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在新西兰涉及个人的生活经历和文化不同于从业工作经验。医疗服务提供者期望工作和行为在一个文化安全的习俗，并必须有理解和认识到负责行动的文化背景。从业者必须在文化上敏感，并能够有助于实现积极的健康结果和做法。另一方面，怀唐伊条约和毛利人的健康护理实践方面。它曾作为国家的基础。
和其他种族一样，毛利人也有自己独特的信仰和习俗。他们有其独特的种族起源、社会经济地位、精神信仰、宗教、残疾、社会经济地位和职业。当谈到健康，他们也有自己的做法。毛利人有自己的故事要讲。这些人没有普遍的献身或崇拜的结构体系.。
The Kawa Whakaruruhau is an experience in New Zealand which involves working with individuals whose experiences in life and cultures are different from those of the practitioner. Healthcare providers are expected to work and behave in a culturally safe custom, and must have understanding and awareness to accountable action in cultural backgrounds. Practitioners must then be culturally sensitive and are able to contribute to the attainment of positive health results and practices. On the other hand, the Treaty of Waitangi and the health of Maori are aspects of nursing practice. It has served as the country’s foundation.
Just like all other races, the Maori people also have their own different and unique beliefs and practices. They have their distinctive ethnic origins, socioeconomic status, spiritual beliefs, religion, disabilities, socioeconomic status and occupation. When it comes to health, they also have their own practices that they follow. Maori people have their own story to tell. These people have no structured system of devotion or worship which is being practiced in general.
In a study being conducted, it was shown that Maori population group have the poorest health status (on average) than any other cultural groups in New Zealand. It is said that their unmet necessity for healthcare compared to other individuals are higher. The health care cost have prevented the 23 percent, and 8 percent of children from seeing a GP when they needed to during the past 12 months. They are more likely than other population group to have tooth extraction due to poor oral health and most adults would only visit any dental healthcare provider for dental problems or none at all. The Ministry of Health and the Government are making actions in order lower the inequalities affecting this population group. If this group of people are to live longer, will have healthier and better lives, they will be able to fulfil and accomplish their potential to join in the country’s society.
Arguments were raised among researchers on how the socio-economic factors affect the health, but it was accepted that they are associated. It’s likely that a blend of material deficiency (such as poor nutrition and housing) and the tension produced by low social status resulting in health inequalities.
There are critical factors affecting the society’s socio-economic status. Namely the income, education, and occupation. These factors are key aspects of health. People in the society who are living in good conditions continue to have more improved health than those who live in poverty, in an environment of growing living standards, developments in life expectancy, shifting causes of ailments and disorders, and death and improvements in medical technologies ever since the 19th period. Health disparities are found among rich and poor groups in every part and for nearly all illnesses. The lifestyle regime and environment greatly affect Maori health and are shaped by the socio-economic factors. The behavioural ranges and the material shortcomings of people’s lives are affected by employment status, income and education.
Because socio-economic factors largely determine the health factors, developments are primarily influenced by things such as the quality of housing and levels of income. These are in relation to society-wide distribution of resources. Nonetheless, services in health are essential ways of addressing health inequalities and problems.
Assessment 1: Task 2
OBESITY IN NEW ZEALAND’S
MAORI and NON-MAORI ADULTS
An individual’s healthy body size is vital for having a good health as well as wellbeing. Obesity is defined as having excess adipose tissue in the body. According to Obesity Society (2010), there are numerous different ways and procedures to determine excess fat or tissue. A fat cell is also an endocrine cell and an adipose tissue is considered an endocrine organ. Per se, the adipose tissue produces countless products. These products are the cytokines, metabolites, factors for the coagulation of blood, and lipids among others. If one is obese, it means that the person is excessively overweight and the weight is above the ideal to be healthy. Being obese is also putting your health at serious danger as this can cause diabetes type 2, hypertension, osteoarthritis, cancers, sleep apnoea, cardiovascular diseases, stroke, social and psychological problems. Significantly, excess obesity or adiposity causes higher levels of inflammation and circulating fatty acids. This can lead to resistance in insulin, which can then lead to Diabetes Mellitus (DM type 2).
