Why do Pacific communities in Aotearoa-New Zealand continue to face significant health disparities despite decades of targeted government policy?

In this landmark volume, editors Sir Collin Tukuitonga, Roannie Ng Shiu, and Patrick Thomsen bring together Pacific scholars to establish foundational markers for understanding the complex factors impacting community wellbeing. While Pacific peoples are among the most researched groups in the country, the contributors argue that current systems have failed to translate this data into equitable outcomes. The editors curate a deep dive into critical intersections of health, including maternal care, mental health, and the specific needs of Pacific youth, disabled people, and Rainbow+ communities. By centering the voices of Pacific experts, this work serves as both a critique of the status quo and a roadmap for a more efficient, equitable health system that treats Pacific wellbeing as an urgent public priority.

This book is essential reading for students of Pacific health and professionals operating within the public health sector. It is a vital resource for anyone working to improve health outcomes within Aotearoa-New Zealand or across the broader Pacific region.

• Cover
• Half-Title Page
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Foreword
• Contributors
  • Book Editors
  • Chapter Authors
• Setting the scene: Pacific health research in Aotearoa-New Zealand
  • Chapter summary
  • Introduction
  • Population trends and patterns
  • Socioeconomic trends
  • Health trends
  • Research and data needs for a healthy and informed future
  • References
• Pacific identity and wellbeing
  • Chapter summary
  • Introduction
  • Clarity between ethnicity and ethnic identity
  • Psychological perspectives on ethnic identity and wellbeing
  • Ethnic identity
  • Wellbeing
  • Pacific identities and wellbeing
  • Components of Pacific identities
  • Wellbeing
  • Conclusion
  • References
• The health of children and young people
  • Chapter summary
  • Introduction
  • Determinants of children and young people’s health
  • Pacific child and adolescent deaths
  • Neonates: Preparing for life
  • Pacific adolescents and young people
  • Illness and disease
    • Respiratory conditions
    • Infectious diseases
  • Optimising development and potential
    • Development and behaviour
  • Family violence and child abuse
  • Conclusion
  • References
• The health of women and reproductive health
  • Chapter summary
  • Introduction
  • Pacific women in gynaecology
    • Impact of obesity
    • Fertility
  • Cancers
    • Endometrial cancer
    • Other cancers
  • Contraception
  • Pacific women in obstetrics
    • Antenatal
    • Place of birth
  • Risk factors
    • Obesity
    • Maternal complications of obesity
    • Obesity and increased risk of gestational diabetes
    • Obesity and increased risks of hypertensive disorders in pregnancy
    • Complications of obesity in pregnancy for the baby
  • Other birth outcomes of note
    • Maternity clinical indicators trends
  • Pacific women have reported higher rates of complications
  • Perinatal and maternal mortality review committee report 2018
  • Conclusions
  • References
• Complex criticalities: An introduction to Pacific Rainbow+ communities health and wellbeing in Aotearoa-New Zealand and the Pacific
  • Chapter summary
  • Introduction
  • The ABCs of labels and Rainbow+ health and wellbeing
  • Heterosexism and heteronormativity
  • LGBT and the QIA+
  • MVPFAFF+
  • Intersectionality
  • The role of discrimination in the health and wellbeing of Pacific Rainbow+ communities in Aotearoa-New Zealand
  • Rainbow health and wellbeing research in Pacific contexts
    • Snapshot: Fiji
    • Snapshot: Papua New Guinea
  • Conclusion
  • Further Reading
  • References
• Tagata Sa‘ili Malo: The story of the Pacific disability community
  • Chapter summary
  • Introduction
  • Background: Whakawhanaungatanga
    • Mainstream disability community
    • Pacific people and disability
  • Te Ao Aotearoa
  • Shift one: New Zealand disability strategy, 2001
  • Shift two: New Zealand disability strategy 2016–2022
  • The opportunity
  • Shaping a Pacific model of disability support
  • Activation life-giving vision
    • Vision: Tagata Sa’ilimalo – The pursuit of success, the celebration of achievement, of individual, and collective vitality.
    • Vision in action: Soalaupule – self-determination, shared decision making, shared accountabilities, and shared outcomes
  • Conclusion
  • Post-script
  • References
• Manato‘a: The health of Pacific males
  • Chapter summary
  • Introduction
  • Gender and indigenous masculinities in relation to men’s health
  • Health statistics
  • Talanoa-vā an integrated approach
    • Case study 1: Masculine behaviours and social activities in the Pacific and abroad
    • Case study 2: Resilience and wellbeing in the Pacific region
  • Conclusion
  • Suggested further readings
  • References
• Mental health
  • Chapter summary
  • Introduction
  • Intergenerational trauma
  • Environmental determinants
  • Antenatal period
  • Postnatal
  • Children and adolescents
  • Adulthood
  • Substance abuse and addictions
  • Old age
  • Use of mental health services
  • Conclusion
  • Worthwhile questions in the context of COVID-19
  • Key readings
  • References
• Addiction: Alcohol, tobacco, and other drug use in Pacific communities across Aotearoa-New Zealand and the Pacific region
