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The Health of Queensland's Samoan Population 2009

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The Health of Queensland's Samoan Population 2009 Queensland Health The health of Queensland’s Samoan population 2009 The health of Queensland’s Samoan population 2009 Published by the State of Queensland (Queensland Health), December, 2011 ISBN 978-1-921707-71-1 This document is licensed under a Creative Commons Attribution 3.0 Australia licence. To view a copy of this licence, visit creativecommons.org/licenses/by/3.0/au. © State of Queensland (Queensland Health) 2011. You are free to copy, communicate and adapt the work, as long as you attribute the State of Queensland (Queensland Health). For copyright information contact: The IP Officer Purchasing and Logistics Unit Queensland Health GPO Box 48 Brisbane QLD 4001 [email protected] For further information contact: Queensland Health Multicultural Services Division of the Chief Health Officer Queensland Health GPO Box 2368 Fortitude Valley BC QLD 4006 Suggested citation: Queensland Health. The health of Queensland’s Samoan population 2009. Division of the Chief Health Officer, Queensland Health. Brisbane 2010. Project team: Project Sponsor: Ellen Hawes Project Manager: Marina Chand Project officer: Hanamenn Hunt Samoan Facilitator: Felise Tautalasoo (Lemalu) Research supervisor: Dr David Yeboah Pacific Islander & Māori Needs Assessment Advisory Group An electronic version of this document is available at www.health.qld.gov.au/multicultural Table of Contents Executive summary I About the document II 1 Data sources 1 1.1 Literature review 1 1.2 Quantitative data sources 1 1.2.1 Hospital separation data 1 1.2.2 Australian Bureau of Statistics 2 1.3 Focus groups with Samoan community members and leaders 2 1.4 Health service provider survey 2 1.5 Data quality 3 2 A profile of Queensland’s Samoan population 4 2.1 Population size and growth 4 2.2 Languages spoken at home 4 2.3 Ancestry 5 2.4 Religious affiliation 6 2.5 Year of arrival 6 2.6 Participation in voluntary activities 6 2.7 Age and sex distribution 6 2.8 Geographic distribution 7 2.9 Summary of the Samoan population profile 7 3 Samoan health beliefs 8 4 Wellness and illness, the health status of Samoan Queenslanders 11 4.1 Self-reported health status and quality of life 11 4.2 Life expectancy 11 4.3 Infant mortality and health 11 4.4 Deaths – avoidable and all causes 11 4.5 Hospital separations – all causes and avoidable 12 5 Determinants of Samoan health and wellbeing 14 5.1 About this chapter’s data sources 14 5.2 Determinants of health 14 5.3 Broad features of society 15 5.4 Health behaviours 15 5.4.1 Tobacco use 15 5.4.2 Alcohol consumption 16 5.4.3 Dietary behaviour 17 5.4.4 Physical activity 18 5.4.5 Sexual behaviours 19 5.4.6 Vaccination status 20 5.5 Psychosocial factors 20 5.5.1 Psychological and mental health 20 5.5.2 Interpersonal violence 21 5.6 Socioeconomic characteristics 22 5.6.1 Access to health services 22 5.6.2 Income, employment and education 24 5.6.3 Family and neighbourhood 27 5.6.4 Housing 28 5.7 Knowledge, attitudes and beliefs 29 5.7.1 Health literacy 29 5.7.2 Help seeking behaviour 30 6 Health outcomes 32 6.1 Cancer 32 6.2 Cardiovascular disease 33 Coronary heart disease (heart attack and angina) 33 Stroke 33 6.3 Diabetes 33 6.4 Mental health 34 6.5 Respiratory disease 35 6.6 External causes 36 6.7 Musculoskeletal disease 36 6.8 Communicable disease 37 7 The way forward to improve Samoan health 38 Attachment 1 - Data and methodology 39 Attachment 2 – Focus group prompting points (community members) 40 Attachment 3 – Focus group prompting points (community leaders) 42 Attachment 4 – Summary of focus group results 44 Attachment 5 - Results of survey of health service providers 46 Attachment 6 – Standards for Statistics on Cultural and Language Diversity 48 References 49 List of tables Table 1 Queensland Samoan population by key CALD indicators, 2006 .............................................................4 Table 2 Queenslanders who spoke Samoan at home by birthplace, 2006 .........................................................5 Table 3 Queenslanders with Samoan ancestry by birthplace, 2006 ...................................................................5 Table 4 Queenslanders with Samoan ancestry by top 10 LGAs, 2006.................................................................6 Table 5 Samoa-born Queenslanders by year of arrival, 2006 .............................................................................6 Table 6New Zealand prevalence (per cent) risk and protective factors in adult males and females by ethnic group (age-standardised) 2006/07......................................................................................................... 