Identify three health issues in New Zealand
3. Cardiovascular disease
Cancer is a group of disease involving abnormal cell growth. Many people are affected by cancer because the population is becoming older. Most cancer can be cured if they have got treatment in time. Many people are living longer if they get effective treatment on time even if the cancer is didn’t cure. Out of the 100000 population, 487.3 per cent of the people are suffering from cancer in New Zealand. Mostly over and above the 75years of age people are more affected than 0-24 years of age (2508 out of 100000 and 19 out of 100000). 7971 people died from cancer in 2005 but the male death rate is higher than the female rate are died(Health.govt.nz, 2019). It is one of the biggest causes of morbidity and mortality in New Zealand has increase by one-third lives of people in New Zealand who suffering from it.
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In New Zealand male is dying before the age of 75 from the cancer is 11.01 per cent, for females, 9.3 per cent. But 46.27 per cent male is estimated for having to develop the risk of cancer in the age of 75. There will be 35867 new cases of cancer in 2018. There are many types of cancer such as lung cancer, skin cancer, breast cancer and colon cancer and more other. Among them, lung cancer is the most common cause of cancer which is lead to death in New Zealand because it detected late then as compared to other cancer. In 2018, 1758 deaths because of cancer and it are nearly one in five. Lung cancer caused 34 per cent in the Maori population which is lead to deaths and 17 per cent of non-Maori deaths by cancer in 2015. Among them, 32.97 per cent of male and 28.1 per cent of the female are mostly affected by skin cancer. Because of lung cancer, 5 kiwis die every day and other 6 are diagnosed with lung cancer. Between the age of the 45-64 years, the male is mostly affected and for both man and women affect between aged of 65-74 years.(Ministry of health, 2019)
Skin cancer also increases the incidence rate in 2018 in New Zealand. There are two types of skin cancer which is melanoma and non-melanoma. Non- melanoma is the most common cancer but Melanoma is the most serious kind of skin cancer in New Zealand. The new case is an increase of 31 Per cent in 2018 and the death rate is 1.85 per cent.(Ministry of Health, 2018)
Suicide is the act of intentionally causing one’s own death. Suicide was the third leading cause of death in New Zealand among other health issue for the Maori population and the second leading cause of death for the Pacifica. Suicide rate are indications by population’s mental health and wellbeing. There are several groups of people within community that have higher rate of engaging in suicidal behaviour. 500 New Zealanders are dying by suicide in every year and many more attempting suicides. It is effect to the people and many other included; family ( Whanau), Friends, society and workmates. The major cause of suicide is impulsivity and substances (alcohol and drugs). The risk factor of suicide is mental illness, family history of suicide, sexual and emotional abuse and lake of social support (family and community).(Ministry of health, 2011)
Adult is in higher rate between the age of the 15-24 and 45-60 among adult female are more prone to suicidal behaviour rather than male. As compare to the other ethnic population Maori population are having higher suicide rate in New Zealand. In 2015, 527 people are died because of suicidal attempted. In this year youth are highest rate of suicide between age of the 15-24 years around 16.9per 100000 and aged 25-44 years 16.3
The suicidal rate is higher in Maori than non-Maori for both males and females. Among Maori males, the suicide rate was 25.3 per 100000, 1.7 times that of non-Maori. For Maori female, the suicide rate was 2.4 times that of the non-Maori female. But in 2015, 31.7 per 100000 Maori male are suicide rate, the highest rate in ten year period from 2007.
