Rainbow health in Aotearoa New Zealand – finally getting the attention it deserves?

Adams, John S.; Neville, Stephen

doi:10.1071/hc22152

J. Prim. Health Care

2023

DOI: 10.1071/hc22152

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Rainbow health in Aotearoa New Zealand – finally getting the attention it deserves?

John S. Adams

Stephen Neville²

Abstract: A welcome focus on health services -but determinants of health are wider than thisTe Pae Tata has identified improving the access and quality of primary health and other health services for Rainbow people (especially for transgender and intersex) as a priority.

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“…In a viewpoint article, Adams and Neville ask whether Rainbow people (LGBTQIA+) have access to health services that work for them. 8 While Te Pae Tata promises a 'new health system' and improved health outcomes for Rainbow people, the authors caution that more specific and detailed action plans are needed on how equity will be achieved.…”

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Across the spectrum of primary health: from rainbow health to end-of-life care

Goodyear‐Smith

Stokes

2023

J. Prim. Health Care

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This issue starts with a thoughtful editorial from Emeritus Professor Richard Baker from Leicester, who identifies the role of primary health care in reducing inequalities and the burden of multimorbidity in an aging population. 1 Services which provide comprehensive clinical care, a public health perspective, have equality of access, and a therapeutic relationship lead to increased life expectancy of disadvantaged populations. The role primary health care plays in reducing mortality should not be under-estimated.A viewpoint article by Kathleen Potter explores how both the quality of life and the quality of death in the elderly might be improved by understanding the care trajectories of people experiencing age-related terminal decline. 2 She suggests that aged residential care providers are a rich source of data that could be tapped and analysed to inform endof-life care.An important study has looked nationally at which general practices are no longer enrolling patients (have closed books). 3 Practices close their books when they reach capacity, and this can have serious impact on unenrolled patients who need primary care consultations. A third of all practices were found to have closed books in June 2022, with the issue particularly concentrated around the middle-lower North Island (Wairarapa, Midcentral and Taranaki). General practices with fees towards the middle of the range were more likely to have closed books, whereas Very Low Cost Access were more likely to remain open. As more of our workforce retire, this problem is unlikely to resolve in the short-term.Many of the papers in this issue have a focus on sexual or mental health. In 2017 gonorrhoea and syphilis became notifiable diseases in 2017, requiring clinicians to complete an anonymised case report form on diagnosis. Contact tracing of partners is important to reduce spread of these sexually transmitted infections (STIs). However, a review of surveillance data has found that contact tracing was recorded as 'planned' or initiated' for only about 80% of cases, with the actual outcomes unknown. 4 For 20% of syphilis and 16% of gonorrhoea cases, contract tracing was not possible because the contacts were anonymous.Another STI is the Human Papillomavirus (HPV), with most of cervical cancer now known to be caused by preceding infections of certain HPV subtypes. Cervical screening is switching from cervical cytology to HPV testing, which can be done with vaginal selfswabs. A study looking at primary care staff experience of the new screening pathway piloted in three NZ regions found positive support for self-swabbing, but provided useful lessons to inform the national roll-out. 5 There are several studies about the rainbow community. Queer-identifying men report use more tobacco and e-cigarettes than the general population. A qualitative study has found that vaping in this population is used to facilitate social interaction and manage stress, in addition to smoking cessation. 5 Carroll and colleagues surveyed fifth-year medical students about providing healt...

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confidence: 99%

Across the spectrum of primary health: from rainbow health to end-of-life care

Goodyear‐Smith

Stokes

2023

J. Prim. Health Care

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Rainbow health in Aotearoa New Zealand – finally getting the attention it deserves?

Abstract: A welcome focus on health services -but determinants of health are wider than thisTe Pae Tata has identified improving the access and quality of primary health and other health services for Rainbow people (especially for transgender and intersex) as a priority.

Cited by 1 publication

References 21 publications

Across the spectrum of primary health: from rainbow health to end-of-life care

Across the spectrum of primary health: from rainbow health to end-of-life care

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