Demographic
Indians in New Zealand form the fastest growing ethnic group and are the second largest ethnic population. Indian people, as per latest 2007 Census data in New Zealand, have numbers rising to 105,000 showing a growth rate of 68 per cent between 2001 and 2006. Chinese among Asians remained the biggest group with 148,000 while the Indian population was second. The total population of New Zealand is currently 4,181,060.
For purposes of clarity, New Zealand Indian people are also known as South Asians or Asian Indians. They are mainly from the Indian Subcontinent (or South Asia) and includes seven countries which are members of SAARC (South Asian Association for Regional Cooperation), namely: Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka. (MOH, Asian Public Health Project Report 2003)
The prevalence of type 2 diabetes among New Zealand Indians exceeds that seen in Maori and Pacific Islanders. (Duncan, Schofield, Duncan, Kolt, and Rush 2004). This is reiterated by the Asian Health in Aotearoa Survey in 2003 stating that South Asians have an increased prevalence of diabetes compared with other New Zealanders.
This is an issue of increasing importance to New Zealand as Asian Indians are projected to account for 13% of New Zealand's population by 2021. In spite of their population growth, Asian ethnic groups have been largely neglected by New Zealand health and research policies. For example, only Maori and PI children were over-sampled in the 2002 National Children's Nutrition Survey. In addition, Maori and PI children were analysed separately, whereas children of Asian decent were grouped with New Zealand Europeans. This is a common theme in national surveys by government organisations; such as the Ministry of Health, and Sport and Recreation New Zealand.
In order to understand the public health needs of Asian populations in New Zealand, and to tailor preventative health strategies, it is vital that future surveys distinguish between these ethnic groups. (Duncan, Schofield, Duncan, Kolt, and Rush 2004)
For purposes of clarity, New Zealand Indian people are also known as South Asians or Asian Indians. They are mainly from the Indian Subcontinent (or South Asia) and includes seven countries which are members of SAARC (South Asian Association for Regional Cooperation), namely: Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka. (MOH, Asian Public Health Project Report 2003)
The prevalence of type 2 diabetes among New Zealand Indians exceeds that seen in Maori and Pacific Islanders. (Duncan, Schofield, Duncan, Kolt, and Rush 2004). This is reiterated by the Asian Health in Aotearoa Survey in 2003 stating that South Asians have an increased prevalence of diabetes compared with other New Zealanders.
This is an issue of increasing importance to New Zealand as Asian Indians are projected to account for 13% of New Zealand's population by 2021. In spite of their population growth, Asian ethnic groups have been largely neglected by New Zealand health and research policies. For example, only Maori and PI children were over-sampled in the 2002 National Children's Nutrition Survey. In addition, Maori and PI children were analysed separately, whereas children of Asian decent were grouped with New Zealand Europeans. This is a common theme in national surveys by government organisations; such as the Ministry of Health, and Sport and Recreation New Zealand.
In order to understand the public health needs of Asian populations in New Zealand, and to tailor preventative health strategies, it is vital that future surveys distinguish between these ethnic groups. (Duncan, Schofield, Duncan, Kolt, and Rush 2004)
Background
The high prevalence of diabetes among Indians is in line with the elevated levels of Body Fat (BF) at a given body size seen among Asian populations overseas. In New Zealand, knowledge of the ethnic variation in Body Fat (BF) and other body composition variables is restricted to New Zealand European, Maori, and PI ethnic groups. New Zealand Asians are of particular interest because of their rapid population growth, and the lack of published data on their Body Mass Index (BMI) to % BF relationships. Furthermore, compared with Europeans, Asians from other countries show elevated levels of BF and greater morbidity and mortality at a given BMI. (Duncan, Schofield, Kolt and Rush 2004)
High rates of prevalence and mortality from coronary artery disease (CAD) in Asian Indian immigrants have been consistently documented worldwide. As a result, the Asian Indian immigrant population has been identified as an ''at risk'' special population in Healthy People 2010. At high risk of coronary heart disease and type 2 diabetes despite low body mass index (BMI) and absence of traditional risk factors in Asian Indians such as elevated low-density lipoprotein cholesterol (LDL-C) and total cholesterol appear to have its basis in impaired glucose tolerance and insulin resistance associated with pronounced central or abdominal obesity, features now identified as part of metabolic syndrome. As a fast-growing Asian immigrant group, the importance of effective prevention strategies to reduce risk of chronic disease in this population cannot be underestimated. (Kirah, Endemann, Ayer, 2005)
Diabetes complications are chronic, debilitating and their management is costly. Moreover, the general Indian population is not commonly aware that diabetes can lead to major complications like blindness, kidney failure, cardiovascular diseases and neurological impairment. Determining priorities and ensuring the best use of available resources represent a challenge to governments, those advising them and those responsible for service delivery at the local level. However, reducing diabetes and cardiovascular disease in our population and reducing health inequalities between ethnic groups and regions are priorities in the New Zealand Health Strategy (MOH 2000).
