Representatives from the Asian community in Auckland approached the Ministry of Health’s Public Health Directorate in 2002 requesting that the public health needs of Asian people be considered in developing public health strategies. The Asian Network and the Auckland Regional Public Health Service were keen for health agencies to assess the public health needs of Asian people and subsequently foster programmes and interventions that would start to address some of these needs.
The Ministry of Health facilitated the establishment of an Asian Public Health Project Team in 2002 to oversee an initial health assessment, and this report contains the results of the work undertaken by the Project Team. The Project Team included representatives of the three Auckland District Health Boards, the Asian Network and the Auckland Regional Public Health Service.
The purpose of the report is to compile available information on Asian public health needs to assist decision-makers, programme planners and other interested parties to better respond to the increasing public health needs of Asian people living within the Auckland region.
The report attempts to provide a comprehensive view of Asian people’s public health needs within the Auckland region, but there has been limited research in this area and a key finding is that the needs of Asian populations and the more specific needs of the many sub-populations will require further and ongoing research.
The scope of this report is confined to some broad recommendations and starting points. Given that there is limited public health funding for Asian-specific initiatives, mainstream public health providers will be encouraged to use the information in this report as a catalyst to develop activities and programmes that are more sensitive to the key Asian populations within the Auckland region.
Another limitation is that there has been no analysis of primary, secondary or tertiary health care needs of Asian people. The focus has been on public health or needs best addressed through a population-wide approach rather than treatment of specific diseases or illnesses.
Purpose
1. To provide an up-to-date Asian demographic, health utilisation and hospitalisation data profile focusing on the Auckland region.
2. To compile and summarise available public health related reports pertaining to Asians living in the Auckland region.
3. To carry out a literature review of international public health approaches to Asian populations within non-Asian countries.
4. To carry out a stock-take of current personal and public health services, resources and organisations within New Zealand focusing on the Auckland region.
5. To undertake consultation with the Asian community (amongst four main groups: i. Chinese; ii. Indian Sub-continent including Indian; iii. Korean; and iv. South-east Asian including Cambodian, Vietnamese and Japanese) and approximately 15 key informant interviews within the Auckland region to determine key public health issues.
6. To develop suggested options for public health to address identified Asian needs within the New Zealand context.
Key Results
The Asian population is diverse and increasing
About 65 percent of all Asian people in New Zealand live in the Auckland region, with the current Auckland population being over 146,000 people. The Asian population is made up of extremely diverse ethnic sub-groups, but overall it is the second largest population group in the Auckland region, making up about 12.5 percent of the population. Within the Auckland region, Chinese are the largest Asian group with about 45 percent of all Asian people, followed by Indian (27%) and then Korean (9%). The Asian population is expected to continue to increase mainly through further immigration.
Most Asian people are young and middle-aged adults
As immigration is the main means of Asian population increase in New Zealand, only 5 percent of the Asian population in the Auckland region is 65 years or older. Over half of Asian people in the Auckland region are between the ages of 25 to 65 years, while around 20 percent are 15 to 24 years and another 20 percent are 0 to 14 years. The generally young age structure of the Asian population partially explains the overall good health status of the population group.
Many Asian people are well-educated, but have lower than average incomes
Nearly one-third of Asian people have a tertiary education but, overall, Asian peoples have worse than average unemployment rates (7.4% in 2001) and most significantly very low income levels (only 17% of Asian people earned over $30,000 in 2001). These figures are reinforced by qualitative research that indicates many Asian people experience difficulties with employment, including under-employment where skills are not being fully utilised.
The Asian population has diverse health issues
Overall health status for Asian people is good, but a range of health issues have been identified including a number of significant areas of concern.
The six top potentially avoidable deaths for Asian people in the Auckland region are heart disease, motor vehicle crashes, stroke, lung cancer, diabetes and suicide, and the six leading causes of preventable hospitalisations are angina (heart pain), gastroenteritis, respiratory infections, road injuries, dental conditions and asthma.
Both the consultation meetings and key informant interviews found that mental health (eg, language barriers, social isolation, under-employment and stigmatisation), cardiovascular disease and diabetes (eg, lifestyle changes around diet and physical activity) and sexual health (eg, very high abortion rates) are leading health issues along with communicable diseases (eg, high rates of TB), and traffic injuries.
Asian communities want better access to health services that cater to their needs
Consultation meetings and key informant interviews were useful in assisting to define health issues, identifying difficulties or barriers in accessing health services, and exploring possible strategies to address public health issues in Asian communities within the Auckland region.
A range of solutions was put forward by participants at the consultation meetings, and by key informants. These focused on reducing language barriers and cultural barriers through the provision of interpreters, recruitment of more Asian health professionals, and the development of more culturally-sensitive services.
There is community support for enhancing mainstream services, targeting of resources and ensuring that service development involves Asian communities through partnerships and other mechanisms.
Asian communities are ready and willing to participate in improving their communities’ health
Asian communities in the Auckland region appear to be generally cohesive, have a strong sense of culture, identity and belonging, and an eagerness to participate and integrate in mainstream service delivery. Asian networks are already reasonably well established, and some successful initiatives are underway that provide a foundation for improved Asian peoples' health in the future.
Recommendations focus on building Asian community infrastructure, providing direction for advocacy, and enhancing mainstream providers
The Asian Public Health Project Team will continue to meet for at least a further 12 months to oversee implementation of a comprehensive range of recommendations. A key focus of the recommendations is enhancement of services provided by mainstream public health providers to better meet the diverse needs of Asians within the Auckland region.
The Project Team considers priority should also be given to improving access to health services by Asian communities. Many health providers do not provide services, or health education resources, appropriate for Asian communities. For example, lack of English language proficiency is a key issue for new immigrants, and this impacts on access to health care, employment prospects, income levels and other factors which determine health status.
Resourcing existing Asian community organisations is seen as one way of facilitating ongoing advocacy around these issues.