Health is affected by the interaction between personal and environmental factors. Environmental influences include physical, socio-economic, cultural and political factors as well as the availability of health services. It is generally accepted that the socio-economic factors – especially education and income – are the most important determinant of population health status. Poor people with limited education generally have poor health.
Pacific people generally have lower socio-economic status than other New Zealanders – 42% live in decile 10 (most deprived) areas instead of the expected 10% given their proportion within the general population. While there has been some improvement since 1990, Pacific people remain worse off than other New Zealanders. Poor educational outcomes, high unemployment and low income levels have a major impact on Pacific people’s health and wellbeing.
Education and employment
Generally, more young Pacific people than others leave school without formal qualifications, but the proportion of Pacific people gaining the National Certificate of Educational Achievement (NCEA) Level 2 improved significantly in the 2000s and 2010s. Unemployment among Pacific people is higher than the national rate – 6.2% in September 2018, compared with 3.9%. Unemployment is a major cause of poverty, and of related health consequences for both adults and children.
In 2013 the median income for Pacific wage and salary earners was $19,700, compared with $28,500 nationally. Unlike for other ethnic groups, the Pacific median income was lower than in 2006, when it was $20,500. People on low incomes sometimes delay doctor’s visits until they are very sick.
Snug as a bug
Since the early 2000s social-housing provider Housing New Zealand has been insulating its older houses to improve tenants’ comfort and health. In early 2008 New Plymouth tenant Sally Falaniko’s house was insulated. In the 2007 winter her two sons and daughter had spent time in hospital with pneumonia, but the following winter her four kids were healthy and happy. The previous year Falaniko had constantly run her gas heater. Now she no longer needed to, saving a considerable amount on her gas bill.
Overcrowding and poor-quality housing is a major social and public health problem for Pacific families. In 2013, 40% of Pacific people lived in overcrowded houses, compared to 20% of Māori, 18% of Asian and 4% of European people. Overcrowding encourages the spread of disease, including rheumatic fever, tuberculosis, meningococcal disease and skin infection.
Pacific people are heavily reliant on rental housing, and make up a quarter of Housing New Zealand’s clients. Since the early 21st century Housing New Zealand’s Healthy Housing programme – where state houses are insulated and extended to accommodate larger Pacific families – has significantly reduced the incidence of infectious diseases.
Population groups who live in cohesive and mutually supportive societies generally have better health. Some traditional support structures within New Zealand Pacific communities have been eroded, and many individuals and families have limited social support. Churches play an important role in supporting some Pacific families – but young New Zealand-born people may not be connected to their family, church and community.