Indigenous adolescent health in Aotearoa New Zealand: Trends, policy and advancing equity for rangatahi Maori, 2001-2019.

Autor:	Clark TC; School of Nursing, Faculty of Medical Health Sciences, University of Auckland, Private Bag 92019 Auckland 1142, New Zealand., Ball J; Department of Public Health, University of Otago, Wellington, PO Box 7343, Newtown, Wellington 6242, New Zealand., Fenaughty J; School of Counselling, Human Services and Social Work, Faculty of Education and Social Work, University of Auckland, Private Bag 92019 Auckland 1142, New Zealand., Drayton B; Department of Statistics, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand., Fleming TT; School of Health, Te Herenga Waka | Victoria University of Wellington, PO Box 600, Wellington 6140, New Zealand., Rivera-Rodriguez C; Department of Statistics, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand., Le Grice J; School of Psychology, Faculty of Science, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand., Peiris-John R; Section of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand., Bavin LM; Section of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand., Schwencke A; Faculty of Medical Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand., Sutcliffe K; School of Health, Te Herenga Waka | Victoria University of Wellington, PO Box 600, Wellington 6140, New Zealand., Lewycka S; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK.; Oxford University Clinical Research Unit, Hanoi, Vietnam., Lucassen M; School of Health, Wellbeing and Social Care, The Open University, Milton Keynes MK7 6AA, UK., Waa A; Eru Pōmare Māori Health Research Unit, Department of Public Health, University of Otago, Wellington, PO Box 7343, Wellington 6242, New Zealand., Greaves LM; School of Social Sciences, Faculty of Arts, University of Auckland, Private Bag 92019 Auckland 1142, New Zealand., Crengle S; Department of Preventative and Social Medicine, Otago Medical School, PO Box 56, Dunedin 9054, New Zealand.
Jazyk:	angličtina
Zdroj:	The Lancet regional health. Western Pacific [Lancet Reg Health West Pac] 2022 Aug 12; Vol. 28, pp. 100554. Date of Electronic Publication: 2022 Aug 12 (Print Publication: 2022).
DOI:	10.1016/j.lanwpc.2022.100554
Abstrakt:	Background: Rangatahi Māori, the Indigenous adolescents of Aotearoa New Zealand (NZ), have poorer health outcomes than Pākehā (NZ European /other European/"White") adolescents. We explored the influence of policies for Indigenous youth by presenting health trends, inequities and contrasting policy case examples: tobacco control and healthcare access. Methods: Cross-sectional representative surveys of NZ secondary school students were undertaken in 2001, 2007, 2012 and 2019. Health indicators are presented for Māori and Pākehā adolescents (relative risks with 95% CI, calculated using modified Poisson regression) between 2001-2019 and 2012-2019. Policy examples were examined utilising Critical Te Tiriti Analysis (CTA). Findings: Rangatahi Māori reported significant health gains between 2001 and 2019, but an increase in depressive symptoms (13.8% in 2012 to 27.9% in 2019, RR 2.01 [1.65-2.46]). Compared to Pākehā youth there was a pattern of persistent Māori disadvantage, particularly for racism (RR 2.27 [2.08-2.47]), depressive symptoms (RR 1.42 [1.27-1.59]) and forgone healthcare (RR 1.63 [1.45-1.84]). Tobacco use inequities narrowed (RR 2.53 [2.12-3.02] in 2007 to RR 1.55 [1.25-1.93] in 2019). CTA reveals rangatahi Māori-specific policies, Māori leadership, and political support aligned with improved outcomes and narrowing inequities. Interpretation: Age-appropriate Indigenous strategies are required to improve health outcomes and reduce inequities for rangatahi Māori. Characteristics of effective strategies include: (1) evidence-based, sustained, and comprehensive approaches including both universal levers and Indigenous youth-specific policies; (2) Indigenous and rangatahi leadership; (3) the political will to address Indigenous youth rights, preferences, priorities; and (4) a commitment to an anti-racist praxis and healthcare Indigenisation. Funding: Two Health Research Council of New Zealand Project Grants: (a) Fleming T, Peiris-John R, Crengle S, Parry D. (2018). Integrating survey and intervention research for youth health gains. (HRC ref: 18/473); and (b) Clark TC, Le Grice J, Groot S, Shepherd M, Lewycka S. (2017) Harnessing the spark of life: Maximising whānau contributors to rangatahi wellbeing (HRC ref: 17/315). Competing Interests: Cure Kids funds of the lead author's (TC's) Professorial Chair. Cure Kids had no role in data collection, analysis, interpretation, writing of the manuscript nor the decision to submit. SC receives board fees from Interim Māori Health Authority and WellSouth Primary Health Network. (© 2022 The Author(s).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu