Coronary heart disease among Pacific Island people in New Zealand

Coronary heart disease is the leading cause of death in New Zealand. Death rates are higher among the Maori than the European population but rates have been declining in both groups over recent years. The occurrence of coronary heart disease among the Pacific Island population in New Zealand is unknown. Data from the National Health Statistics Centre (NHSC) and the Auckland coronary or stroke (ARCOS) study were used to describe the occurrence of coronary heart diseases among Pacific Island people. Age standardised mortality rates show that coronary heart disease is an important cause of death among Pacific Island men. Death rates have declined between 1973-77 and 1978-82 but this trend did not continue among men in the 1983-86 period. Age standardised mortality rates from coronary heart disease from the ARCOS data are 175/100,000 and 52/100,000 for Pacific Island men and women compared with 325/100,000 and 141/100,000 for Maori men and women. Age standardised rates for European men and women are 154/100,000 and 36/100,000 respectively.     

Incidence of cancer among Pacific Island people in New Zealand.

AIM: to describe the epidemiology of new cancer registrations among Pacific Island people in New Zealand with a view to identifying important cancers for preventive activities. METHODS: new cancer cases registered with the New Zealand Cancer Registry of the Health Statistical Services for the decade 1979-88 were analysed. Cancer cases among Pacific Island people were compared with cancer cases among Maori and the remainder of the New Zealand population (other). RESULTS: while the number of cases reported among Pacific Island people was relatively small (1884), age standardised rates for cancer of all sites were much higher than age standardised rates for Maori and other populations. The age standardised rate (per 100,000 person years) for cancer of all sites among males in all age groups was 400 for Pacific Island, 308.8 for Maori and 295.3 for others. The age standardised rate for cancer of all sites among women in all age groups was 373.3 for Pacific Island women, 324.2 for Maori and 313.4 for other women. Liver cancer was more common among Pacific Island men than could be explained by temporary migration from the Pacific Islands for treatment. The age standardised rate for liver cancer was 28.2 for Pacific Island men, 11.4 for Maori and 1.9 for other men. Cancer of the cervix was the leading site among Pacific Island women as in Maori women, compared with breast cancer among women in the rest of the population. The age standardised rate for cervical cancer was 61.8 for Pacific Island, 69.0 for Maori and 59.3 for other women. CONCLUSION: in the decade 1979-88 there was an excess number of new registrations for some cancers described among Pacific Island people compared with Maori and other ethnic groups. Temporary migration from the Pacific Islands for treatment may explain some of the excess cases.     

Positive provider interventions for enhancing influenza vaccination uptake among Pacific peoples in New Zealand

Despite having reported influenza vaccination rates similar to New Zealand Europeans, Pacific peoples have significantly higher rates of infection, hospitalisation and intensive care unit admission than any other group in New Zealand. Much of this may be due to the presence of comorbidities. However, it is in the interest of Pacific health to promote vaccination widely within this group. Little has been written about what prevents and encourages positive vaccination amongst Pacific peoples. This article reviews current themes about vaccination practices amongst ethnic minorities with a view to identifying positive vaccination strategies for Pacific peoples living in New Zealand.     

Infant sleep position: a New Zealand survey

Four thousand and forty-one infants aged 1-4 months were included in a national survey to determine the position in which New Zealand infants usually sleep. Infants were most commonly put down on the side or on the front with the face to one side. Many changed position during sleep. By far the most common position in which infants ended up sleeping was on the front with the face to one side. The proportion of infants in the various sleep positions changed with age. Speculation as to a possible relationship between sleep position and sudden infant death must take into account that many infants do not sleep in the position in which they are put down and that there are changes in position with age.     