In 2016, 553 people died because of suicide in New Zealand. There were 412 male suicides and 141 female suicides. In 2016, Maori rate was twice that for non-Maori for both male and female. Over the ten years period, the rate of suicide for Maori was consistently higher than the rate for non-Maori for both males and females. The rate for males increased markedly from 2013 is 21.2 per 100000 and 2016 is 31.7 per 100000. But in 2017/18 the Maori suicide total, 142 deaths during this year.(Ministry of Health, 2019)
“Cardiovascular disease generally refers to a condition affecting the heart and blood vessel such as heart failure and high blood pressure”. It is one of the leading causes of death in New Zealand because of heart disease, stroke, blood vessel disease and ischemic heart disease which are 33 per cent death yearly die. In New Zealand every 90 minutes people are die from heart disease, among them many of people dies too early and could be prevented (Health Navigator, 2019).Maori adults are more likely die due to cardiovascular disease more than Non Maori. There is a different factor which is contribution to having a cardiovascular disease such as diet, age, obesity.
“Ischemic heart disease (IHD) is a condition in which there are insufficient blood and oxygen flow to the heart muscle (myocardium), as a result of a mismatch between supply and demand”. In 2011/12 IHD occurrence about 5.5 per cent for NZ adults aged over 15years. 6.9 percent of man and 4.1 percent of female are affected by IHD. Almost 30 per cent of people are diagnosed with IHD over the age of 75 year. Maori are more 1.8 times as likely as diagnosed with IHD rather than non Maori adult. Pacific and Asian adult are less diagnosed with IHD which is 2 per cent. 1.9 times as likely to have IDP compared with the people from non-Deprived areas. IHD contributed to 6027 deaths in 2006.
“Stroke is classed as insufficient blood flow to the brain”. The risk factor for stroke includes high blood Cholesterol, hypertension, diabetes and smoking. Stroke risk is increase by the age of individual and age of over 75 years the risk of stroke are having greatest. “In 2011/12 about 1.8 per cent of adults or 62000 individuals had ever experienced a stroke at some point during their lives”. “The rate for men and women is about the same (1.9% and 1.7%) and the proportion of individuals who have ever had a stroke has not changed since 2006/07”. Stroke risk increases with age, 80% of individuals over the Age of 76 years have had a stroke, the highest of any age group. Maori individuals, 1.3 times as likely to having a stroke as compare to non-Maori individuals when adjusted for age and sex. Strokes killed about 2700 people and 26 per cent in 2006.(National Health Committee, 2013)
For the cancer age is the most important risk factor for overall and for individual cancer types. According to the most current statistical data from epidemiology the median age of a cancer diagnosis is 66 years. Some of the cancer case are occurs below the age and some of the cancer occur above the age in people. “One-quarter of new cancer cases are diagnosis is 61 years for breast Cancer 65 years for colorectal cancer, 70 years for lung cancer and 65 years for prostate cancer”. Bone cancer is diagnosed among the people under the age of 20 years, 10 per cent of leukaemia are diagnosed in children and Adolescents under age of 20 years. Some types of cancer such as neuroblastoma are more common in children or adolescent than in an adult.(Ministry of health, 2011)
In New Zealand, suicide is to attend more likely among young people between 15-24 aged. 80% of Suicides occur in individuals aged 25 and over. The risk factors for suicide may vary with age. In Particular, although poor mental health is the major risk factor for suicidal behaviour at any age, Factors relating to family, trauma and related issues appear to play a stronger role in the aetiology of Youth suicide rather than the older population. The suicidal rates of young in New Zealand increase during the last half-century mostly female.(Association of Salaried medical specialists(ASMS), 2019)
Above 65 years of age population of Maori is death by CVD around 64.4% where male were 61.1% and females were 66.7%in 100%. About non-Maori population were death in the 65 years and over Age group is 93.4% where male were 91.2% and female 94.7% in 100 %.( ministry, 2018)
2.2 And 2.3
“Negatives change in societal conditions lead to anomie, a sense of hopelessness that subsequently leads to an increase in suicidal behaviour at the individual level”.
