Abstract
BackgroundHealth equity is a priority in the global sustainable development agenda. Available health equity indicators often focus on health outcomes, access to healthcare, risk factors and determinants such as income, education, and gender. Less attention has been given to other social determinants, including those related to place and ethnicity. Measures such as income, education, and gender, however, may not provide policy-makers with sufficient information to redress inequities. In this paper, we begin to develop health equity indicators for young Pasifika peoples in Logan, Queensland, Australia. While health data on Pasifika young people in Queensland is scant, available data suggests significant inequalities. The purpose of the study was to develop an understanding of the drivers of these disparities through the lens of the social determinants of health, to create health equity indicators.MethodsFollowing meetings with community stakeholders to develop respectful and collaborative partnership processes, we took a youth participatory action research approach. Six peer researchers (3 male, 3 female) were recruited from the Logan area for the project. Following training, the peer researchers undertook 31 qualitative interviews with young Pasifika (16–24 years old). Data was manually analysed, coded and grouped into themes to develop the draft indicators. Interviews used the culturally appropriate Talanoa storytelling approach.ResultsSix key themes were identified from the interviews and were used to develop example indicators related to: spiritual and socio-cultural dimensions, place, access to culturally responsive services, economic and material dimensions and political dimensions. The results demonstrate health inequities experienced by Pasifika populations are strongly linked to place and their economic, social and cultural position.ConclusionsThis study emphasises the need to understand the multiplicity of place-based factors that interact in complex ways to shape health inequities for young Pasifika peoples. It highlights health equity indicators must go beyond healthcare services, outcomes and a limited number of objective determinants, to include a more holistic focus. Starting to measure health and wellbeing via the lens of the social determinants of health will help to identify where policy-makers and programmes can intervene to begin to more adequately address inequities.
Highlights
Health equity is a priority in the global sustainable development agenda
Six key thematic areas of health and well-being were identified from interviews: spiritual dimensions, sociocultural dimensions, place, access to culturally responsive services, economic and material dimensions and political dimensions
Analysis of the data demonstrated participants took a holistic view of health, with spiritual, cultural, social, economic and political processes intersecting in often contradictory ways to influence health and give meaning to Pasifika young people’s lives
Summary
Health equity is a priority in the global sustainable development agenda. Available health equity indicators often focus on health outcomes, access to healthcare, risk factors and determinants such as income, education, and gender. Less attention has been given to other social determinants, including those related to place and ethnicity Measures such as income, education, and gender, may not provide policy-makers with sufficient information to redress inequities. Despite global improvements in health outcomes and increases in life expectancy in many countries, regardless of their level of development, inequities are widening and of increasing policy concern [6, 7]. These inequities manifest in the levels of health risks to which different population groups are exposed and in differential access to its resources [4, 8]. It is relevant to the United Nations Sustainable Development Goal (SDGs) Goal 10, which aims to “reduce inequality within and among countries”, and Goal 3, that aims to “ensure healthy lives and promote well-being for all at all ages” [9]
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