COVID‐19: we must not forget about Indigenous health and equity

McLeod, Melissa; Gurney, Jason; Harris, Ricci; Cormack, Donna; King, Paula

doi:10.1111/1753-6405.13015

Cited by 79 publications

(65 citation statements)

References 32 publications

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“…2 , 8 , 9 , 21 , 22 Our study supports the ongoing need for the response to address systemic barriers, such as health-care access, to achieving equitable health outcomes for minority and higher-risk groups, particularly in the absence of elimination. 23 …”

Section: Discussionmentioning

confidence: 99%

COVID-19 in New Zealand and the impact of the national response: a descriptive epidemiological study

Jefferies

French

Gilkison

et al. 2020

The Lancet Public Health

249

270

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BackgroundIn early 2020, during the COVID-19 pandemic, New Zealand implemented graduated, risk-informed national COVID-19 suppression measures aimed at disease elimination. We investigated their impacts on the epidemiology of the first wave of COVID-19 in the country and response performance measures. MethodsWe did a descriptive epidemiological study of all laboratory-confirmed and probable cases of COVID-19 and all patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in New Zealand from Feb 2 to May 13, 2020, after which time community transmission ceased. We extracted data from the national notifiable diseases database and the national SARS-CoV-2 test results repository. Demographic features and disease outcomes, transmission patterns (source of infection, outbreaks, household transmission), time-to-event intervals, and testing coverage were described over five phases of the response, capturing different levels of non-pharmaceutical interventions. Risk factors for severe outcomes (hospitalisation or death) were examined with multivariable logistic regression and time-to-event intervals were analysed by fitting parametric distributions using maximum likelihood estimation. Findings 1503 cases were detected over the study period, including 95 (6•3%) hospital admissions and 22 (1•5%) COVID-19 deaths. The estimated case infection rate per million people per day peaked at 8•5 (95% CI 7•6-9•4) during the 10-day period of rapid response escalation, declining to 3•2 (2•8-3•7) in the start of lockdown and progressively thereafter. 1034 (69%) cases were imported or import related, tending to be younger adults, of European ethnicity, and of higher socioeconomic status. 702 (47%) cases were linked to 34 outbreaks. Severe outcomes were associated with locally acquired infection (crude odds ratio [OR] 2•32 [95% CI 1•40-3•82] compared with imported), older age (adjusted OR ranging from 2•72 [1•40-5•30] for 50-64 year olds to 8•25 [2•59-26•31] for people aged ≥80 years compared with 20-34 year olds), aged residential care residency (adjusted OR 3•86 [1•59-9•35]), and Pacific peoples (adjusted OR 2•76 [1•14-6•68]) and Asian (2•15 [1•10-4•20]) ethnicities relative to European or other. Times from illness onset to notification and isolation progressively decreased and testing increased over the study period, with few disparities and increasing coverage of females, Māori, Pacific peoples, and lower socioeconomic groups.Interpretation New Zealand's response resulted in low relative burden of disease, low levels of population disease disparities, and the initial achievement of COVID-19 elimination.

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Section: Discussionmentioning

confidence: 99%

COVID-19 in New Zealand and the impact of the national response: a descriptive epidemiological study

Jefferies

French

Gilkison

et al. 2020

The Lancet Public Health

249

270

View full text Add to dashboard Cite

show abstract

“…The relationship between COVID-19 and indigenous peoples is gaining rapid visibility in the international media and academic publications, as the historical evidence on the interdependence between colonization, viruses, bacteria, and their tragic impact on native peoples is revisited (Wade 2020 ). Several works address the crisis from the perspective of the responses of healthcare systems to the specific epidemiological characteristics of native populations (Cupertino et al 2020 ; Gonçalves et al 2020 ; McLeod et al 2020 ; Meneses et al 2020 ). Other works note the differentiated effects of COVID-19 on these populations, due also to their histories of marginalization (Power et al 2020 ; White 2020 ).…”

Section: Uncertaintiesmentioning

confidence: 99%

Plagues, past, and futures for the Yagan canoe people of Cape Horn, southern Chile

et al. 2021

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The manner in which the COVID-19 pandemic has affected the indigenous Yagan people of Navarino Island in southern Chile is the topic of this paper. Like other First Nation communities, these nomadic people suffered decimation and disease in successive encounters with Europeans, and then, in the mid-twentieth century, forced sedentarization by the Chilean State. More recently, the Yagan have fought the expansion of salmon aquaculture to the Island. Making use of a sociomaterial approach, we examine how the threat of past and present viruses and diseases, added to the tragic effects of colonization, become part of a broader sociohistorical debate on the right of coastal peoples to their maritories. Paradoxically, our results suggest that COVID-19 has become part of an assemblage of ethnic revitalization, opening possibilities for the Yagan clans to make some of their envisioned futures possible.

