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Feature

‘Heroes’ tackling inequities in tamariki and rangatahi wellbeing

08 December 2022
Some 12 to 13 years ago, more than 6,000 children, including some 1,200 tamariki Māori, were born to change the world.

It’s not the plot of the latest superhero movie. They’re the children born to women who volunteered to take part in  (GUiNZ), the country’s largest longitudinal study of child development.

Research Director Dr  (Tūhoe) of the UniServices-run study, who is also an associate professor at Te Kupenga Hauora Māori, the Māori Health Department at Waipapa Taumata Rau, University of ɫƵ, calls the pregnant women who signed up to the extensive 21-year study in 2009 “absolute heroes” who volunteered because they wanted to make a difference. And they and their children are.

“Growing Up in ɫƵ is an important study for Aotearoa, with the Māori cohort alone representing the largest longitudinal study of Māori wellbeing this country has ever seen,” says Paine. “That makes it an important opportunity for researchers, community advocates, policymakers, iwi, hapū and other stakeholders to gain evidence and insights that can help all of us take action against the longstanding and terrible inequities we see in child and youth wellbeing, particularly for Māori.”

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Research Director Dr Sarah-Jane Paine
“Growing Up in ɫƵ is an important study for Aotearoa, with the Māori cohort alone representing the largest longitudinal study of Māori wellbeing this country has ever seen.”

Sarah-Jane Paine

Inequities and Māori resilience

Children hugging their parent

Māori clearly face health inequities. The proof? Māori life expectancy at birth is more than seven years shorter than for non-Māori.

“What Growing Up in ɫƵ does that no other study can really do is help us understand the pathways or trajectories that lead to these inequities,” says Paine. “Because we’re following the same group of families over time, we can start to pinpoint the ages and life stages when particular inequities begin to appear.”

Inequities begin even before conception, with babies born to wāhine Māori, as well as Pacific women, having  than babies born to women of other ethnicities.

“What Growing Up in ɫƵ does that no other study can really do is help us understand the pathways or trajectories that lead to these inequities.”

Sarah-Jane Paine

GUiNZ evidence was important in legislation passed in 2021 requiring non-organic bread-making wheat flour to be fortified with folic acid to prevent those birth defects. It’s just one example of how participating families have made a difference, says Paine.

The study has uncovered plenty more evidence of inequities. A by Foundation Director Professor Susan Morton found that “Māori and Pasifika children experience the highest burden of socioeconomic disadvantage in their early years as well as an unequal burden of significant co-morbidities in terms of health and development throughout their life course.”

By age eight, the study found, Māori and Pacific children experienced poorer mental health. To connect the dots to where negative mental health outcomes begin, a piece of GUiNZ research is now examining whether different experiences, such as poverty in early life, lead to poor mental wellbeing later in life.

In addition to identifying problems, the study is also focused on identifying possible solutions, particularly those that come from the communities represented in the study.

One study found that. Other work found that for children who identified as Māori, .

Keeping whānau in the study

Growing Up in ɫƵ doesn’t just examine physical and mental wellbeing – it also examines factors such as social relationships, family economic situations and children’s living environments, including neighbourhood and school communities.

Gathering all that information through surveys and face-to-face interviews is a significant commitment for the whānau involved. 

“We understand that life gets busier as children grow older, and that different families experience different stressors, so sometimes when we reach out to our participants to take part in a survey, it might not be a good time in their lives,” says Paine. “Despite how dynamic life is, about 80 percent of families have participated every time, so that’s something to be celebrated.

“The issue is, if 20 percent of families aren’t participating, their experience isn’t being captured in Growing Up in ɫƵ. What we’ve seen is that the groups we are more likely to lose contact with over time are Māori or Pacific, so that negatively impacts the value of the study for Māori and Pacific communities."

Researchers often label some study participants as ‘hard to reach’ or ‘disengaged’. That’s problematic, says Paine.

“It’s our responsibility as researchers to connect with those families, to support them to be part of the study and help them understand why their contributions are important.”

“Young people are leading Aotearoa in national discussions about climate change and the voting age, and I want to bring that energy into Growing Up in ɫƵ. When we share research and recommendations, we need to make sure we’re not just writing academic articles or policy briefs for government officials."

Sarah-Jane Paine

 GUiNZ has put measures in place to ensure Māori and Pacific families feel supported and valued as participants. During the, Māori interviewers engaged with Māori whānau while Pacific interviewers engaged with Pacific families.

“We can already see in our analysis that it made a significant difference,” says Paine. “Despite the terrible context of the Delta and Omicron outbreaks, which were going on at the same time as our 12-year interviews, our preliminary data suggests that having interview teams that understand the realities for Māori and Pacific communities and helpful and appreciated."

Another new measure was that for families committed to speaking te reo Māori at home, questionnaires were provided in te reo and interviews conducted by fluent speakers.

Paine is working to extend the study’s commitment to Māori and Pacific people even further across the organisation.

“We need more Māori and Pacific researchers within our study team and broader network of GUiNZ data users to ensure that the work we do is meaningful for our families and communities and reflects our own priorities,” says Paine. “This will generate better publications, better policy briefs and better recommendations for Māori and Pacific communities.”

Democratising data and outputs

Another goal for Paine is to ensure the data and outputs from the study are easily accessible, not only to people with advanced biostatistical skills, but also to community organisations, parents and even children and youth themselves.

“Young people are leading Aotearoa in national discussions about climate change and the voting age, and I want to bring that energy into Growing Up in ɫƵ,” says Paine. “When we share research and recommendations, we need to make sure we’re not just writing academic articles or policy briefs for government officials. There’s a whole community of tamariki and rangatahi wellbeing activists that could use the data we have to shape the conversations they want to lead."

To make that easier, Project Āmua – āmua means ‘future’ – is looking for ways to ensure that Māori data is made available for Māori communities to engage with. A data visualisation prototype has already been built. 

“To achieve equity for Māori in Aotearoa, Māori need to lead – to bring our research questions, policy priorities, networks and innovative solutions to the decision-making table,” says Paine. “That’s what’s going to make a difference for whānau Māori.”

 

Note: While this article focuses on Māori, Growing Up in ɫƵ represents the major ethnic and cultural communities of Aotearoa and similar principles to those expressed here apply to addressing the inequities experienced by Pacific, migrant and other disadvantaged communities.