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Stephen Haslett - One of the best experts on this subject based on the ideXlab platform.
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a challenge to the cross cultural validity of the sf 36 health survey factor structure in Maori pacific and new zealand european ethnic groups
Social Science & Medicine, 2000Co-Authors: Kate M Scott, Diana Sarfati, Martin Tobias, Stephen HaslettAbstract:This paper reports on a principal component factor analysis of the SF-36 health status questionnaire in the three major ethnic groups in New Zealand (New Zealand Europeans, Maori and Pacific). The SF-36 is hypothesised to have a two-dimensional structure with distinct (weakly correlated) mental and physical health components, and support for this structural model has generally been found cross-nationally. However, in Maori and Pacific models of health mental and physical dimensions are not generally seen as separable, or independently functioning. This raises the possibility that the questionnaire's hypothesised structural model would not be supported among Maori and Pacific ethnic groups. This study evaluated that possibility. The results of the analysis showed a similar factor structure among New Zealand Europeans, and younger Maori (
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a challenge to the cross cultural validity of the sf 36 health survey factor structure in Maori pacific and new zealand european ethnic groups
Social Science & Medicine, 2000Co-Authors: Kate M Scott, Diana Sarfati, Martin Tobias, Stephen HaslettAbstract:This paper reports on a principal component factor analysis of the SF-36 health status questionnaire in the three major ethnic groups in New Zealand (New Zealand Europeans, Maori and Pacific). The SF-36 is hypothesised to have a two-dimensional structure with distinct (weakly correlated) mental and physical health components, and support for this structural model has generally been found cross-nationally. However, in Maori and Pacific models of health mental and physical dimensions are not generally seen as separable, or independently functioning. This raises the possibility that the questionnaire's hypothesised structural model would not be supported among Maori and Pacific ethnic groups. This study evaluated that possibility. The results of the analysis showed a similar factor structure among New Zealand Europeans, and younger Maori (<45 years) to that reported by Ware et al. for Western European countries. Among Pacific people and older Maori (45 years and over), however, the factor structure did not clearly differentiate physical and mental health components. Implications are discussed both specific to the SF-36 (and in particular the use of principal component summary scores), and more generally for the cross-cultural validity of self-reported health status measures.
Kate M Scott - One of the best experts on this subject based on the ideXlab platform.
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a challenge to the cross cultural validity of the sf 36 health survey factor structure in Maori pacific and new zealand european ethnic groups
Social Science & Medicine, 2000Co-Authors: Kate M Scott, Diana Sarfati, Martin Tobias, Stephen HaslettAbstract:This paper reports on a principal component factor analysis of the SF-36 health status questionnaire in the three major ethnic groups in New Zealand (New Zealand Europeans, Maori and Pacific). The SF-36 is hypothesised to have a two-dimensional structure with distinct (weakly correlated) mental and physical health components, and support for this structural model has generally been found cross-nationally. However, in Maori and Pacific models of health mental and physical dimensions are not generally seen as separable, or independently functioning. This raises the possibility that the questionnaire's hypothesised structural model would not be supported among Maori and Pacific ethnic groups. This study evaluated that possibility. The results of the analysis showed a similar factor structure among New Zealand Europeans, and younger Maori (
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a challenge to the cross cultural validity of the sf 36 health survey factor structure in Maori pacific and new zealand european ethnic groups
Social Science & Medicine, 2000Co-Authors: Kate M Scott, Diana Sarfati, Martin Tobias, Stephen HaslettAbstract:This paper reports on a principal component factor analysis of the SF-36 health status questionnaire in the three major ethnic groups in New Zealand (New Zealand Europeans, Maori and Pacific). The SF-36 is hypothesised to have a two-dimensional structure with distinct (weakly correlated) mental and physical health components, and support for this structural model has generally been found cross-nationally. However, in Maori and Pacific models of health mental and physical dimensions are not generally seen as separable, or independently functioning. This raises the possibility that the questionnaire's hypothesised structural model would not be supported among Maori and Pacific ethnic groups. This study evaluated that possibility. The results of the analysis showed a similar factor structure among New Zealand Europeans, and younger Maori (<45 years) to that reported by Ware et al. for Western European countries. Among Pacific people and older Maori (45 years and over), however, the factor structure did not clearly differentiate physical and mental health components. Implications are discussed both specific to the SF-36 (and in particular the use of principal component summary scores), and more generally for the cross-cultural validity of self-reported health status measures.