Social determination of health: Suicidal rate is increase by social determinant of health Such as; unpleasant financial situation and social isolation, loss of a loved one, and stress caused by working roles, income and education which may lead to increases the suicide rate. Income also increase the suicidal behaviour which may occur because of poverty and stress which may cause by financial problems, family (broken family, conflict within family, perceived level of family support), Instability, physical illness, alcoholism, victim of violence and mental health problem. Education also impacts the individual’s self evaluation, self esteem and interactions with others which may lead to suicide. They get limited education and effect in their individual behaviour they get to the collection level of information. Inequalities also increase the rate of suicide. “Inequality affects the individuals by reinforcing Feelings of hopelessness and impossibility when they note that individuals around them share the same difficulties but others face a much better economic situation ”.for example; people living in urban area as Very poor who are living in the same neighbourhood of rich people. “Inequality can bring a sense of Injustices, promoting a feeling of revolt and person bankruptcy for not achieve economic success”.
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Individual behaviour: The individual behaviour also leads to an increase rate of suicide such as; alcohol and Drugs abuse, depression, offending behaviour (for the some people their mental problem put at risk of offending).Between the 19 to 63 percent of young adult dying by suicide have a substance use disorder( including alcohol, cannabis and other drugs abuse).There are many factors where young people are having the alcohol and drugs include low self esteem, hopelessness, social isolation , and impulsivity and impulsive violent aggressively.(Minstry of health, 2005)
Social policy: There is a social policy which may decrease the rate of suicide such as; give the individual awareness and education programmer, providing job opportunities, reducing crime and reoffending, and reducing welfare dependency .(Ministry of Health, 2019) . To prevent the bullying advisory group is a collaboration of 17 agencies including government are working together to reduce bullying in New Zealand. They are improving in access to mental and behaviour health services mostly in the rural community where mental health condition are not easily get treatment. Most of the rural people may get difficulties to get mental health care so that government solve that problem by providing the health insurance to access in mental health service. (Ministry of health, 2017)
There are different determinants of health such as; policy making, social factors, health service, Individual behaviour, biology and genetics amount them individual behaviour is the most Prevalence in lungs cancer. Lung Cancer is mainly caused by tobacco, smoking and exposure to Second-hand smoke which is come in individual behaviour. Smoking and tobacco is a chemical substance where smoke enters the blood stream and effect the whole body. The risk of lung cancer is raise with the number of year and number of cigarettes they smoked each day even it can be occur in people who have never smoked but exposure prolonged to second hand smoke.
Social factor: The second most key factor cause is social factor. It is mainly affected such as; lack of education, incomes and poverty, poor nutrients, Genetic, lack of available services such as health and inaccessibility of job can have both direct and indirect impact on health.
Maori people consume unhealthy food and they stay in unhygienic place which may develop the obesity which may lead the cancer. Maori people have different culture and as well as different eating habits. Just like birds, fish, potato and sweet potato which contain more carbohydrates and started to gain weight. Maori people smoke smoking more than non Maori because they didn’t get proper education about smoking and how it effects on health and increase the risk of cancer.
Health service: Many rural societies have poor access in health service due to long distance from health service and due to shortage of GP (general practitioners). Many rural people are did not get early stage at diagnosis, screen detected and optimum treatment which may increase the rate of cancer. Another factor is difference in the treatment pathway. (Ministry of health, 2019)
Social policy: There are many public policies that aim to decrease the risk of cancer. They provide public health campaigns to encourage healthy behaviour, to regulate health consumption, screening programmes to detect cancer early, health insurance policies to improve in access in healthcare.
