The need for a Pacific-specific low birth weight threshold: A comparison between Samoan babies born in Samoa with Samoan babies born in Aotearoa New Zealand Falegau Melanie Lilomaiava Silulu Master of Public Health 2011 The need for a Pacific-specific low birth weight threshold: A comparison between Samoan babies born in Samoa with Samoan babies born in Aotearoa New Zealand Falegau Melanie Lilomaiava Silulu A thesis submitted to Auckland University of Technology in partial fulfilment of the requirements for the degree of Master of Public Health (MPH) 2011 School of Public Health Primary Supervisor: Professor Janis Paterson Table of Contents Table of Contents ........................................................................................................................................................ i List of Figures.............................................................................................................................................................. iv List of Tables ................................................................................................................................................................ v Attestation of Authorship ........................................................................................................................................... vi Acknowledgements ................................................................................................................................................... vii Abstract ..................................................................................................................................................................... xii Study aims .....................................................................................................................................................................xii Design and Methods ......................................................................................................................................................xii Results .......................................................................................................................................................................... xiii Discussion ..................................................................................................................................................................... xiii Conclusions ................................................................................................................................................................... xiii Chapter 1 - Introduction ............................................................................................................................................. 1 1.1 Outline of the thesis .................................................................................................................................................. 2 1.1.1 Literature Review .............................................................................................................................................. 2 1.1.2 Study aims and Objectives ................................................................................................................................ 3 1.1.3 Methods ............................................................................................................................................................ 3 1.1.4 Results ............................................................................................................................................................... 3 1.1.5 Discussion.......................................................................................................................................................... 4 1.1.6 Conclusions and recommendations .................................................................................................................. 4 Chapter 2 - Literature Review ..................................................................................................................................... 5 2.1 Pacific and Samoan population in New Zealand ...................................................................................................... 6 2.1.1 Early Pacific migration to Aotearoa New Zealand ............................................................................................. 6 2.1.2 Pacific migration to Aotearoa New Zealand: Labour for industry and manufacture ........................................ 6 2.1.3 Demographics of Pacific people in Aotearoa New Zealand .............................................................................. 8 2.1.3.1 Population growth ..................................................................................................................................... 8 2.1.3.2 Gender ..................................................................................................................................................... 10 2.1.3.3 Age structure ........................................................................................................................................... 11 2.1.3.4 Birthplace ................................................................................................................................................. 13 2.1.3.5 Multiple ethnicities .................................................................................................................................. 15 2.1.3.6 Geographical distribution ........................................................................................................................ 16 2.2 Samoan population in Samoa................................................................................................................................. 18 2.2.1 Early South East Asian migration to Samoa .................................................................................................... 18 2.2.2 A brief history of Samoa .................................................................................................................................. 18 2.2.3 Culture and social norms ................................................................................................................................ 20 2.2.3.1 Fa’aSamoa................................................................................................................................................ 21 2.2.3.2 Vā ............................................................................................................................................................. 21 i 2.2.4 Demographics of Samoans in the Independent State of Samoa ..................................................................... 22 2.2.4.1 Population growth ................................................................................................................................... 22 2.2.4.2 Age structure ........................................................................................................................................... 24 2.2.4.3 Gender ..................................................................................................................................................... 24 2.2.4.4 Multiple ethnicities .................................................................................................................................. 25 2.2.4.5 Geographical distribution ........................................................................................................................ 26 2.3 Health status of Aotearoa New Zealand Pacific, Aotearoa New Zealand Samoan and Samoan populations ....... 27 2.3.1 The health status of the Pacific population in Aotearoa New Zealand ........................................................... 27 2.3.2 The health status of the Samoan Aotearoa New Zealand population ............................................................ 28 2.3.3 The life expectancy of the Pacific population in Aotearoa New Zealand........................................................ 28 2.3.4 The life expectancy of the Samoan Aotearoa New Zealand population ......................................................... 29 2.3.5 The health status of Samoans in Samoa ......................................................................................................... 29 2.3.6 The life expectancy of Samoans in Samoa ...................................................................................................... 30 2.4 Birth weight and indicators of health ..................................................................................................................... 31 2.4.1 Infant mortality ............................................................................................................................................... 31 2.4.2 Risk factors associated with infant mortality .................................................................................................. 31 2.4.3 Low birth weight as a primary risk factor of infant mortality ......................................................................... 34 2.5 Pacific and Samoan birth weight characteristics .................................................................................................... 40 2.5.1 A case for having a Pacific-specific low birth weight threshold ...................................................................... 41 Chapter 3 - Study aims and Objectives.......................................................................................................................43