OPTIMISING HEALTH FOR PACIFIC CHILDREN
Diverse Pacific people account for around 9% of New Zealand’s total population – approximately 470,000 people – half of whom have Samoan heritage. The next four largest groups are Cook Island Māori, Tongan, Niuean and Fijian – and one half of Pacific children also identify as (Aotearoa) Māori. The youthful Pacific population structure requires policy-makers to prioritise the needs of children and young people.
Pacific children inequitably experience poor health more than children of any other ethnic group, including preventable diseases which risk permanent life effects.
Pacific children experience a higher incidence of a range of conditions, including respiratory conditions such as asthma, dental problems, ear disease and hearing difficulties, and skin infections, than children from other ethnic groups. That the state has enabled and not prevented the health inequities listed above is an untenable situation for New Zealand.
There is a moral imperative to act decisively to eliminate ethnic inequities in health. Despite multiple plans and strategies to improve health of Pacific people over the past two decades, it appears that their health status has deteriorated, reflecting the deterioration in socio-economic circumstances and rising costs of living.
Systemic racism and inadequacy is locking Pacific people into poverty, food insecurity and poor housing, which are key drivers of the health burden for Pacific children and their families
RECOMMENDATIONS
It is time to make courageous decisions and take decisive actions to eliminate health inequities in Aotearoa New Zealand.
Every effort should be made to break the systemic factors contributing to the cycle of disadvantage among Pacific families and support intergenerational wealth creation.
Engaging Pacific leadership and communities is also vital: knowledge, approaches, determination (born from alofa/aroha for community), creativity and networks to effectively address issues are all found and best led from within the communities affected – as was shown during COVID-19 pandemic responses.
1. Lift income support, and remove barriers to income and wealth generation
Implement the Welfare Expert Advisory Group recommendations, such as further lifting benefit incomes, improving all the components of Working for Families and reducing sanctions.
Reverse Work and Income culture so that sole-parent families are supported, appreciated and prioritised and no longer stigmatised.
Implement the measures detailed in the Moana Connect report ‘Tamaiti ole Moana’ to improve incomes for Pacific families, in particular strengthening workers’ wage bargaining power and reforming KiwiSaver to help those on lower incomes.
Implement the recommendations of the Human Rights Commission Pacific Pay Gap Inquiry, in particular mandated pay transparency, raising the minimum wage to the living wage, and improving laws against harassment and violence at work.
Prioritise improving pathways to home ownership and efforts to generate inter-general wealth, including ensuring Pacific people have access to home-ownership support and lending models which support multigenerational home-ownership.
2. Improve access to healthcare
Offer free primary and community healthcare for all children up to 18 years of age, and expand free after-hours care.
Improve accessibility of well-child services: increase efforts to ensure the well-child/tamariki ora checks are equitably reaching Pacific children, including that the B4 school check is working for all children, so that every child is tested, screened and appropriate follow-up occurs.
Ensure every Pacific child has a stable, trusted enrolled general practice health home from pregnancy.
3. Expand and enable holistic Pacific-led healthcare
·Expand Pacific providers: fund more Pacific health providers, especially in areas of high concentration of Pacific people such as Auckland and Porirua; and shift funding structures to better support holistic continuity of care at one location, rather than requiring people to move between providers of healthcare and other support services.
o In general, Pacific providers will generate better health outcomes for Pacific families, partially thanks to better interactions, and also thanks to a joined-up approach emphasising continuum of care (where funding structures allow) rather than a transactional approach. Enabling real choice of provider and approach empowers families.
Invest further to lift the proportion of Pacific (and Māori) doctors and other health professionals in training. We support the Tamaiti Ole Moana recommendation to “introduce more cost-of-living support for Pacific people in training” for the social worker workforce as well as the physical health and mental health workforce”.
Fully cost and fund Pacific strategies and implementation, communicate related strategic prioritisation to the health sector, and publicly report measures and indicators which hold those in leadership roles responsible for the results.
o The Pae Ora – Healthy futures system 2022 is an excellent framework enabling actions to eliminate inequities, but it is important that accountabilities and responsibilities are made clear.
4. Community support options
Make highly effective social support services – such as those provided by Whānau Ora during the pandemic –more readily available to all families in need. Co-locate these support options with Pacific health and social service providers, to engage Pacific communities.
Make permanent and expand the Ka Ora Ka Ako free school meals programme for learning, social and behavioural benefits.
Resource and support community development and mobilisation “by community for community” groups – to engender empowerment and pride to enhance wellbeing. One example is the Pasifika Autism Support Group which is run by parents of autistic Pacific children, providing Pacific-appropriate support, information, and health navigation.
5. Improve housing quality and urban design for health and safety
Ensure improvements to the quality of rental housing (which have already benefited many Pacific families) reach all rentals.
Build large houses suitable for Pacific families, in all parts of the housing sector, and especially social housing, enabling homes for families with 7+ householders and enabling multi- generational living. This supports and aligns with the Taitamariki Youth demands for quality housing as a human right vital to health and wellbeing.
Continue to improve pedestrian safety where children live (residential driveways), and on streets including cul-de-sacs and local roads especially routes to school.
IMPACTS AND INDICATORS
If implemented, these actions would be steps towards moving Aotearoa to be a nation where all children and families flourish free from poverty.
Implementing the recommendations above will improve the health of Pacific children and their families; and reduce their rates of material hardship, food insecurity and housing stress, both in the immediate future and for the longer term.
They will also increase much needed equity – in both health and wealth – for Pacific children.
Significantly more Pacific children and their families will live free from the many harmful effects of poverty. They will have better life outcomes, better health and be better able to contribute to society.
The Government would be much more likely to meet its child poverty reduction targets and meet them on schedule, including reducing material hardship; and child poverty would also measurably reduce on a range of other indicators.
Optimising Pacific children’s health:
Is relevant to New Zealand meeting its targets for UN Sustainable Development Goal 1: “End poverty in all its forms everywhere” and Goal 3: “Ensure healthy lives and promote well-being for all at all ages”.
Is essential for New Zealand to meet its obligations under the UN Convention on the Rights of the Child.
Is an essential step towards the national vision “that New Zealand be the best place in the world for children and young people”.
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