Te Kani Kingi

Cohort Profile: Growing Up in New Zealand

Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand, Growing Up in New Zealand, University of Auckland, Auckland, New Zealand, School of Medicine, University of Auckland, Auckland, New Zealand, Starship Children’s Hospital, Auckland District Health Board, Auckland, New Zealand, School of Population Health, University of Auckland, Auckland, New Zealand, Department of Public Health, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand, Office of the Deputy Vice-Chancellor (Māori), Massey University, Wellington, New Zealand, Bioinformatics Institute, University of Auckland, Auckland, New Zealand, Ministry of Pacific Island Affairs, Auckland Office, Auckland, New Zealand, Department of Psychology, University of Auckland, Auckland, New Zealand, Roy McKenzie Centre for the Study of Families, Victoria University, Wellington, New Zealand, Department of Psychology, University of Otago, Dunedin, New Zealand and School of Medical Sciences, University of Auckland, Auckland, New Zealand

Prevalence of mental disorders among Maori in Te Rau Hinengaro: The New Zealand Mental Health Survey

Objective: To describe the prevalence of mental disorders (period prevalence across aggregated disorders, 12 month and lifetime prevalence) among Māori in Te Rau Hinengaro: The New Zealand Mental Health Survey. Method: Te Rau Hinengaro: The New Zealand Mental Health Survey, undertaken between 2003 and 2004, was a nationally representative face-to-face household survey of 12 992 New Zealand adults aged 16 years and over, including 2595 Māori. Ethnicity was measured using the 2001 New Zealand census ethnicity question. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0), was used to measure disorder. The overall response rate was 73.3%. This paper presents selected findings for the level and pattern of mental disorder prevalence among Māori. Results: Māori lifetime prevalence of any disorder was 50.7%, 12 month prevalence 29.5% and 1 month prevalence 18.3%. The most common 12 month disorders were anxiety (19.4%), mood (11.4%) and substance (8.6%) disorders and the most common lifetime disorders were anxiety (31.3%), substance (26.5%) and mood (24.3%) disorders. Levels of lifetime comorbidity were high with 12 month prevalence showing 16.4% of Māori with one disorder, 7.6% with two disorders and 5.5% with three or more disorders. Twelvemonth disorders were more common in Māori females than in males (33.6% vs 24.8%) and in younger age groups: 16–24 years, 33.2%; 25–44 years, 32.9%; 45–64 years, 23.7%; and 65 years and over, 7.9%. Disorder prevalence was greatest among Māori with the lowest equivalized household income and least education. However, differences by urbanicity and region were not significant. Of Māori with any 12 month disorder, 29.6% had serious, 42.6% had moderate and 27.8% had mild disorders. Conclusion: Mental disorders overall and specific disorder groups (anxiety, mood and substance) are common among Māori and measures of severity indicate that disorders have considerable health impact. Findings provide a platform for informing public health policy and health sector responses to meeting mental health needs of Māori.

Development of a culturally attuned psychiatric outcome measure for an indigenous population

Outcome measures are critical to the development of quality mental health services and for their continuous improvement activities. For many cultures, credible and robust outcome measures are not available. This project aimed to continue the development of an outcome measure suitable for use by Māori (the Polynesian indigenous population of Aotearoa [New Zealand]). The tool was developed within the framework of a holistic Māori model of health and tested for its utility in the settings of small Māori Mental Health Service providers. Of the two versions tested, qualitative and quantitative evaluation established a clear endorsement of one version for which some psychometrically credible evidence was obtained. A software package to incorporate the routine collection of such outcome measurement information into a national data base providing online feedback to service providers is also briefly described.

Pre-adolescent cardio-metabolic associations and correlates: PACMAC methodology and study protocol

Introduction Although cardiovascular disease is typically associated with middle or old age, the atherosclerotic process often initiates early in childhood. The process of atherosclerosis appears to be occurring at an increasing rate, even in pre-adolescents, and has been linked to the childhood obesity epidemic. This study will investigate the relationships between obesity, lifestyle behaviours and cardiometabolic health in pre-pubescent children aged 8–10 years, and investigates whether there are differences in the correlates of cardiometabolic health between Māori and Caucasian children. Details of the methodological aspects of recruitment, inclusion/exclusion criteria, assessments, statistical analyses, dissemination of findings and anticipated impact are described. Methods and analysis Phase 1: a cross-sectional study design will be used to investigate relationships between obesity, lifestyle behaviours (nutrition, physical activity/fitness, sleep behaviour, psychosocial influences) and cardiometabolic health in a sample of 400 pre-pubescent (8–10 years old) children. Phase 2: in a subgroup (50 Caucasian, 50 Māori children), additional measurements of cardiometabolic health and lifestyle behaviours will be obtained to provide objective and detailed data. General linear models and logistic regression will be used to investigate the strongest correlate of (1) fatness; (2) physical activity; (3) nutritional behaviours and (4) cardiometabolic health. Ethics and dissemination Ethical approval will be obtained from the New Zealand Health and Disabilities Ethics Committee. The findings from this study will elucidate targets for decreasing obesity and improving cardiometabolic health among preadolescent children in New Zealand. The aim is to ensure an immediate impact by disseminating these findings in an applicable manner via popular media and traditional academic forums. Most importantly, results from the study will be disseminated to participating schools and relevant Māori health entities.

Capturing the Capitals: A Heuristic for Measuring the “Wealth” of New Zealand Children in the Twenty-First Century: An Application to the Growing Up in New Zealand Longitudinal Cohort

The concept of “wealth” is recognized as an important determinant of health. However, wealth can mean different things within different cultures. In this chapter, we understand wealth through the lens of Bourdieu’s conceptualization of three capitals—economic, social, and cultural—an approach that allows for cultural difference in understanding what wealth means. Here, we focus on wealth as accessed by children in New Zealand, using the new longitudinal study Growing Up in New Zealand as an example of a large-scale research project requiring the development of conceptually and methodologically robust tools to measure wealth. Utilizing the life course and socioecological framework of Growing Up in New Zealand, children’s wealth is understood to exist at multiple levels: parental, household, extended family, informal society, formal institutions, and regions. Providing robust evidence for effective policy development about the wealth of children’s environments requires that we develop tools incorporating interactions between household and nonhousehold resources and variations in forms of capital across different cultural and ethnic groups.