Obesity is increasing globally, resulting from a positive energy balance - which is a long term excess of the intake of energy, such as food and beverage intake over energy spending like physical activity and basal metabolic rate. Although some are more genetically prone to gain weight than others, the speedy increase in the occurrence of obesity in the recent years has happened too rapidly to be explained by changes in genetic. Most of the experts believe that living in an increasingly ‘obesogenic’ surrounding is the reason. This kind of environment promotes food and drinks over-consumption and also restricts the opportunities for physical activity. People overeat foods rich in calories and exercise rarely.
Body mass index or BMI (weight adjusted by the height) is a very beneficial population measure commonly utilized to categorise underweight, overweight, and obesity. Most of the doctors in New Zealand and health professionals use BMI. This measures the weight adjusted for height and calculated by weight division in kilograms by height in meters squared (kg/m2). It measures the adiposity of the body. For individuals aging 20 years and above, the BMI classification for overweight is less than 25kg/m2, while for obese is greater than 30kg/m2. This indicates whether a person has a healthy weight and provides a very strong health risk estimate. The elevated body mass index is now ranking with major world health problems like maternal and childhood malnutrition, hypertension, high level of cholesterol, unsafe sex, iron-deficiency, alcohol, unsafe water and smoking, in the total burden of disease globally. For obese individuals, the weight loss based primarily on changes in lifestyle can be very difficult to attain and more challenging to maintain as well. Backup approaches (like medications on obesity), can be vital tools to treat obesity effectively in some people. Many of us eat too much junk food, do not get enough exercise, and are getting fat. Cases of premature deaths, serious illnesses and increasing costs in healthcare are contributed by obesity.
Waist measurements is used to further quantify the health risk and to evaluate the progress of the health interventions. Increased waist measurement is seen in central obesity. It is a substitution measurement of the intra-abdominal, or the visceral fat. Central obesity, is opposite to peripheral obesity. Peripheral obesity is an excess fat on the hips, buttocks, thighs. The measurements are taken in the mid-point in between the bottom rib and iliac crest or taken around the umbilicus if these are out of sight or hard to measure. The risk is greater for men having a waist measurement higher than 102 cm and 88 cm for women. Waist-to-height and waist-to-hip are additional measurements in adults, are of limited scientific use if the waist circumference and BMI are used regularly.
In the recent years, there has been a dramatic rise in obesity in almost all nations, and New Zealand isn’t an exemption. The epidemic of obesity cases in New Zealand has stretched to levels of crisis, according to the health and nutrition experts. An international study shows that Kiwis have a greater obesity rate compared to Australians, and two out of three in adults are classified as overweight or obese. This number has tremendously increased by 50% over the past 30 years. So far it has been the biggest increase among developed countries in the study (The New Zealand Herald). “Overweight” is having a “body mass index” or BMI of 25.0 - 29.9, meanwhile “obese” is when a person is having a BMI of 30 or more (Fight the Obesity Epidemic). Obesity is now prevalent and has been regarded as globally epidemic by the World Health Organization.
In 2008/09, the mean body mass index (BMI) of Maori adults was at 29.9 kg/m2 for the males and 30.7 kg/m2 for the females. Results show that MÄori males and females had a considerably higher mean body mass index than non-MÄori males and females. In the year 1997 to 2008/2009, there was a growth in the mean body mass index in both the MÄori males and females. Obesity prevalence was at 41% in the male Maori and 48% in female Maori. Both male and female Maori were 1.5 and 2 times more possible to become obese than the male and female non-MÄori respectively. Those with a body mass index over 40, are the major concern which are the so-called the ‘morbidly obese’. The New Zealand Health Survey 2006/07 presented that 9.3% of female Maori and 5.6% of male Maori were morbidly obese, while the non-MÄori and non-Pacific rates are only at 2.9% and 1% respectively. To make sense, a person who is 168cm tall or 5 ft. 6” would need to have a weight of 113kg in order to have a body mass index of 40. If a person is 183cm or 6 ft. tall, he or she should weigh 134kg. What’s more concerning was the surge in the quantity of the so-called ‘super-obese’ individuals with a body mass index of 55 and more. The study on Adult Nutrition in 2008/09, projected that New Zealand has 1900 MÄori having a BMI of 55 and more. Possibly 200 of these Maori people are located in the Midlands area. While the rate of individuals becoming obese has decelerated, the rate of individuals who are becoming morbidly obese continued to increase in New Zealand over the previous decade.#p#分页标题#e#
The 2002/03 Health Survey New Zealand shows that 20.8% of adults were obese, 32.5% were overweight, excluding obesity. Obese Maori men were at 27%; obese Maori women were at 27%; obese Pacific men were at 36% and obese Pacific women were at 47%. It was shown that more than half of all the adults had grown and gained more than 10 kilograms since the age 18. The statistics for obesity in New Zealand adults, got worse in the year 2011/2012. Obese adults were was at 28%, which is about one million adults and the rate of obesity increased by 26% since 2006/07. Almost one in three adults aging 15 years old and above were obese and a further 34% were considered to be overweight. The New Zealand’s classification of “obese” or “overweight” follows the best practice internationally. The BMI is the basis obtained from weight and height measurements. An adult individual which has a BMI of 25 has reached the point where evidence on research indicates that, on average, excessive body fat results in health damage. Higher BMI results in greater health risk.
