Academic journal article Health Sociology Review

The Subjective Experience of Polynesians in the Australian Health System

Academic journal article Health Sociology Review

The Subjective Experience of Polynesians in the Australian Health System

Article excerpt

WHY AUSTRALIA NEEDS TO BE CONCERNED

Postcolonial reconfigurations of the South Pacific may explain why Australian scholar- ship is so limited regarding ethnographic, political, or cultural understandings of Polynesia and instead, concentrates almost exclusively on Melanesia. As Brown (1998, p. 112) points out: ?It is surprising how relatively little is known about the Pacific Island migrant community in Australia and else- where'. This situation has not changed, and argu- ably may be deteriorating as Pacific Studies are in decline (Cooney, 2009). As a consequence of this neglect, Australia is, in terms of scholarship, largely unprepared for the rapid escalation of Polynesian migration. The number of New Zealand-born people living in Australia increased by 89 percent over the last two decades, from 280,200 in 1989 to 529,200 in 2009 (Australian Bureau of Statistics [ABS], 2010). One in six Maori now live in Australia (Hamer, 2009a) and increased migration of Pacific Islanders1 both from New Zealand and the home islands means Polynesians are now one of Australia's fastest growing migrant populations with a current combined estimate of Maori and Pacific Islanders at 126,000 (Hamer, 2007, 2009a). While many Polynesians have settled in Sydney and Melbourne, it is now Queensland, most par- ticularly outlying areas of Brisbane and the Gold Coast that are rapidly becoming the destination of choice (Queensland Health, 2009a). Most Polynesians are clustered in ?blue collar' occupa- tions, and are at risk of fluctuating employment, poor working conditions and the impact of such work on their bodies by middle age (Robson & Harris, 2007; Rodriguez, 2012).

As New Zealand is home to the biggest Polynesian population in the world, the avail- able statistics on obesity and related illness pro- vide important baseline data for health workers in Australia (Queensland Health, 2011a; van Driel, Komaric, Smart, & Steele, 2009). Detailed analysis of New Zealand statistics also indicates a disturbing trend: That prevalence of obesity is increasing in these communities (Obesity Task Force, 2008). When adjusted for age, Goulding et al. (2007) estimate two-thirds of Polynesian children in New Zealand, aged 5-14, are already obese. According to the New Zealand Ministry of Health (2012) the leading cause of death for Polynesians is ischaemic heart disease. However, of on-going concern is the incidence of type 2 diabetes (T2D). As with cardiovascular illness, not only do Maori and Pacific Islanders in New Zealand have one of the highest rates of diabe- tes in the world, they are much more likely to die from the disease than non-Polynesians (New Zealand Health Survey, 2008). Additionally as the estimated number of those who remain undiagnosed could be as high as a third or a half again, actual prevalence rates are thought be significantly higher. Given that T2D and most forms of heart disease are largely preventable, there is considerable evidence that other factors are at work to influence these figures, in par- ticular cultural eating practices, social disadvan- tage, multiple 'high risk' factors and equity of health access.

It has been known for at least two decades that Maori and Pacific Islanders under-utilise health care services in the early stages of illness, and throughout the length of illness (Baxter, 2002). It is also evident that as treatable illnesses become more severe, the effectiveness of health service intervention is greatly reduced. The empirical data suggests this has not changed, and the rea- sons behind this reluctance to engage with the health system appear to remain the same as they were two decades ago (Ellison-Loschmann & Pearce, 2006). There are the factors commen- surate with social disadvantage such as cost - GP and specialist fees, dental services, pharmaceuti- cals, outpatient care and transport costs directly incurred - but also additional pressures such as possible job loss for absenteeism, reduced family income, or lack of public and/or private trans- port. …

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