Diana Sarfati - One of the best experts on this subject based on the ideXlab platform.
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indigenous inequalities in cancer what role for health care
Anz Journal of Surgery, 2013Co-Authors: Sarah Hill, Diana Sarfati, Bridget Robson, Tony BlakelyAbstract:Introduction: Poorer cancer survival in Indigenous populations contributes to health inequalities in both New Zealand and Australia. Methods: We reviewed recent evidence of cancer treatment and outcomes among Maori and non-Maori New Zealanders and examined the range of factors that may contribute to poorer survival in Maori. Results: There is clear evidence that Maori have poorer cancer survival compared with other ethnic groups, particularly European New Zealanders. Two recent studies show that Maori patients receive poorer quality treatment for cancers of the lung and colon, even after adjusting for patient factors. These findings suggest the need to consider how the health-care system as a whole may disadvantage Indigenous patients. Discussion: We present a framework for considering how inequalities may arise in the delivery of cancer care, taking account of the health system as a whole - including the structure and organization of cancer services - as well as treatment processes and patient factors. A key feature of this framework is that it directs attention towards system-level factors affecting cancer care, including the location, resourcing and cultural focus of services. Our analysis suggests a need to look beyond individual patient factors in order to improve the quality and equity of cancer services and to optimize cancer survival in Indigenous populations.
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if nobody smoked tobacco in new zealand from 2020 onwards what effect would this have on ethnic inequalities in life expectancy
The New Zealand Medical Journal, 2010Co-Authors: Tony Blakely, Kristie Carter, Nick Wilson, Richard Edwards, Alistair Woodward, George Thomson, Diana SarfatiAbstract:Background Smoking contributes to the 7 to 8 year gap between Maori and non-Maori life expectancy (2006 Census). To inform current discussions by policy-makers on tobacco control, we estimate life-expectancy in 2040 for Maori and non-Maori, never-smokers and current-smokers. If nobody smoked tobacco from 2020 onwards, then life expectancy in 2040 will be approximated by projected never-smoker life expectancy. Method Life-tables by sex/ethnicity/smoking status for 1996-99 were estimated by merging official Statistics New Zealand life-tables, census data and linked census-mortality rate estimates. We specified six modelling scenarios, formed by combining two options for future per annum declines in mortality rates among never-smokers (1.5%/2.5% and 2.0%/3.5% for non-Maori/Maori; i.e. assuming a return to long-run trends of closing ethnic gaps as in pre-1980s decades), and three options for future per annum reductions in the mortality rate difference comparing current to never-smokers (0%, 1% and 2%). Results In 1996-1999, current smokers had an estimated 3.9 to 7.4 years less of life expectancy relative to never-smokers. This smoking difference in life expectancy was less among Maori than among non-Maori. If the 2006 census smoking prevalence remains unchanged into the future, we estimate the difference in 2040 between Maori and non-Maori life expectancy will range from 1.8 to 6.1 years across the six scenarios and two sexes (average 3.8). If nobody smokes tobacco from 2020 onwards, we estimate additional gains in life expectancy for Maori ranging from 2.5 to 7.9 years (average 4.7) and for non-Maori ranging from 1.2 to 5.4 years (average 2.9). Going smokefree as a nation by 2020, compared to no change from the 2006 Census population smoking prevalence, will close ethnic inequalities in life expectancy by 0.3 to 4.6 years (average 1.8 years; consistently greater for females). Discussion If smoking persists at current rates it will become an even greater constraint on life expectancy improvements for New Zealanders in the future. Continued increases in life expectancy, and closing of the Maori:non-Maori gaps in life expectancy, would be greatly assisted by the end of tobacco smoking in Aotearoa-New Zealand by 2020.
