Dr Api Talemaitoga

Transcript

1. Lung Health Issues in NZ › Dr Api Talemaitoga › GP, Pacific Health Advocate › Chair, Tangata O Le Moana
2. Declaration of interests/conflicts › General Practitioner – Normans Road Surgery (CHCH) and Cavendish Clinic (Manukau) › Member of EAG, Asthma Foundation › Board Member, RNZCGP › Member Pegasus Health and Alliance Health Plus, PHO › Member HWNZ Medical Workforce Taskforce Governance Group › Chair, Tangata O Le Moana (Pacific Health Provider Network, Auckland)
3. Te Ha`Ora (The Breath of Life) National Respiratory Strategy › Strong equity focus › High quality respiratory services for ALL Nzers › Lower the incidence of respiratory diseases in NZ and it’s impact on people and whanau/aiga › Determinants of health › Everyone has a role to play in improving the status quo
4. Te Ha`Ora (The Breath of Life) National Respiratory Strategy › Everyone has a role to play in improving the status quo › No need to ‘reinvent the wheel’ • Various models of care have been tried • Community engagement is important • Cross sectoral cooperation is NOT optional! …illustrate some of the issues by giving you some examples with Pacific peoples
5. Respiratory conditions in primary care › Childhood pneumonia › Bronchiolitis › Asthma › COPD
6. Childhood Pneumonia › Bacterial or viral infection of the lungs › Fever, chills, SOB, coughing, chest pain › Rx Fluids, rest, good diet, antibiotics › Prevention: Breastfeeding, smoke-free environment, flu vaccine, healthy diet, warm well-insulated home › NZ- Highest rates HVDHB, ADHB, CMDHB, NDHB › Death rates: Maori 5.4x, Pacific 6x more › (2002 – 2011: 110 died; 59 Maori, 35 Pacific chrn)
7. Bronchiolitis › Common in first 12 months of life › Virus – caught by close contact; cough/fever › Rx Keep warm, hydrate › Prevention: Good hygiene, warm well insulated home, flu vaccine › NZ – nearly 5,400 babies admitted in 2013 › Maori 3.4x and Pacific 4.3x more
8. Asthma › Sensitive airways that react to triggers – virus, house dust mite, cold weather › Wheeziness and SOB, coughing › Rx Inhalers, nebuliers, hydrate, keep warm › Prevention: Good awareness/education of condition › Preventative medication, smoke-free, warm well- insulated house, flu vaccine › NZ – over 450,000 people take medication for it › Maori 3x, Pacific 3.7x and most deprived 3.2x more › $800 million/year in costs
9. COPD – Chronic Obstructive Pulmonary disease › Emphysema, chronic bronchitis and chronic asthma › Caused by SMOKING › Rx STOP smoking, healthy body weight, warm dry home, pulmonary rehab › NZ – nearly 30,000 people live with COPD › Maori 3.5x, Pacific 2.8x and most deprived areas 5.1x more hospitalisation rates › Maori 2.2x and most deprived areas 2.7x death rates › (2011: HBDHB, Lakes DHB and Wairarapa DHB high death rates)
10. › Healthy diet/weight › NO SMOKING › Access to quality primary care › Good health literacy › Warm well-insulated housing › Maori › Pacific › Poor › Combination of ‘all the above’ Common themes
11. › Smoking/passive smoking status › Education level › Where they live › Their level of health literacy › Immunisation status/beliefs › Competing priorities in their lives – ‘determinants of the determinants’ › Deliver our advice/treatment in a non-judgemental and culturally appropriate way Do you and I as health providers really KNOW our patients?
12. Young and likely to continue to be so 12
13. High numbers of people with no formal education 13
14. Hard going over the past 8 years or so 14
15. Health indicators and access to healthcare- a mixed picture Gains Challenges Immunisation rates Life expectancy gap 7.7 years PHC access Tobacco Diabetes care indicators Obesity Community programmes Rheumatic fever
16. Rheumatic fever remains an unsolved problem in NZ SIGNIFICANT DISEASE IMPACT › 600-800 admissions p.a. › Premature death › Rheumatic Fever causes 150-200 deaths p.a. in NZ This is two times the number of people who die from cervical cancer Source: Wilson and Webb, 2012 Rheumatic Fever Incidence rate per 100,000
17. Multiple determinants of health
19. Summary › Everyone has a role to play › We need to understand our patients better › Determinants of health very important › Use successful community models already tried › TELL SOMEONE THIS WEEK TO STOP SMOKING
20. › Dr Api Talemaitoga › A.Talemaitoga@xtra.co.nz › HIKOI FOR HOMES 21/11/15 › www.hikoiforhomes.co.nz Thank you