Publications by authors named "Donna M Cormack"

5 Publications

  • Page 1 of 1

Survey of Barriers and Facilitators to Engagement in a Multidisciplinary Healthy Lifestyles Program for Children.

J Nutr Educ Behav 2020 05 26;52(5):528-534. Epub 2019 Nov 26.

Liggins Institute, University of Auckland, Auckland, New Zealand; Department of Pediatrics, Taranaki District Health Board, New Plymouth, New Zealand.

Objective: To understand facilitators and barriers to engagement in a multidisciplinary assessment and intervention program for children and adolescents with obesity, particularly for Māori, the Indigenous people of New Zealand.

Methods: Whānau Pakari participants and caregivers (n = 71, 21% response rate) referred to the family-based healthy lifestyles program in Taranaki, New Zealand, were asked to participate in a confidential survey, which collected self-reported attendance levels and agreement with statements around service accessibility and appropriateness and open-text comments identifying barriers and facilitators to attendance.

Results: Self-reported attendance levels were higher when respondents reported sessions to be conveniently located (P = .03) and lower when respondents considered other priorities as more important for their family (P = .02). Māori more frequently reported that past experiences of health care influenced their decision to attend (P = .03). Facilitators included perceived convenience of the program, parental motivation to improve child health, and ongoing support from the program.

Conclusions And Implications: Program convenience and parental and/or self-motivation to improve health were facilitators of attendance. Further research is required to understand the relationship between past experiences with health care and subsequent engagement with services.
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May 2020

Experience of racism and associations with unmet need and healthcare satisfaction: the 2011/12 adult New Zealand Health Survey.

Aust N Z J Public Health 2019 Feb 8;43(1):75-80. Epub 2018 Oct 8.

Biostatistics Group, Dean's Department, University of Otago, New Zealand.

Objective: Racism may affect health through differential access to, and quality of, healthcare. This study examined associations between experience of racism and unmet need and satisfaction with healthcare.

Methods: Cross-sectional analysis of the 2011/12 adult New Zealand Health Survey (n=12,596) was undertaken. Logistic regression was used to examine associations between experience of racism (by a health professional and other experiences of racism [ever]) and unmet need for a general practitioner and satisfaction with a usual medical centre in the past year.

Results: Experience of racism by a health professional and other forms of racism were higher among Māori, Pacific and Asian groups compared to European/Other. Both racism measures were associated with higher unmet need (health professional racism adjusted OR 3.52, 95%CI 2.42-5.11; other racism OR 2.21, 95%CI 1.78-2.75) and lower satisfaction with a usual medical centre (health professional racism adjusted OR 0.25, 95%CI 0.15-0.34; other racism OR 0.60, 95%CI 0.45-0.79).

Conclusions: Racism may act as a barrier to, and influence the quality of, healthcare. Implications for public health: Addressing racism as a public health issue and major driver of inequities in healthcare and health outcomes is required within the health sector and wider society.
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February 2019

Racism and health in New Zealand: Prevalence over time and associations between recent experience of racism and health and wellbeing measures using national survey data.

PLoS One 2018 3;13(5):e0196476. Epub 2018 May 3.

Eru Pōmare Māori Health Research Centre, Department of Public Health, University of Otago, Wellington, New Zealand.

Objectives: Racism is an important health determinant that contributes to ethnic health inequities. This study sought to describe New Zealand adults' reported recent experiences of racism over a 10 year period. It also sought to examine the association between recent experience of racism and a range of negative health and wellbeing measures.

Methods: The study utilised previously collected data from multiple cross-sectional national surveys (New Zealand Health Surveys 2002/03, 2006/07, 2011/12; and General Social Surveys 2008, 2010, 2012) to provide prevalence estimates of reported experience of racism (in the last 12 months) by major ethnic groupings in New Zealand. Meta-analytical techniques were used to provide improved estimates of the association between recent experience of racism and negative health from multivariable models, for the total cohorts and stratified by ethnicity.

Results: Reported recent experience of racism was highest among Asian participants followed by Māori and Pacific peoples, with Europeans reporting the lowest experience of racism. Among Asian participants, reported experience of racism was higher for those born overseas compared to those born in New Zealand. Recent experience of racism appeared to be declining for most groups over the time period examined. Experience of racism in the last 12 months was consistently associated with negative measures of health and wellbeing (SF-12 physical and mental health component scores, self-rated health, overall life satisfaction). While exposure to racism was more common in the non-European ethnic groups, the impact of recent exposure to racism on health was similar across ethnic groups, with the exception of SF-12 physical health.

