Ethnic differences in the use and experience of child healthcare services in NZ

Using data from Growing Up in New Zealand, this research had two aims:

• to examine ethnic differences in life-course trajectories in the use and experience of healthcare services in early childhood (ie, immunisation, dental checks and use of GPs)
• to quantify the contribution of relevant explanatory factors to ethnic differences.

Current policy indicates there should be equitable access by ethnicity for healthcare services. However, empirical evidence points to persistent ethnic gaps in several domains.

The underlying mechanisms behind ethnic differences in the use and experience of child healthcare services was explored via econometric approaches. Analysis focussed on a range of factors, encompassing mobility, socio-economic status, mother and child characteristics, household characteristics and other social aspects. Analysis was conducted at each data time point that was then available, which included antenatal, 9 months, 2 years and 4 years post-birth.

Findings

• There is consistent evidence that Asian and Pacific people have a higher likelihood of child immunisation relative to NZ Europeans and Māori. This was evident at their 15 month and four years immunisations, as well as their mothers’ antenatal intention. The one time point where Pacific people had a lower rate relative to NZ European was for receiving all first-year immunisations on time.
• Social factors play a role. This included discouragement or encouragement regarding child immunisation. When broken down by source, discouragement by family members has the largest marginal effect, followed by health professionals; whereas for encouragement, medical professionals have the largest positive influence.
• Perceived ethnically motivated discrimination by a health professional was significant with respect to reducing the likelihood of someone achieving their first choice Lead Maternity Carer (LMC), and also reducing satisfaction levels with child’s GP.
• Some ethnic gaps were unexplained, despite the wealth of factors employed as independent variables in the analysis. This included understanding why Pacific mothers are much less likely to achieve their first choice LMC compared with NZ Europeans; and also understanding the ethnic gaps for both Māori and Pacific peoples relative to NZ Europeans concerning dental service use.

For enquiries about this research please email research@msd.govt.nz 

The views and interpretations in this report are those of the researchers and are not the official position of the Ministry of Social Development.

This study was led by AUT’s NZ Work Research Institute (NZWRI) in collaboration with the University of Auckland and Oxford University Clinical Research Unit