Effects of self-reported racial discrimination and deprivation on Māori health and inequalities in New Zealand: cross-sectional study

Harris, Ricci; Tobias, Martin; Jeffreys, Mona; Waldegrave, Kiri; Karlsen, Saffron; Nazroo, James

doi:10.1016/s0140-6736(06)68890-9

Cited by 315 publications

(254 citation statements)

References 15 publications

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“…Our analysis was based on selfreported data which rely, at least in part, on a respondent interpreting a negative experience as being HIV-related discrimination. This is an inherent limitation of all research into discrimination, since it relies not only on subjective experience but also on a person's willingness to report the experience (Rothon & Heath, 2003;Harris et al, 2006;Huebner et al, 2004;Krieger, 2000;Peretti-Watel et al, 2007). For example, we can not rule out the possibility that the concept (and reporting) of discrimination varies between cultures, specifically between gay men (predominantly white in our study) and heterosexual men and women of black African origin.…”

Section: Mental Healthmentioning

confidence: 85%

HIV-Related Discrimination Reported by People Living with HIV in London, UK

et al. 2007

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Section: Mental Healthmentioning

confidence: 85%

HIV-Related Discrimination Reported by People Living with HIV in London, UK

et al. 2007

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“…Survey data indicate that Maori New Zealanders are more likely to report having experienced discrimination from health professionals on the basis of their ethnicity. 43 Evidence from the United States suggests that interpersonal discrimination contributes to ethnic disparities in care, 7,9 but treatment inequities there are driven more by differences between healthcare providers than by differential care within the same facility. 35,37,42 The balance of these factors may be somewhat different in New Zealand, where ethnic segregation is less marked than in the United States.…”

Section: Discussionmentioning

confidence: 99%

Ethnicity and management of colon cancer in New Zealand

Hill

Sarfati

Blakely

et al. 2010

Cancer

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BACKGROUND: Racial and ethnic inequalities in colon cancer treatment have been reported in the United States but not elsewhere. The authors of this report compared cancer treatment in a nationally representative cohort of Maori (indigenous) and non-Maori New Zealanders with colon cancer. METHODS: On the basis of cancer registry data, 301 Maori patients and 329 randomly selected non-Maori patients were identified who were diagnosed with colon cancer between 1996 and 2003. Medical notes were reviewed, and surgical and oncology treatments were compared by indigenous status. RESULTS: Maori and non-Maori patients had similar rates of surgical resection, although Maori patients were less likely to undergo extensive lymph node clearance and were more likely to die during the postoperative period. Maori patients were significantly less likely to receive chemotherapy for stage III disease (relative risk [RR], 0.69; 95% confidence interval [CI], 0.53-0.91) and were more likely to experience a delay of at least 8 weeks before starting chemotherapy (RR, 1.98; 95%CI, 1.23-3.16). Treatment disparities were not explained by differences in tumor characteristics or patient comorbidity. CONCLUSIONS: Maori New Zealanders with colon cancer were less likely to receive adjuvant chemotherapy and experienced a lower quality of care compared with non-Maori patients. The authors concluded that attention to health system factors is needed to ensure equal access and quality of cancer treatment for indigenous and ethnic minority populations.

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“…The marginalisation of these groups both 104 spatially but also more broadly (see work on the relationship between poor health outcomes and racial 105 discrimination in NZ such as Harris et al, 2006; Harris et al, 2012; Harris et al, 2015) suggests that 106 5 MEGs in NZ might be more likely to experience increased rates of residential mobility. The neglected 107 concept of 'malign migration' holds that marginalised, socially disadvantaged groups are more likely 108 to experience residential mobility, and this is more common in inner city (often deprived) areas: this is 109 detrimental to health (Warfa et al, 2006).…”

Section: Introduction 20mentioning

confidence: 99%

To move or not to move? Exploring the relationship between residential mobility, risk of cardiovascular disease and ethnicity in New Zealand

Darlington‐Pollock

Norman

Lee

et al. 2016

Social Science & Medicine

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3Residential mobility can have negative impacts on health, with some studies finding that residential 4 mobility can contribute to widening health gradients in the population. However, ethnically 5 differentiated experiences of residential mobility and the relationship with health are neglected in the 6 literature. To examine the relationship between residential mobility, risk of cardiovascular disease 7 (CVD) and ethnicity, we constructed a cohort of 2,077,470 participants aged 30+ resident in New 8Zealand using encrypted National Health Index (eNHI) numbers linked to individual level routinely 9 recorded data. Using binary logistic regression, we model the risk of CVD for the population stratified 10 by ethnic group according to mover status, baseline deprivation and transitions between deprivation 11 statuses. We show that the relationship between residential mobility and CVD varies between ethnic 12 groups and is strongly influenced by the inter-relationship between residential mobility and deprivation 13 mobility. Whilst residential mobility is an important determinant of CVD, much of the variation 14 between ethnic groups is explained by contrasting deprivation experiences. To reduce inequalities in 15 CVD within New Zealand, policies must focus on residentially mobile M ori, Pacific and South Asian 16 populations who already have a heightened risk of CVD living in more deprived areas. 17 Key words 18New Zealand; CVD; Ethnicity; Inequalities; Mobility; Migration; Deprivation; Record Linkage 19 Introduction 20Cardiovascular disease (CVD) and associated morbidities are among the leading causes of global deaths 21 (World Health Organisation, 2014). In New Zealand (NZ) there are marked variations between ethnic 22 groups in the prevalence of CVD (Blakely et al., 2004;Riddell et al., 2007;Jatrana and Blakely, 2008; 23 Kerr et al., 2008; Grey et al., 2010; Mehta et al., 2011; Perumal et al., 2012; Ker et al., 2015; Mehta et 24 al., 2014;Exeter et al., 2015;Wells et al., 2015). Between 1980 and 1999, while all ethnic groups 25 experienced reductions in CVD mortality, M ori and Pacific populations saw markedly smaller 26 2 reductions than non-M ori non-Pacific (nMnP) groups (Blakely et al., 2005). By 2007, these disparities 27 had not disappeared: M ori males and females almost invariably had the highest age-specific prevalence 28 of CVD across all age groups, as well as the highest age-standardised prevalence of CVD (7.41 29 compared to NZ's total population at 4.77, and 5.68 for the Pacific group) (Cheuk Chan et al., 2008). 30Stark differences in risk of CVD and CVD mortality between ethnic groups are not restricted to NZ. 31For example, rates of ischaemic heart disease amongst South Asian males are 30 to 40% higher than 32 rates amongst the UK's general population (Department of Health, 2001). In the US in 2013, Black 33 groups had 30% higher mortality from CVD than Whites, increasing to 113% higher CVD mortality 34 than Asians and Pacific Islanders (Singh et al., 2015). 35Exploring why ethnic in...

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Effects of self-reported racial discrimination and deprivation on Māori health and inequalities in New Zealand: cross-sectional study

Cited by 315 publications

References 15 publications

HIV-Related Discrimination Reported by People Living with HIV in London, UK

HIV-Related Discrimination Reported by People Living with HIV in London, UK

Ethnicity and management of colon cancer in New Zealand

To move or not to move? Exploring the relationship between residential mobility, risk of cardiovascular disease and ethnicity in New Zealand

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