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Survival Disparities in Indigenous and Non-Indigenous New Zealanders with Colon Cancer: The Role of Patient Comorbidity, Treatment and Health Service Factors
Journal of Epidemiology and Community Health, 2010Co-Authors: Sarah Hill, Diana Sarfati, Tony Blakely, Bridget Robson, Gordon Purdie, Jarvis T. Chen, Elizabeth R. Dennett, Donna Cormack, Ruth CunninghamAbstract:Background Ethnic disparities in cancer survival have been documented in many populations and cancer types. The causes of these inequalities are not well understood but may include disease and patient characteristics, treatment differences and health service factors. Survival was compared in a cohort of Maori (Indigenous) and nonMaori New Zealanders with colon cancer, and the contribution of demographics, disease characteristics, patient comorbidity, treatment and healthcare factors to survival disparities was assessed. Methods Maori patients diagnosed as having colon cancer between 1996 and 2003 were identified from the New Zealand Cancer Registry and compared with a randomly selected sample of non-Maori patients. Clinical and outcome data were obtained from medical records, pathology reports and the national mortality database. Cancer-specific survival was examined using KaplaneMeier survival curves and Cox hazards modelling with multivariable adjustment. Results 301 Maori and 328 non-Maori patients with colon cancer were compared. Maori had a significantly poorer cancer survival than non-Maori (hazard ratio (HR)¼1.33, 95% CI 1.03 to 1.71) that was not explained by demographic or disease characteristics. The most important factors contributing to poorer survival in Maori were patient comorbidity and markers of healthcare access, each of which accounted for around a third of the survival disparity. The final model accounted for almost all the survival disparity between Maori and non-Maori patients (HR¼1.07, 95% CI 0.77 to 1.47). Conclusion Higher patient comorbidity and poorer access and quality of cancer care are both important explanations for worse survival in Maori compared with non-Maori New Zealanders with colon cancer.
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a challenge to the cross cultural validity of the sf 36 health survey factor structure in Maori pacific and new zealand european ethnic groups
Social Science & Medicine, 2000Co-Authors: Kate M Scott, Diana Sarfati, Martin Tobias, Stephen HaslettAbstract:This paper reports on a principal component factor analysis of the SF-36 health status questionnaire in the three major ethnic groups in New Zealand (New Zealand Europeans, Maori and Pacific). The SF-36 is hypothesised to have a two-dimensional structure with distinct (weakly correlated) mental and physical health components, and support for this structural model has generally been found cross-nationally. However, in Maori and Pacific models of health mental and physical dimensions are not generally seen as separable, or independently functioning. This raises the possibility that the questionnaire's hypothesised structural model would not be supported among Maori and Pacific ethnic groups. This study evaluated that possibility. The results of the analysis showed a similar factor structure among New Zealand Europeans, and younger Maori (
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a challenge to the cross cultural validity of the sf 36 health survey factor structure in Maori pacific and new zealand european ethnic groups
Social Science & Medicine, 2000Co-Authors: Kate M Scott, Diana Sarfati, Martin Tobias, Stephen HaslettAbstract:This paper reports on a principal component factor analysis of the SF-36 health status questionnaire in the three major ethnic groups in New Zealand (New Zealand Europeans, Maori and Pacific). The SF-36 is hypothesised to have a two-dimensional structure with distinct (weakly correlated) mental and physical health components, and support for this structural model has generally been found cross-nationally. However, in Maori and Pacific models of health mental and physical dimensions are not generally seen as separable, or independently functioning. This raises the possibility that the questionnaire's hypothesised structural model would not be supported among Maori and Pacific ethnic groups. This study evaluated that possibility. The results of the analysis showed a similar factor structure among New Zealand Europeans, and younger Maori (<45 years) to that reported by Ware et al. for Western European countries. Among Pacific people and older Maori (45 years and over), however, the factor structure did not clearly differentiate physical and mental health components. Implications are discussed both specific to the SF-36 (and in particular the use of principal component summary scores), and more generally for the cross-cultural validity of self-reported health status measures.