High rates of prevalence and mortality from coronary artery disease (CAD) in Asian Indian immigrants have been consistently documented worldwide. As a result, the Asian Indian immigrant population has been identified as an ''at risk'' special population in Healthy People 2010. At high risk of coronary heart disease and type 2 diabetes despite low body mass index (BMI) and absence of traditional risk factors in Asian Indians such as elevated low-density lipoprotein cholesterol (LDL-C) and total cholesterol appear to have its basis in impaired glucose tolerance and insulin resistance associated with pronounced central or abdominal obesity, features now identified as part of metabolic syndrome. As a fast-growing Asian immigrant group, the importance of effective prevention strategies to reduce risk of chronic disease in this population cannot be underestimated. (Kirah, Endemann, Ayer, 2005)
Diabetes complications are chronic, debilitating and their management is costly. Moreover, the general Indian population is not commonly aware that diabetes can lead to major complications like blindness, kidney failure, cardiovascular diseases and neurological impairment. Determining priorities and ensuring the best use of available resources represent a challenge to governments, those advising them and those responsible for service delivery at the local level. However, reducing diabetes and cardiovascular disease in our population and reducing health inequalities between ethnic groups and regions are priorities in the New Zealand Health Strategy (MOH 2000).
Social Influences
Social influences like religion, philosophy, cultural taboos, presence of others, taste and palatability, anxiety, stress, psychological disturbances, environmental factors such as climate and metabolic factors (hormone levels, caloric requirements), aromas, meal time, memories, and certain food advertisements are the external factors that influence our eating habits and patterns. With a significantly high percentage of insulin-resistant population characterised by central obesity (increased abdominal fat) in Indians, the serious stumbling block is the high glycemic load in Indian diets offering multiple sources of carbohydrate rich foods including potatoes, pulses and sugars, worsened by increased alcohol consumption. (Indian Express 2009)
Variables
According to Asian Health in Aotearoa: An analysis of the 2002/03 New Zealand Health Survey the following was found:
Socio-demographic variables:
1. Age
South Asians are older (on average) than Chinese, South-East Asians and Koreans
2. Housing
Nearly all Asian people (99%) live in urban areas.
Asian people (31%) are more likely to live in most deprived (lowest NZDep2001 quintile) areas than Europeans (13%), although less likely than Maori (43%) and Pacific (66%).
South Asians (38%) were more likely to live in the lowest NZDep01 quintile areas than other Asian people.
3. Education, Occupation & Income
Asian people (47%) are less likely to have a paid job than all New Zealanders (65%).
Asian people (25%) are less likely to receive government income support than all New Zealanders (38%).
Asian people (20%) are more likely to live in a low income household.(less than $15,000 annually) than other New Zealanders. (15%)
Lifestyle:
1. Physical activity
Asian people are less likely to be physically active than other New Zealanders. South Asian women are less likely to be physically active than other Asian women.
2. Alcohol
South-East Asian men are more likely to binge drink than other Asian men.
3. Tobacco
South-East Asians were more likely to allow smoking inside their homes than other Asian people.
4. Cannabis
South-East Asian men were more likely to use cannabis than other Asian men.
5. Obesity
South-Asians are more likely to be overweight and obese than other Asian people.
6. Lifestyle & Years in New Zealand
Increasing time living in New Zealand was associated with increased consumption of alcohol and cannabis among Asian people.
Chronic Disease:
1. Cardiovascular Disease & Diabetes
The prevalence of diabetes was higher among Asians than Europeans (8% vs. 3%).
South Asians have a higher prevalence of treated high cholesterol (12%) and diabetes (14%) compared with other Asian people.
2. Other Chronic diseases
South Asians have a higher prevalence of asthma (16%) than other Asian people.
Socio-demographic variables:
1. Age
South Asians are older (on average) than Chinese, South-East Asians and Koreans
2. Housing
Nearly all Asian people (99%) live in urban areas.
Asian people (31%) are more likely to live in most deprived (lowest NZDep2001 quintile) areas than Europeans (13%), although less likely than Maori (43%) and Pacific (66%).
South Asians (38%) were more likely to live in the lowest NZDep01 quintile areas than other Asian people.
3. Education, Occupation & Income
Asian people (47%) are less likely to have a paid job than all New Zealanders (65%).
Asian people (25%) are less likely to receive government income support than all New Zealanders (38%).
Asian people (20%) are more likely to live in a low income household.(less than $15,000 annually) than other New Zealanders. (15%)
Lifestyle:
1. Physical activity
Asian people are less likely to be physically active than other New Zealanders. South Asian women are less likely to be physically active than other Asian women.
2. Alcohol
South-East Asian men are more likely to binge drink than other Asian men.
3. Tobacco
South-East Asians were more likely to allow smoking inside their homes than other Asian people.
4. Cannabis
South-East Asian men were more likely to use cannabis than other Asian men.
5. Obesity
South-Asians are more likely to be overweight and obese than other Asian people.
6. Lifestyle & Years in New Zealand
Increasing time living in New Zealand was associated with increased consumption of alcohol and cannabis among Asian people.
Chronic Disease:
1. Cardiovascular Disease & Diabetes
The prevalence of diabetes was higher among Asians than Europeans (8% vs. 3%).
South Asians have a higher prevalence of treated high cholesterol (12%) and diabetes (14%) compared with other Asian people.
2. Other Chronic diseases
South Asians have a higher prevalence of asthma (16%) than other Asian people.