Awareness of sudden infant death syndrome risk factors among mothers of Pacific infants in New Zealand

AIM: To describe the awareness of Sudden Infant Death Syndrome (SIDS) risk factors among mothers of Pacific infants in New Zealand. METHODS: The data were gathered as part of the Pacific Islands Families Study in which 1376 mothers were interviewed when their infants were six weeks old. Included in this interview were questions designed to examine the mothers' awareness of SIDS risk factors. RESULTS: Over one third (38.8%) of mothers were unable to accurately report a SIDS risk factor, 53.4% reported the risk associated with putting the baby to sleep in a prone position, 31.5% maternal smoking, and 19.5% correctly reported other SIDS risk factors. Lack of awareness of SIDS risk factors was significantly associated with Samoan and Cook Islands Maori ethnicity, being Pacific Islands born, having no post school qualifications, lower household income, not being fluent in English, having more than five children, and not attending antenatal classes. CONCLUSIONS: Despite SIDS prevention efforts, a considerable number of mothers in this cohort reported no awareness of SIDS risk factors. More effective methods are needed to provide consistent SIDS prevention information across Pacific ethnic groups.     

The epidemiology of breast cancer in Pacific women in New Zealand

AIM: To describe the epidemiology of breast cancer in Pacific women in New Zealand and determine whether ethnic disparities exist. METHODS: Analysis of data obtained from the New Zealand Cancer Registry for breast cancer notifications from 1987-94 inclusive. Statistical analysis compared the age-specific incidence, tumour stage at presentation and pathological tumour type of Pacific, Maori and Other women. RESULTS: Notification data were analysed for 12,914 breast cancer cases including 688 Maori and 227 Pacific women. The age-standardised incidence rate per 100,000 person years for Pacific women (104.5) was statistically significantly (p<0.05) lower than that for Other (139.1) and Maori (148.6) women. Pacific and Maori women presented with significantly less localised tumours (31.4% and 41.3% respectively) than Other women (47.2%). CONCLUSION: Ethnic disparities in breast cancer epidemiology exist in New Zealand. Pacific women may have decreased incidence rates of breast cancer but they and Maori women present with a more advanced stage of breast cancer than Other women. The latter is a modifiable factor which could be targeted by improved participation in screening programmes.     

Abortion experiences among New Zealand women.

In May 1976 the incidence of abortion among New Zealand women was surveyed over a national random probability sample of 1200 women aged 15 years and over. Of the respondents who had ever been pregnant, 16.6 percent had at some stage considered terminating their pregnancy, and one-third of them subsequently attempted to obtain an abortion with 84 percent success. Single women and/or women in the 15-24 year age group were more likely than married or older women to have considered abortion when pregnant, and were more likely to have followed through with an abortion attempt after considering abortion. Prior to 1974, 62 percent of the abortion attempts involved an unqualified operator, in contrast to only 5 percent of those attempted or obtained from 1974-1976. Women with abortion experiences shifted from a low incidence of contraception and reliance on inadequate methods prior to the abortion attempt, to a higher incidence and use of more adequate methods subsequent to the abortion attempt. Extrapolation from the survey data yielded a median estimated incidence of 8000 abortions per annum on New Zealand women.     

Serious illness in 204 New Zealand families during a 16 year period

Mothers of 204 senior school pupils completed a questionnaire about serious illness in nuclear family members during the lifetime of each adolescent. The information provided was sufficiently detailed to estimate incidence of various types of illness, to categorise illness by degree of seriousness and to compare illness histories between families. Gynaecological conditions in mothers and accidents and infectious diseases in children were the most common serious illness; asthma was reported in 7% of the individuals (27% of families). There had been 17 deaths, 31 life threatening illnesses, 108 major illnesses (defined as at least one week in hospital for a medical condition or for major surgery), 150 serious but non-major illnesses and 84 episodes of minor surgery. Six percent of families reported 36% of the medically serious illnesses.     

Contraceptive practice among New Zealand women.

In May 1976 the contraceptive practices of New Zealand women were surveyed among a national random probability sample of 1200 women aged 15 years and over. The survey found 93 percent of women aged 15-44 years considered themselves at risk of pregnancy. Of all women surveyed, almost half (two-thirds of those at risk) currently practised contraception. The highest incidence was among women aged 25-44 years. Single women at risk contracepted less frequently than did married women. The most frequently used method was the contraceptive pill, favoured particularly by younger women. It was followed by sterilisation of either partner, which was most frequent among women aged 25-44 years.