In the year 2013, the healthcare cost of New Zealand’s overweight and obesity was estimated at $722 million per year (The Encyclopedia of New Zealand). According to the Ministry of Health 2013’s annual report, more than 1 million adults are now obese in New Zealand. In 2011-12 estimated 28% of adults from age 15 years and above were considered obese. The obese adults’ ratio has increased from 19% in 1997, to 26% in 2006-07 and is now at 28%. Weight excess was a major contributor leading to several health conditions which include diabetes type 2 (DM2), ischaemic heart disease (IHD), stroke and many types of cancer. The rates of obesity were higher among Maori adults which is at 44% and Pacific adults 62%. The obesity rate in New Zealand is higher compared with other OECD (Organization for Economic Co-operation and Development) countries, although it has a similar obesity rate to Australia, while the rates (including European and or other adults) were beyond the 22% on the OECD average. It was also stated in the report that it (obesity) was strongly associated with socioeconomic deficiency or deprivation. It is said that the BMI in Pacific, Maori, and South and East Asian people is less accurate. Higher onset of BMI figures are in Pacific and Maori people while lower onset are in South and East Asian population.
If the existing trends in obesity continued, it would surpass tobacco use as the primary and leading risk factor for disease by 2016. According to Kevin Hague (Green Party health spokesman), this country could not afford the cost of rising diseases related to obesity and hitting the 1 million mark should be the Government’s wake up call. The Ministry of Health’s report also confirmed another new high showing that 225,700 people have now been diabetes-diagnosed and 25.5% of adults have pre-diabetes, which is 1/4 of the total population. At the current rate, this country would be hit with a surge of heart disease and diabetes, which would cripple the New Zealand's health system. The overtaking of obesity and diabetes in the health system will mean that the New Zealanders’ health needs will not be met by the increasingly strained health care system. The Minister of Health even committed $60 million per year for the prevention of obesity and diabetes, which is nearly 30% reduction in funding since 2008 while the rates of obesity and diabetes still soar. The Ministry of Health’s figures display obesity is continuing to be excessively higher in the Maori group than other parts of the New Zealand population. Maori’s health care access is also a problem, having 37% of the Maori group are unable to afford to go to the doctor. Obesity has also been termed by the World Health Organisation as ‘an epidemic’.
It may be beneficial and helpful for the patient to be asked as well as the family if appropriate, about their opinions and interpretations of their own weight, and any probable reasons for gaining weight. An obesity Conference, was held in Whangarei which incorporated the nurse practitioners, primary health doctors, surgical specialists in private hospitals, and allied health professionals coincides with the Diabetes Awareness Week. The conference suggested multi-disciplinary methods and approaches to obesity. The drivers which lead to obesity, like eating well barriers due to perceived expenditure of foods which are healthy, lacking time to prepare the meals and predispositions in genetics. Nevertheless, while acknowledging obesity is acceptable as a societal or genetic factor, it wouldn’t mean that it will already be untreatable or unavoidable. Having an active way of life, psychological interventions and dietary advice were considered parts of the multi-disciplinary method to obesity..
Conclusion:结论
As we age, the more we are prone to becoming obese. Not only this country, but almost all nations globally are having struggles when it comes to obesity. Several studies show that in New Zealand, the Pacific and Maori population have the highest digits in obesity compared to the South and East Asian groups. Obesity prevalence is high and the cases are increasing rapidly due to our sedentary lifestyle, genetics and poor diet control. Self-discipline, control and active lifestyle would play an important role in addressing this problem. These measures do not only apply to the New Zealand population but all other nations worldwide.
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