monitor experiences of racial discrimination in national surveys.

How much does health care contribute to health gain and to health inequality? Trends in amenable mortality in New Zealand 1981-2004

Objective : To estimate the contribution of health care to health gain, and to ethnic and socio‐economic health inequalities, in New Zealand over the past quarter century.

Self-Reported Experience of Racial Discrimination and Health Care Use in New Zealand: Results From the 2006/07 New Zealand Health Survey

OBJECTIVES We investigated whether reported experience of racial discrimination in health care and in other domains was associated with cancer screening and negative health care experiences. METHODS We used 2006/07 New Zealand Health Survey data (n = 12 488 adults). We used logistic regression to examine the relationship of reported experience of racial discrimination in health care (unfair treatment by a health professional) and in other domains (personal attack, unfair treatment in work and when gaining housing) to breast and cervical cancer screening and negative patient experiences adjusted for other variables. RESULTS Racial discrimination by a health professional was associated with lower odds of breast (odds ratio [OR] = 0.37; 95% confidence interval [CI] = 0.14, 0.996) and cervical cancer (OR = 0.51; 95% CI = 0.30, 0.87) screening among Maori women. Racial discrimination by a health professional (OR = 1.57; 95% CI = 1.15, 2.14) and racial discrimination more widely (OR = 1.55; 95% CI = 1.35, 1.79) were associated with negative patient experiences for all participants. CONCLUSIONS Experience of racial discrimination in both health care and other settings may influence health care use and experiences of care and is a potential pathway to poor health.

Do healthy and unhealthy behaviours cluster in New Zealand

Objective: To describe the co‐occurrence and clustering of healthy and unhealthy behaviours in New Zealand.

Did it fall or was it pushed? The contribution of trends in established risk factors to the decline in premature coronary heart disease mortality in New Zealand

Objective: To estimate the contribution of trends in three risk factors – systolic blood pressure (SBP), total blood cholesterol (TBC) and cigarette smoking – to the decline in premature coronary heart disease (CHD) mortality in New Zealand from 1980‐2004.

How much does health care contribute to health inequality in New Zealand

Objective: To quantify the contribution of health care to ethnic and socio‐economic inequalities in health in New Zealand in 2000‐02, using the concept of ‘amenable’ mortality (deaths at ages 0‐74 years from causes responsive to health care).

Do all ethnic groups in New Zealand exhibit socio-economic mortality gradients?

Objectives: First, to establish whether a deprivation gradient in all‐cause mortality exists for all ethnic groups within New Zealand; second, if such gradients do exist, whether their absolute slopes are the same; and third, if such gradients exist, what impact the unequal deprivation distributions of the different ethnic groups have on the observed ethnic inequalities in life expectancy at birth.

Can the incidence and prevalence of coronary heart disease be determined from routinely collected national data? Population-based estimates for New Zealand in 2001--03.

Objective: To produce internally consistent estimates of coronary heart disease (CHD) incidence, prevalence, survival and mortality as a decision aid for service planning and resource allocation.

Co‐occurrence and clustering of tobacco use and obesity in New Zealand: cross‐sectional analysis

Objective: To describe the co‐occurrence and clustering/aversion of tobacco use and obesity in New Zealand.

The burden of coronary heart disease in Māori: population-based estimates for 2000-02

Objective: To estimate coronary heart disease (CHD) incidence, prevalence, survival, case fatality and mortality for Māori, in order to support service planning and resource allocation.