People of Pacific Island ethnicity are an important and growing part of New Zealand society and culture. In 2013 they comprised 7.4% of the country’s population and were major contributors to New Zealand’s success in sport, music and the arts – and increasingly in business and academia. Despite this, Pacific people have some of the worst health statistics of all New Zealanders.
These ethnic disparities in health are attributable to adverse socio-economic circumstances such as high unemployment, low educational achievement, low income, overcrowding and cold houses. Pacific people also have a high prevalence of risk factors such as smoking, unhealthy diets and obesity. Furthermore, they have problems in getting access to quality health-care services.
The Pacific population has a high birth rate, putting Pacific people among the fastest-growing population groups in New Zealand. In 2013 the Pacific fertility rate was 2.73 births per woman, compared to the national rate of 2.02. In 2011 the median age of childbearing for Pacific women was 27 years, while the national median was 30 years.
The fertility rate for Pacific teenagers was higher than the total rate in the mid-2000s, suggesting lower use of contraception. Because children born to teenage mothers are at risk of low birth weight, perinatal mortality and socio-economic disadvantage, health advocates recommended that family-planning programmes targeted Pacific communities. Yet they also recognised that it was more acceptable in some cultures to have children young.
The health benefits of breastfeeding are well-known. But in 2009 Porirua breastfeeding advocate Ligi Igasia found many Pacific mothers were too embarrassed to attend public clinics teaching breastfeeding techniques. She began visiting them in their homes, and soon had a number of mothers breastfeeding their babies for more than six months.
In 2013, 36% of the Pacific population were aged under 15, compared with 20% of New Zealand’s total population. This reflected the community’s higher fertility rate. Only 5% of the Pacific population were aged 65 and over, compared with 14% of the national population. This imbalance was a product of immigration – people who migrate to New Zealand tend to be younger – and the higher death rate of Pacific people.
Data from 2005–7 showed that Pacific people had a considerably higher death rate (8.8 deaths per 1,000 people) than the total national population (5.8 per 1,000). In 2012–14 life expectancy at birth was 74.5 for Pacific males and 78.7 for Pacific females. This was lower than the national average of 79.5 for males and 83.2 for females.
Between 2004 and 2008 the leading causes of death among Pacific children aged under 15 were accidental threats to breathing and road accidents. For Pacific people aged 15–64, road accidents and suicide were the leading causes of death. Falls were the leading cause of death for Pacific people aged 65 and over.
Between 2000 and 2008 the avoidable death rate for Pacific people was approximately 50% greater than for the total New Zealand population. Avoidable deaths are those of people under 75 years of age where effective prevention, treatment options and health-care technologies are available.
Attitudes to health
All Pacific cultures have a holistic view of health with a strong spiritual dimension. This asserts that good health is the result of a balanced relationship between humans and their environment. Disease, injury and even death can occur if this balance is put out of kilter, sometimes as a result of wrongdoing by the victim or a family member. These beliefs may contribute to the tendency for some Pacific people to avoid doctors’ visits and health interventions.
Social wellbeing and health status
While Pacific people have experienced real gains in social wellbeing since the mid-1990s – such as in educational achievement and paid work – their overall outcomes are poor compared with other New Zealanders. The New Zealand Health Surveys have also shown that the majority of Pacific people were less likely to report excellent or very good health than the total population.