  • Chapter summary
  • Introduction
    • Alcohol
    • Homebrew
    • Kava
    • Tobacco
    • Illicit drugs
    • Betel nut
  • Strategies targeting alcohol and substance use in the Pacific region
  • Alcohol, tobacco, and other drugs, use for Pacific people in New Zealand
    • Alcohol
    • Tobacco
    • Illicit drugs
    • Gambling
    • Kava
    • Pacific alcohol and other drug services in New Zealand
  • Conclusion
  • References
• Fonua Ola: Re-imagining Pacific health promotion for the wellbeing of humanity and the planet
  • Chapter summary
  • Introduction
    • As a poet, let me conclude this chapter with a poem that was inspired during the Covid-19 pandemic:
    • Dawn, deep, devotional, beach reflections
  • References
• Pacific health data in Aotearoa New Zealand: Users, sources, and important considerations
  • Chapter summary
  • Introduction
  • Uses of Pacific health data
  • Ethnicity data: Definitions and methods of output
    • Definition of ethnicity
    • Ethnicity classification
    • Ethnicity data outputs
  • Data sources
    • Census
    • Integrated data infrastructure
  • Pacific data sovereignty
  • References
• Healthcare horizons: Scanning the data to navigate the barriers and enablers for Pacific communities
  • Chapter summary
  • Introduction
  • Long-term conditions
  • Access to healthcare
  • Ambulatory sensitive hospitalisations
  • Medicine access equity and polypharmacy
  • COVID-19: Pacific health service delivery leadership and opportunities
  • Stigma and discrimination
  • Cultural competence
  • Language and communication
  • Pacific health services
  • Pacific workforce
  • Conclusion
  • References
• Longitudinal and life course research: Pacific birth cohort study
  • Chapter summary
  • Introduction
    • Background context
  • The PIF Study: A Pacific birth cohort study
  • Study design
    • Participants
    • Theoretical framework
    • Data collection
  • Case study: Physical growth, metabolic risk, and potential lifecourse outcomes
  • Case study: Role of cultural alignment and identity in maintaining wellbeing
  • Knowledge translation and impact
  • Current and future research with the PIF Study
  • Conclusion
  • References
• Prosperous Pacific families through Wha-nau Ora
  • Chapter summary
  • Introduction
  • Background to Whānau Ora
  • The concept of whānau ora and origins of the Whānau Ora Initiative
  • Pasifika Futures
  • Vision and purpose
  • Leadership and governance
  • Pasifika Futures strategy and outcomes framework
  • Pasifika Futures outcomes framework
  • Commissioning programmes
  • The family journey
  • Pasifika Futures results
  • Pasifika Futures limited commissioning case study series
  • Core navigation case study
    • Navigating towards financial stability: The Fonua family’s success story with Pasifika Futures’ Whānau Ora partner Aotearoa Tongan health workers association
  • Commissioning for innovation case study
    • Navigating academic success: Josefa’s Whānau Ora educational journey at Otahuhu College
  • Commissioning for communities case study
    • Empowering cultural connection: Maria’s journey with Pasifika Futures’ Whānau Ora partner Tupumaiaga A Niue Trust
  • Commissioning for community resilience case study
    • Overcoming overcrowded living conditions and financial strain during COVID-19: Pasifika Futures’ Whānau Ora and community responsiveness and resilience partner: K’aute Pasifika
  • References
• Mana-mai-le-lagi: Storying the importance of lived experience and community connection in health research with Pacific Rainbow+ communities
  • Chapter summary
  • Introduction
  • Genesis: Lived experience
  • Connections: The foundation of the project
  • Conceptualising: In search of a research project and name
  • Process: Community consultations, protocol, and the power of inclusive collaboration
  • Decentring the main centres in community consultations
  • Reciprocity in process
  • Inclusive collaborations and dissemination to serve community practitioners
  • Reflections of a research assistant on the Manalagi project consultation process
  • Taualuga
  • References
• Loimata Suamalie and Tapasa- Mo Aiga: Wayfinding sexual violence within a Samoan diaspora aiga
  • Chapter summary
  • Introduction
  • Wayfinding Vā ethics and critical collaborative autoethnography
  • Tapasā Mo Aiga model
  • Our purpose: The triadic intentions
  • To make healing accessible
  • To make the impossible possible
  • To make healthy structures for our families
  • Wayfinding, vā, purpose, and sexual violence
  • Wayfinding the quadrants through my siblings
  • Seven sails: Equitable space and process
  • Wayfinding the seen/scene and unseen
  • Wayfinding the shame, silence, and hope for our Aiga
  • Continuum
  • References
• Notes
• Index

Sir Collin Tukuitonga is a Niuean public health leader and the Associate Dean Pacific at the University of Auckland. He has held senior executive roles at the WHO, SPC, and the NZ Ministry of Health.

Li’amanaia Dr. Roannie Ng Shiu is a Samoan health scholar and a Senior Research Fellow and Co-Director of the Centre for Pacific and Global Health at the University of Auckland.

Malaeulu Seuta’afili Patrick Thomsen is a Samoan Associate Professor of Primary Healthcare and General Practice, and the Associate Dean Pacific at the University of Otago Wellington Medical School.

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