Māori Health Review Issue 50

These researchers compared the health gains, net-cost and cost-effectiveness of New Zealand’s existing national human papillomavirus (HPV) vaccination programme of vaccination dispersed across schools and primary care (an observed coverage of only 47%) with two other alternative vaccine delivery programmes with higher estimated coverage: school-based only (the estimated coverage is 73%), and mandatory school-based vaccination but with opt-out permitted (estimated coverage 93%). A Markov macro-simulation model was developed for 12-year-old girls and boys in 2011, with future health states of: cervical cancer, pre-cancer (CIN I–III), genital warts, and three other HPV-related cancers (oropharyngeal, anal, vulvar cancer). The current HPV vaccination programme has an estimated cost-effectiveness of $NZ18,800/quality-adjusted life-year (QALY) gained compared to the status quo in New Zealand prior to 2008 (no vaccination, screening alone). The incremental costeffectiveness ratio (ICER) of an intensive school-based-only programme of girls, compared to the current situation, was $NZ34,700/QALY gained. Mandatory vaccination appeared least cost-effective (ICER compared to school-based of $NZ122,500/QALY gained). All interventions generated more QALYs per 12-year-old for Māori and people living in deprived areas (range 5–25% greater QALYs gained).

This investigation into the association of self-rated health and affiliation with a primary care provider (PCP) in New Zealand used data from a New Zealand panel study of 22,000 adults. In any given wave, the odds of being affiliated with a PCP were higher for those in good and fair/poor health relative to those in excellent health. Affiliation with a PCP increased for Europeans as health declined, whereas affiliation with a PCP decreased for Māori as health declined. These associations did not differ significantly by age or gender.

This study linked national hospitalisation, mortality and pharmaceutical dispensing data for 11,348 patients aged 35–84 years discharged from a public hospital with an acute coronary syndrome in New Zealand in 2007. Patients were followed for 3 years, to describe patterns of statin use and predictors of poor maintenance. Within 90 days of discharge, 83% had received a statin. The proportions of patients who were adequately maintained on a statin (MPR ≥80%) were 69% in year 1 of follow-up, 67% in year 2 and 66% in year 3. Patients taking statins prior to admission and those who underwent a coronary procedure were 20–50% more likely to have a MPR ≥80% over 3 years than others. Patients aged 35–45 years and those of Māori or Pacific ethnicity were 13–25% less likely to have a MPR ≥80% than those aged 55–64 years and Europeans.

The Electronic Games to Aid Motivation to Exercise (eGAME) study was a randomised controlled trial to evaluate the effect of active video games on body composition, physical activity and cardiovascular fitness in overweight and obese children in New Zealand. The study recruited 322 children aged 10–14 years who regularly used traditional sedentary video games and randomly allocated them to a 24-week active video games intervention (n=160) or control (n=162). At 24 weeks, statistically significant overall treatment effects were observed favouring the intervention group for body mass index, body mass index z-score and percentage body fat. Regression analyses revealed that the interaction operated consistently across important subgroups (by ethnicity, sex, and cardiovascular fitness).

This paper acknowledges the lack of consistent guidelines for researchers and research teams in New Zealand regarding the governance and ownership of research data collected from Māori individuals or collectives. The article discusses challenges encountered by one research team as it negotiated data ownership and governance of rongoā Māori (tradiational Māori healing). The paper describes ways in which traditional knowledge may be protected in a modern intellectual property law context and how to adequately support those, often community-based organisations, who work at the interface between Indigenous knowledge and the Western world.