Health expert says Maori and Pacific people are at high risk of infectious diseases
Otago University's head of Public Health has just won an award into his research on infectious diseases and is now involved in a new project tackling rheumatic fever.
A New Zealand public health researcher has recently been awarded the Liley Medal for work on the impacts of infectious diseases on Maori and Pacific populations.
Professor Michael Baker says overnight hospitalisations due to serious infections have risen by more than fifty per cent over the past twenty years and inequalities have also surged in that time.
Jenny Meyer asked him what can be done.
MICHAEL BAKER: The fact that we've seen rises in a whole lot of different diseases suggests we're looking at basic determinants that affect many diseases. So the three areas we always come back to are poverty - so that's low income for some people - access to health services and conditions such as housing conditions. And all of those are areas that we can modify. So we would say, for example, that household crowding appears to be a big driver of some diseases. And when we review the literature on this, this is looking at almost 10,000 studies and then whittling down to the high-quality ones, we found a very consistent relationship between living in more crowded households and a higher rate of respiratory infections, gut infections - the diarrhoeal illnesses - and skin infections, so the major things that are putting kids in hospital, for instance, are household crowding. A second area is access to health services, and of course most infectious diseases are very treatable early on. So that's a great opportunity for better prevention. So if people don't get access to treatment for their skin infections early on they wind up in hospital, having long admissions and having a general anaesthetic to have these abcesses drained. So that sort of thing is preventable.
JENNY MEYER: It sounds like what you're saying is that some of these issues are more political than personal, but they do have a huge impact on the personal lives of people who are vulnerable due to their ethnicity.
MB: Yeah, that's absolutely right. In the end, we as a society will make a choice about how we organise the distribution of wealth and access to services and so on.
JM: It does seem that rheumatic fever, in particular, has a bigger hold on indigenous populations. Do you know why that is?
MB: We're actually just about to start a national case control study funded by the Health Research Council, which is going to look at exactly this question. So what we want to do is really look at the environmental factors which we know are important, but also looking at some of the host factors - things like Vitamin D, differences in how people's immune systems behave, and ultimately looking at genetic differences just to try and really understand what is driving these large inequalities. Because for most infectious diseases Maori and Pacific peoples are maybe 2 to 2.5 times more likely to develop serious diseases. With rheumatic fever we're looking at 40-fold or 80-fold differences. So there must be some other complex factors that are driving these inequalities because they're much bigger than what we would normally see. So we're hoping in the next three years to really have some answers to this question.
Otago University's Professor Baker says Australian and New Zealand researchers are now working together to discover a vaccine to protect people from the Group A Strep bacteria in an effort to halt heart disease from rheumatic fever.
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