(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)
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
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
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
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)
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?
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