Martin Tobias - One of the best experts on this subject based on the ideXlab platform.
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decades of disparity widening ethnic mortality gaps from 1980 to 1999
The New Zealand Medical Journal, 2004Co-Authors: Tony Blakely, Bridget Robson, Shilpi Ajwani, Martin Tobias, Martin BonneAbstract:Background Maori and Pacific deaths were severely undercounted in the mid-1980s and first half of 1990s, resulting in numerator-denominator bias when calculating mortality rates by ethnicity. We used the New Zealand Census-Mortality Study to adjust for this bias and calculate corrected ethnic-specific mortality rates from 1980 to 1999. Methods Age-specific adjusters were calculated for the period 1980–99. They were applied to mortality data to obtain a corrected number of deaths. Mortality rates (by age and gender) were calculated by dividing the total number of adjusted deaths by the respective census counts. Results Contrary to unadjusted rates, corrected Maori and Pacific mortality rates were clearly higher than non- Maori non-Pacific rates during the 1980s and early 1990s. From 1980–84 (1361 per 100,000 for males and 965 per 100,000 for females) to 1996–99 (1258 and 894), there was only a modest decrease in Maori 1 to 74 year old mortality rates. Pacific mortality rates changed little from 1980–84 (1264 and 672) to 1996–99 (1144 and 696 per 100,000 for males and females respectively). Non-Maori non-Pacific mortality rates, however, decreased by about 30% from 1980–84 (919 and 553) to 1996–99 (641 and 407 per 100,000 for males and females, respectively). Cancer (lung, prostate, breast, colorectal) mortality rates tended to increase over time among Maori compared to steadily decreasing among non-Maori non-Pacific. Of note, Pacific colorectal cancer mortality rates have increased by about ten-fold during the 1980s and 1990s. All ethnic groups experienced falls in cardiovascular disease mortality rates, but the decreases were much greater among non-Maori non-Pacific. Conclusion The gaps between Maori and non-Maori non-Pacific mortality widened over the 1980s and 1990s mainly due to steadily declining non-Maori non-Pacific mortality rates and stagnant Maori mortality rates. Likewise, the gaps between Pacific and non-Maori non-Pacific mortality also widened during that period. This paper presents Maori, Pacific, and non-Maori non-Pacific mortality rate trends during the 1980s and 1990s. The results presented in this paper, for the first time, correct for ‘undercounting of Maori and Pacific deaths’ and ‘modest overcounting of non-Maori non-Pacific deaths’ that occurred during that period. This so-called numerator-denominator bias for ethnicity recording between census and mortality data has been known about for some time. 1–4 However, it is only with the recent record linkage of census and mortality data in the New Zealand Census-Mortality Study (NZCMS) 5,6 that we can now accurately determine ethnic mortality trends.