Male and female have different incidence in cancer. Few of the cancer are more common in childhood female, but overall, males are higher susceptibility. In childhood, cancer are included, infant leukaemia, malignant melanoma, alveolar soft part sarcoma and thyroid carcinoma but half of the boys are mostly diagnosed in cancer but just 37 per cent in girls. Between the age of 1-14 years are mostly cause by cancer and as the estimated data one in five hundred children are diagnosed with cancer before the age of 15. In between 2010 and 2014, 762 new childhoods under the age of 5years are registrations due to cancer. In 2001 -2009, 37.6 new cases are diagnosed of leukaemia each year and 57.9 per cent of total leukaemia was diagnosed in children under the age of five. In 2010-2014 children are diagnosed new case (61.1%) with cancer which is twice a time higher then 2001-2009. Male are more diagnosed with cancer (118 cases, 50.3 per million) were female are 70cases, 31.4 per million, male is twice a time higher then female. Maori are less diagnosed then non Maori. In 2015 between age of 0-14 years Maori are diagnosed around 13 per cent and non Maori are around 21.6 per cent. In 2016, percentages of Maori children are diagnosed around 16 per cent and Non Maori children are diagnosed around 17 per cent, overall, this year are equally diagnosed both Maori and Non Maori children. In 2017 percentages of Maori children are highly decrease which is around 7 per cent and Non Maori is around 12.8 per cent.
Every year around 700 adult are diagnosed with leukaemia in New Zealand. Increase risk of leukaemia in the age group of 25-49 and in the age group 50-74. In 2017, Maori population are diagnosed around 28 per cent between the age of the 25 -49 but non Maori are diagnosed around 22 per cent between the age of 25-49. 27 per cent of Maori adult are diagnosed with leukaemia and Non Maori 18 per cent in 2016. In 2015, 32 percent of Maori and 22 per cent of non Maori are diagnosed with leukaemia. The higher risk increase 45 to 49 age population in between 25-49 age group which is around 15 per cent.
Leukaemia more commonly occurs in adult but it can also affect the children. Mostly leukaemia is highly chance in between age of 0-4(11.4 %) in childhood and in adult it is highly chance in 70 to 74 age group(50.1%) among other age group. In children leukaemia is diagnosed in Non Maori more than Maori but in adult Maori population are more diagnosed with leukaemia then Non Maori.(National Health Committee, 2013)
The number of suicide in 2013 is 508 people (365 male, 143 female) and 11.0 deaths per 100,000 by suicide in New Zealand. 2.5 times more men are died by suicide then women in 2013. Maori have higher rate of suicide rate more than other ethnic group. Maori have around 27 percent, pacific have around 17 per cent, Asian have around 9 per cent and European have around 19 percent suicide rate. Suicide rate is decease with the age of people among Maori and pacific. Maori between ages of 15 to 19 is higher rate of suicide from other ethnic group.
More Maori and Pacifica people are died by suicide that lives in more deprived area rather than less deprived area. Around 46 per cent of Maori are died by suicide in more deprived and around 6 per cent Maori are died by suicide in less deprived. Around 59 per cent of pacific are died by suicide in more deprived area and around 3 per cent are died by suicide in less deprived area.
Male are more prone by suicide then female mostly Maori male. Most suicide rate is in Maori ethnicity rather than other ethnicity. In more deprived area pacific are more higher died by suicide then Maori and Maori are more died in less deprived area rather than pacific. But higher died rate by suicide is more deprived area in most ethnic.(Ministry of health, 2011)
“Cardiovascular disease places a significant burden on the New Zealand health service”. During 2000-2004, 18 per cent of all Maori population are deaths due to ischemic disease and 23 per cent of all non Maori. Under 65 year’s age, 45 per cent people are death compared to 11 per cent among non-Maori. Almost 30 percent of individual population are diagnosed with IHD over the age of 75. 33 per cent of deaths are cause by cardiovascular disease. Maori are highly diagnosed with IHD about 1.8 times as likely as non -Maori. During 2000-2009, Maori male are more death in the age of 45-64 years which is 3 times that of non Maori male and Maori female are more death in the age of 45-64 years which is 4.39 times that of non Maori female.(Ministry of health, 2011)
In 2011, the prevalence of stroke was about 1.8per cent of adult which is 62000 individual, over the 75 years aged the prevalent rate is rising by 8 per cen. Maori individual were 1.3 times likely have stroke than non Maori individual.
