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Although health provider racial/ethnic bias has the potential to influence health outcomes and inequities, research within health education and training contexts remains limited. This paper reports findings from an anonymous web-based study examining racial/ethnic bias amongst final year medical students in Aotearoa/New Zealand. Data from 302 students (34% of all eligible final year medical students) were collected in two waves in 2014 and 2015 as part of the Bias and Decision Making in Medicine (BDMM) study. Two chronic disease vignettes, two implicit bias measures, and measures of explicit bias were used to assess racial/ethnic bias towards New Zealand European and Māori (indigenous) peoples. Medical students demonstrated implicit pro-New Zealand European racial/ethnic bias on average, and bias towards viewing New Zealand European patients as more compliant relative to Māori. Explicit pro-New Zealand European racial/ethnic bias was less evident, but apparent for measures of ethnic preference, relative warmth, and beliefs about the compliance and competence of Māori patients relative to New Zealand European patients. In addition, racial/ethnic bias appeared to be associated with some measures of medical student beliefs about individual patients by ethnicity when responding to a mental health vignette. Patterning of racial/ethnic bias by student characteristics was not consistent, with the exception of some associations between student ethnicity, socioeconomic background, and racial/ethnic bias. This is the first study of its kind with a health professional population in Aotearoa/New Zealand, representing an important contribution to further understanding and addressing current health inequities between Māori and New Zealand European populations. [ABSTRACT FROM AUTHOR]

For the past 20 years, the New Zealand Deprivation Index (NZDep) has been the universal measure of area-based social circumstances for New Zealand (NZ) and often the key social determinant used in population health and social research. This paper presents the first theoretical and methodological shift in the measurement of area deprivation in New Zealand since the 1990s and describes the development of the New Zealand Index of Multiple Deprivation (IMD). We briefly describe the development of Data Zones, an intermediary geographical scale, before outlining the development of the New Zealand Index of Multiple Deprivation (IMD), which uses routine datasets and methods comparable to current international deprivation indices. We identified 28 indicators of deprivation from national health, social development, taxation, education, police databases, geospatial data providers and the 2013 Census, all of which represented seven Domains of deprivation: Employment; Income; Crime; Housing; Health; Education; and Geographical Access. The IMD is the combination of these seven Domains. The Domains may be used individually or in combination, to explore the geography of deprivation and its association with a given health or social outcome. Geographic variations in the distribution of the IMD and its Domains were found among the District Health Boards in NZ, suggesting that factors underpinning overall deprivation are inconsistent across the country. With the exception of the Access Domain, the IMD and its Domains were statistically and moderately-to-strongly associated with both smoking rates and household poverty. The IMD provides a more nuanced view of area deprivation circumstances in Aotearoa NZ. Our vision is for the IMD and the Data Zones to be widely used to inform research, policy and resource allocation projects, providing a better measurement of area deprivation in NZ, improved outcomes for Māori, and a more consistent approach to reporting and monitoring the social climate of NZ. [ABSTRACT FROM AUTHOR]

The aim of this paper was to see whether all-cause and cause-specific mortality rates vary between Asian ethnic subgroups, and whether overseas born Asian subgroup mortality rate ratios varied by nativity and duration of residence. We used hierarchical Bayesian methods to allow for sparse data in the analysis of linked census-mortality data for 25–75 year old New Zealanders. We found directly standardised posterior all-cause and cardiovascular mortality rates were highest for the Indian ethnic group, significantly so when compared with those of Chinese ethnicity. In contrast, cancer mortality rates were lowest for ethnic Indians. Asian overseas born subgroups have about 70% of the mortality rate of their New Zealand born Asian counterparts, a result that showed little variation by Asian subgroup or cause of death. Within the overseas born population, all-cause mortality rates for migrants living 0–9 years in New Zealand were about 60% of the mortality rate of those living more than 25 years in New Zealand regardless of ethnicity. The corresponding figure for cardiovascular mortality rates was 50%. However, while Chinese cancer mortality rates increased with duration of residence, Indian and Other Asian cancer mortality rates did not. Future research on the mechanisms of worsening of health with increased time spent in the host country is required to improve the understanding of the process, and would assist the policy-makers and health planners. [ABSTRACT FROM AUTHOR]