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a challenge to the cross cultural validity of the sf 36 health survey factor structure in Maori pacific and new zealand european ethnic groups
Social Science & Medicine, 2000Co-Authors: Kate M Scott, Diana Sarfati, Martin Tobias, Stephen HaslettAbstract:This paper reports on a principal component factor analysis of the SF-36 health status questionnaire in the three major ethnic groups in New Zealand (New Zealand Europeans, Maori and Pacific). The SF-36 is hypothesised to have a two-dimensional structure with distinct (weakly correlated) mental and physical health components, and support for this structural model has generally been found cross-nationally. However, in Maori and Pacific models of health mental and physical dimensions are not generally seen as separable, or independently functioning. This raises the possibility that the questionnaire's hypothesised structural model would not be supported among Maori and Pacific ethnic groups. This study evaluated that possibility. The results of the analysis showed a similar factor structure among New Zealand Europeans, and younger Maori (
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a challenge to the cross cultural validity of the sf 36 health survey factor structure in Maori pacific and new zealand european ethnic groups
Social Science & Medicine, 2000Co-Authors: Kate M Scott, Diana Sarfati, Martin Tobias, Stephen HaslettAbstract:This paper reports on a principal component factor analysis of the SF-36 health status questionnaire in the three major ethnic groups in New Zealand (New Zealand Europeans, Maori and Pacific). The SF-36 is hypothesised to have a two-dimensional structure with distinct (weakly correlated) mental and physical health components, and support for this structural model has generally been found cross-nationally. However, in Maori and Pacific models of health mental and physical dimensions are not generally seen as separable, or independently functioning. This raises the possibility that the questionnaire's hypothesised structural model would not be supported among Maori and Pacific ethnic groups. This study evaluated that possibility. The results of the analysis showed a similar factor structure among New Zealand Europeans, and younger Maori (<45 years) to that reported by Ware et al. for Western European countries. Among Pacific people and older Maori (45 years and over), however, the factor structure did not clearly differentiate physical and mental health components. Implications are discussed both specific to the SF-36 (and in particular the use of principal component summary scores), and more generally for the cross-cultural validity of self-reported health status measures.
Neil Pearce - One of the best experts on this subject based on the ideXlab platform.
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improving access to health care among new zealand s Maori population
American Journal of Public Health, 2006Co-Authors: Lis Ellisonloschmann, Neil PearceAbstract:The health status of indigenous peoples worldwide varies according to their unique historical, political, and social circumstances. Disparities in health between Maoris and non-Maoris have been evident for all of the colonial history of New Zealand. Explanations for these differences involve a complex mix of components associated with socioeconomic and lifestyle factors, availability of health care, and discrimination. Improving access to care is critical to addressing health disparities, and increasing evidence suggests that Maoris and non-Maoris differ in terms of access to primary and secondary health care services. We use 2 approaches to health service development to demonstrate how Maori-led initiatives are seeking to improve access to and quality of health care for Maoris.
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social class mortality differences in Maori and non Maori men aged 15 64 during the last two decades
The New Zealand Medical Journal, 2002Co-Authors: Andrew Sporle, Neil Pearce, Peter DavisAbstract:Aims This investigation uses data from 1996-97 to update previous studies of social class mortality differences in Maori and non-Maori New Zealand men aged 15-64 years. Methods Numerator data were obtained from the national death registrations and denominator data were from the 1976, 1986 and 1996 censi. For each social class, age standardised death rates in Maori and non-Maori men were calculated for amenable, non-amenable and all causes of mortality. Results Maori male mortality was significantly higher than non-Maori mortality in each social class and for the total population for amenable (overall RR = 5.3(CI = 4.0-6.9)), non-amenable (overall RR = 2.4(2.2-2.6)) and all causes of mortality (overall RR = 2.4(2.3-2.6)). The social class mortality differences within Maori (relative index of inequality was 3.3) were markedly greater than non-Maori class differences (RII = 1.5). Conclusions The persistently high Maori mortality rates, when controlled for social class, indicate that the poor state of Maori health cannot be explained solely by relative socioeconomic disadvantage. The high Maori rate of potentially preventable deaths indicates that the health sector is still not meeting the serious health needs of many Maori. The social class mortality gradient within Maori underlines the need to address disparities within Maori.
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long term benefits for Maori of an asthma self management program in a Maori community which takes a partnership approach
Australian and New Zealand Journal of Public Health, 1999Co-Authors: M M Ratima, Te H Karu, T Gemmell, T Slater, Wendyl Dsouza, Neil PearceAbstract:Background: In 1991, an intervention trial of the efficacy of an asthma self-management plan was carried out in partnership with a rural Maori community. The program relied on Maori community health workers and other health professionals working in partnership, was delivered through clinics in traditional Maori community centres and Maori processes were followed throughout. The plan was shown to be effective in reducing asthma morbidity.