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“…These realities are embedded in the historical and contemporary contexts of Aotearoa New Zealand and have inflicted Māori since the onset of colonization, exacerbated by neoliberalism. McLeod et al (2020) analyzed the adverse impact of C19 on Māori sited amidst the lower socio-economic factors that intensify communicable disease transmission such as poverty, low-quality housing, homelessness, and high comorbidity rates, exacerbated by differential healthcare access derived from institutionalized racism and colonization.…”

Section: Māorimentioning

confidence: 99%

Negotiating Health Amidst COVID-19 Lockdown in Low-income Communities in Aotearoa New Zealand

Elers

Jayan

Elers

et al. 2020

Health Communication

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Aotearoa New Zealand's public health crisis communication approach amidst the COVID-19 pandemic effectively mobilized the nation into swift lockdown, significantly reducing community transmission. This communication approach has been applauded around the world. How did communities situated amongst the "margins of the margins" in Aotearoa New Zealand navigate through the existing structural barriers to health during the pandemic? In this study, we use a culture-centered analysis to foreground the structural context of disenfranchisement amidst the COVID-19 lockdown. Drawing on in-depth interviews with participants in a larger ethnographic project on poverty and health across three communities in Aotearoa New Zealand, we attend to the ways in which health is negotiated amidst the COVID-19 outbreak and lockdown response at the "margins of the margins." The narratives point out that health communication interventions to prevent COVID-19 in the context of Aotearoa New Zealand furthered the marginalization of communities at the margins, and community voices were largely erased from the enactment of interventions. With the extant structures failing to recognize these aspects of everyday struggles of health at the margins, the health and access challenges were further magnified during COVID-19. Our attention to communication situated in relationship to structures builds a register for health communication scholarship in the context of COVID-19 that is committed to disrupting the behaviorally based hegemonic health communication literature and transforming the unequal terrains of health experiences. The trajectories of COVID-19 (C19) as well as the preventive policy responses to it have disproportionately impacted the global margins (Dutta et al., 2020). Across countries, regions, and communities, those at the gendered, raced, and classed margins have borne largely the effects of the pandemic (Patel et al., 2020). Aotearoa New Zealand has been globally recognized for its decisive leadership and the overarching effectiveness of its science-based C19 response, accompanied by clear communication and state-led welfare support (Cousins, 2020; Dutta et al., 2020; PRovoke Media, 2020). How then do inequities in health play out amidst this effective model of C19 response? Traditionally, Māori, Pasifika, and refugee communities have borne the greatest burdens of poor health outcomes in Aotearoa New Zealand (Mahony et al., 2017; McIntosh & Mulholland, 2011; Ministry of Health, 2014). These features of raced/citizenship-based identity intersect with poverty to produce marginalization (Bowleg, 2020). In this essay, we draw on our ethnographic fieldwork embedded in the culture-centered approach (CCA) with Māori, Pasifika, and refugee communities across three sites in Aotearoa New Zealand to examine the interplays of culture, structure, and agency at the margins in constituting the everyday negotiations of health and wellbeing amidst the C19 outbreak (Dutta, 2020). Our emphasis here is on foregrounding the structural context of margina...

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COVID‐19: we must not forget about Indigenous health and equity

Cited by 79 publications

References 32 publications

COVID-19 in New Zealand and the impact of the national response: a descriptive epidemiological study

COVID-19 in New Zealand and the impact of the national response: a descriptive epidemiological study

Plagues, past, and futures for the Yagan canoe people of Cape Horn, southern Chile

Negotiating Health Amidst COVID-19 Lockdown in Low-income Communities in Aotearoa New Zealand

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