“Determinant of health is broad range of personal, social, economic and environment factors that determine individual and population health”. Maori and non Maori have severely affected the health issues of New Zealand. Individual behaviour is one of the determinant of health with is cause the cancer. In New Zealand, Maori have a highest smoking rate rather than other ethnic group and smoking is more common where Maori population is higher. “The number of Maori smoker is giving down but it is still over double that of NZ European smokers”. 32 per cent of Maori are smokers, 23.1 per cent are ex-smokers and 44.2 per cent are never smoked. But NZ European, 14.1 per cent are smokers, 25.6 per cent are ex-smokers and 60.3 per cent are never smoker. The Maori adult rate of smoking is 34 per cent which is 2.6 times than other population group. From the lung cancer 30 per cent men and 37 per cent of Maori are suffered. The pacific population group are second highest of suffering from cancer epically to lung cancer than Maori due to excessive tobacco consumption and smoking. 45 percent of Maori and 31 percent of pacific people are smoke. In 2006, under the age of 15 years (48.1 percent) of pacific childhood is smoke, which is lived in household with a smoker. Between the ages of 14-15 years (12.0%) young people are smoked at least once a month and 6.9percent are smoked once a day. Pacific men are smoked more than pacific women.(Ministry of Health, 2017)
“Suicidal behaviour is a growing public health concern resulting in morbidity and premature death”. There is a different factor which is associated with suicidal behaviour such as age, sex, psychiatric disorders. Smoking is associated to increase risk of suicide behaviour. It is the second leading cause of death in young people 15 to 29 years of age because of motor vehicle crashes. Psychological disorder, alcohol and substance abuse are major factor for suicidal. Maori population are more prone to suicide. In 2015, suicide rate is higher in Maori then Non Maori for both male and female. Maori people have highly rate of suicide because of poverty, high rate of teenage pregnancies, lake of education and unemployment as compare to the non Maori people. In 2015, 20.3 per cent of Maori male are suicide between the age of the 15 -24 and for women it was 13.4 per 100000. Cultural racism, alcohol and drugs are a major factor in suicides among men. The issues are increase around the cultural identity and the impact of colonisation (BBC News, 2017). (Ministry of Health, 2019) In Pacifica, the most prevalent in the young age between 15-24 years is 45.8 per cent, 25-39 year age is 35.3 per cent, 40+ is 16.8 percent and less than 15 years age is 2.1 per cent(The New Zealand Medical Journal, 2017) .The suicide rate of young Maori male is higher than other population group in New Zealand. In 2010 the Maori youth suicide rate (35.3 per cent) which is twice a times more they non Maori rate (13.4). Suicide rate is rapidly raised for Maori males from 28.6 in 2010 to 46.6 in 2012.(Education counts, 2013) The Maori young are suicide because their parents were separated or have a marital conflict. For Maori children, they experienced sexual, physical and emotional abuse as compare to other population group.(BBC News, 2017)
- Association of Salaried medical specialists(ASMS). (2019, July 11). ASMS. Retrieved from sucide rate among Maori men rise to higest in decade: http://www.asms.govt.nz
- Ministry of health. (2011, May 5). Ministry of Health. Retrieved from Health and society: http://www.health.govt.nz
- Ministry of Health. (2017, April). Ministry of Health. Retrieved from Health and independence report : http://www.health.govt.nz
- Ministry of Health. (2018, july 23). Ministry of Health. Retrieved from Melanoma New Zealand: http://www.health.govt.nz
- Ministry of health. (2019, february 04). Ministry of Health. Retrieved from lung cancer: http:// www.health.govt.nz
- Ministry of Health. (2019, july 10). Ministry of Health. Retrieved from suicide facts data: http://www.health.govt.nz
- National Health Committee. (2013, December). National Health committee. Retrieved from strategic overview cardiovascular disease in New Zealand: http://www.moh.govt.nz
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