Relationships matter in health choices

26 Jan, 2021
 
Kabir Dasgupta, Gail Pacheco, Alexander Plum

New research led by AUT’s NZ Work Research Institute (NZWRI) finds that interactions with family members and health professionals are crucial in determining immunisation uptake, engagement rates and satisfaction levels with New Zealand’s health system.

The report, “Ethnic Differences in the use and experience of child healthcare services in NZ”, is funded by the Ministry of Social Development and the Health Research Council.

The research investigated ethnic differences in the use and experience of child healthcare services in Aotearoa New Zealand and focused on decisions to immunise, seek dental care, and visit the doctor.

Using data from Growing Up in New Zealand, this country’s largest longitudinal study, the report analysed responses from around 6,000 parents at four time points: antenatally; when the children were nine-months; then two-years; and then four-years-old.

The following key findings emerged:

  • Asian and Pacific peoples are more likely to immunise their child(ren) for their 15-month and four-year-old immunisations compared with NZ European and Māori. The only time point at which Pacific peoples had lower immunisation rates relative to NZ Europeans was in getting all first-year immunisations on time.
  • Social factors, such as discouragement or encouragement, played a key role in child immunisation decisions. Family members discouraging immunisation had the largest effect, followed by discouragement from health professionals. On the flipside, health professionals encouraging immunisation had the largest positive effect on the decision to immunise.
  • If a mother perceives ethnic bias from a health professional, it significantly reduces the likelihood she will secure her first choice in lead maternity carer (LMC) and also reduces satisfaction levels with the child’s GP.
  • A range of individual and household characteristics are associated with improving the use and experience of child healthcare services. However, the relative importance of many of these characteristics changes over time. For example, socio-economic status appears to be strongly associated with timely immunisation in a child’s first year but is not significant for later immunisations.
  • Despite the wealth of factors used in the analysis, some ethnic gaps remain unexplained. These include understanding why Pacific mothers are much less likely to secure their first choice of LMC compared with NZ Europeans; and understanding why Māori and Pacific peoples access child dental services at a lower rate than NZ Europeans.

NZWRI Director, Professor Gail Pacheco, says, “When it comes to improving access to child healthcare services, and immunisation uptake in particular, this research highlights the power of personal relationships and institutional interactions with the health system. Furthermore, and perhaps not surprisingly, people who feel they have been discriminated against by a health professional are less likely to engage and, when they do, are more likely to report having a negative experience.”

NZWRI Senior Research Fellows Dr Alexander Plum and Kabir Dasgupta (both pictured) led the empirical analysis in this research, which was carried out in collaboration with the University of Auckland and Oxford University Clinical Research Unit.

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