Purpose
Using data from Growing Up in New Zealand, this research had two aims:
- to examine ethnic differences in life-course trajectories in the use and experience of healthcare services in early childhood (ie, immunisation, dental checks and use of GPs)
- to quantify the contribution of relevant explanatory factors to ethnic differences.
Methodology
This research explored the underlying mechanisms behind ethnic differences in the use and experience of child healthcare services via econometric approaches. First, a multivariate regression analysis was used to adjust raw ethnic gaps in child health care utilisation by relevant covariates. This included a range of factors, encompassing mobility, socio-economic status, mother and child characteristics, household characteristics and other social aspects. Second, a decomposition analysis was used to assess the proportion of each ethnic gap that can be explained, as well as the main drivers behind the explained component. The analysis for both econometric approaches was repeated for each data time point available, which included antenatal, 9 months, 2 years and 4 years post-birth.
Key Results
- There is consistent evidence that Asian and Pacific people have a higher likelihood of child immunisation relative to NZ Europeans and Māori. This was evident at their 15 month and four years immunisations, as well as their mothers’ antenatal intention. The one time point where Pacific people had a lower rate relative to NZ European was for receiving all first-year immunisations on time.
- Social factors play a role. This included discouragement or encouragement regarding child immunisation. When broken down by source, discouragement by family members has the largest marginal effect, followed by health professionals; whereas for encouragement, medical professionals have the largest positive influence.
- Perceived ethnically motivated discrimination by a health professional was significant with respect to reducing the likelihood of someone achieving their first choice Lead Maternity Carer (LMC), and also reducing satisfaction levels with child’s GP.
- Some ethnic gaps were unexplained, despite the wealth of factors employed as independent variables in the analysis. This included understanding why Pacific mothers are much less likely to achieve their first choice LMC compared with NZ Europeans; and also understanding the ethnic gaps for both Māori and Pacific peoples relative to NZ Europeans concerning dental service use.