18 Table 7 Housing tenure all Victoria and Samoa-born persons (Vic), 2006 50 ....................................................28 Table 8 Cancer incidence by Australia and Samoa country of birth 2000-2006................................................32 List of figures Figure 1 Fonofale model of Samoan health.........................................................................................................9 Figure 2 Total avoidable standardised mortality rate, ...................................................................................... 12 Figure 3 All causes standardised mortality rate,............................................................................................... 12 Figure 4 All causes standardised hospital separation ...................................................................................... 13 Figure 5 Total avoidable standardised hospital separation.............................................................................. 13 Figure 6 Conceptual framework for the determinants of health ....................................................................... 15 Figure 7 Individual weekly income all Queensland and Samoa-born persons, 2006 ........................................25 Figure 8 Level of qualification all Australia and Samoa-born, 2006 6................................................................25 Figure 9 Occupation all Queensland and Samoa-born persons, 2006 .............................................................26 Figure 10 All cancers (excluding non-melanocytic skin cancers) standardised .................................................32 Figure 11 Diabetes standardised hospital separation ratio all ..........................................................................34 Figure 12 Diabetes standardised hospital separation ratio all..........................................................................34 Figure 13 COPD standardised hospital separation ratio all...............................................................................36 Figure 14 Musculoskeletal disease standardised hospital separation..............................................................37 II Executive summary This document profiles the health of Samoan Queenslanders. Data from a literature review, the Queensland Hospital Admitted Patient Data Collection, Australian Bureau of Statistics and focus groups with Samoan community members and leaders in Queensland are presented. Quantitative data, particularly on the determinants of health and some health status indicators are not available for the Samoan population. Improved data collection and analysis is required to enable the development of a complete synopsis of the health of Samoan Queenslanders. At the 2006 Census there were 4863 Queenslanders born in Samoa and 13,536 Queenslanders with Samoan ancestry. The population grew at a rate of 20.4 per cent between 2001 and 2006. The Samoan population speaks mainly Samoan at home and is predominantly Christian. The majority of Samoa-born people arrived in Australia between 1991 and 2000. The population is geographically distributed throughout Queensland. The largest populations live in Brisbane, Logan and Ipswich – with 69.8 per cent of the population living in these three Local Government Areas. The Queensland Samoan population has Australian and traditional health beliefs and practices. The importance of Aiga (family) and Va (relational space) to the Samoan world view permeate beliefs about health and illness. Illnesses may be perceived as caused by conflicts with or failed duty towards family, or because of unbalanced social relationships.1 In Samoan culture, the individual can only be described as having meaning in relation to others, not as an individual. Religion and spirituality are also central to health beliefs and people are viewed as having physical, mental and spiritual needs. The fonofale model of Samoan health, developed in New Zealand, has components related to a traditional Samoan meeting house: cultural values (roof); family (floor); and physical, mental, spiritual and other dimensions of wellbeing (four pillars). These traditional health beliefs and the process of acculturation all impact on Samoan health in Queensland. The Samoa-born population display significant health inequalities with higher mortality rates for all causes and avoidable conditions; and higher hospitalisations for all causes, avoidable conditions, COPD, diabetes and diabetes complications. Focus groups identified diabetes, coronary heart disease, mental illness, asthma, obesity and cancer as the health priorities in the Samoan community. The main issues raised in the focus groups included lack of culturally tailored health promotion, economic and communication barriers to health, cultural reluctance to seek help and low health literacy. To improve Samoan health in Queensland, all four focus groups recommended culturally tailored
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