Conclusions: The higher experience of racism among non-European groups remains an issue in New Zealand and its potential effects on health may contribute to ethnic health inequities. Ongoing focus and monitoring of racism as a determinant of health is required to inform and improve interventions.
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August 2018

Investigating the relationship between socially-assigned ethnicity, racial discrimination and health advantage in New Zealand.

PLoS One 2013 31;8(12):e84039. Epub 2013 Dec 31.

Dean's Department, University of Otago, Wellington, New Zealand.

Background: While evidence of the contribution of racial discrimination to ethnic health disparities has increased significantly, there has been less research examining relationships between ascribed racial/ethnic categories and health. It has been hypothesized that in racially-stratified societies being assigned as belonging to the dominant racial/ethnic group may be associated with health advantage. This study aimed to investigate associations between socially-assigned ethnicity, self-identified ethnicity, and health, and to consider the role of self-reported experience of racial discrimination in any relationships between socially-assigned ethnicity and health.

Methods: The study used data from the 2006/07 New Zealand Health Survey (n = 12,488), a nationally representative cross-sectional survey of adults 15 years and over. Racial discrimination was measured as reported individual-level experiences across five domains. Health outcome measures examined were self-reported general health and psychological distress.

Results: The study identified varying levels of agreement between participants' self-identified and socially-assigned ethnicities. Individuals who reported both self-identifying and being socially-assigned as always belonging to the dominant European grouping tended to have more socioeconomic advantage and experience less racial discrimination. This group also had the highest odds of reporting optimal self-rated health and lower mean levels of psychological distress. These differences were attenuated in models adjusting for socioeconomic measures and individual-level racial discrimination.

Conclusions: The results suggest health advantage accrues to individuals who self-identify and are socially-assigned as belonging to the dominant European ethnic grouping in New Zealand, operating in part through socioeconomic advantage and lower exposure to individual-level racial discrimination. This is consistent with the broader evidence of the negative impacts of racism on health and ethnic inequalities that result from the inequitable distribution of health determinants, the harm and chronic stress linked to experiences of racial discrimination, and via the processes and consequences of racialization at a societal level.
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September 2014

The relationship between socially-assigned ethnicity, health and experience of racial discrimination for Māori: analysis of the 2006/07 New Zealand Health Survey.

BMC Public Health 2013 Sep 13;13:844. Epub 2013 Sep 13.

University of Otago, PO Box 7343, Wellington, Wellington South 6242, New Zealand.

Background: In New Zealand, there are significant and long-standing inequalities in a range of health outcomes, risk factors and healthcare measures between Māori (indigenous peoples) and Pākehā (European). This study expands our understanding of racism as a determinant of such inequalities to examine the concept of socially-assigned ethnicity (how an individual is classified by others ethnically/racially) and its relationship to health and racism for Māori. There is some evidence internationally that being socially-assigned as the dominant ethnic group (in this case European) offers health advantage.

Methods: We analysed data from the 2006/07 New Zealand Health Survey for adult participants who self-identified their ethnicity as Māori (n = 3160). The association between socially-assigned ethnicity and individual experience of racial discrimination, and socially-assigned ethnicity and health (self-rated health, psychological distress [Kessler 10-item scale]) was assessed using logistic and linear regression analyses, respectively.

Results: Māori who were socially-assigned as European-only had significantly lower experience of racial discrimination (adjusted odds ratio [OR] = 0.58, 95% confidence interval [CI] = 0.44, 0.78) than Māori who were socially-assigned as non-European. Being socially-assigned as European-only was also associated with health advantage compared to being socially-assigned non-European: more likely to respond with self-rated very good/excellent health (age, sex adjusted OR = 1.39, 95% CI = 1.10, 1.74), and lower Kessler 10 scores (age, sex adjusted mean difference = -0.66, 95% C I = -1.22, -0.10). These results were attenuated following adjustment for socioeconomic measures and experience of racial discrimination.

Conclusions: Results suggest that, in a race conscious society, the way people's ethnicities are viewed by others is associated with tangible health risk or advantage, and this is consistent with an understanding of racism as a health determinant.
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September 2013