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Clark, T. C., Le Grice, J., Moselen, E., Fleming, T., Crengle, S., Tiatia-Seath, Lewcyka, S. (2018). Health and wellbeing of Māori secondary school students in New Zealand: Trends between 2001, 2007 and 2012. Australian and New Zealand Journal of Public Health, , 9 pp.
Abstract: Objective: To describe the health status over time of Māori secondary school students in New Zealand compared to European students.
Methods: Anonymous representative health surveys of New Zealand secondary school students were conducted in 2001, 2007 and 2012 (total n=27,306 including 5,747 Māori).
Results: Compared to 2001, Māori students in 2012 experienced improved health, family and school connections. However, considerable inequity persists with Māori students reporting poorer health, greater exposure to violence and socioeconomic adversity compared to European students. When controlling for socioeconomic deprivation, inequity was substantially reduced, although worse Māori health outcomes remained for general health, mental health, contraceptive use, healthy weight, substance use, access to healthcare and exposure to violence. There was some evidence of convergence between Māori and European students on some indicators.
Conclusions: There have been significant improvements for Māori youth in areas of health where there has been investment. Priority areas identified require adequate resourcing alongside addressing systematic discrimination and poverty.
Implications for public health: Socioeconomic contexts, discrimination, healthcare access and identified priority health areas must be addressed to improve equity for Māori youth. Building on these gains and hastening action on indicators that have not improved, or have worsened, is required.
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Clark, T. C., Lucassen, M., Bullen, P., Denny, S., Fleming, T.M., Robinson, E.M., Rossen, F.V. (2013). The Health and Well-Being of Transgender High School Students: Results From the New Zealand Adolescent Health Survey (Youth’12). Journal of Adolescent Health, , 7 pp.
Abstract: Purpose: To report the prevalence of students according to four gender groups (i.e., those who reported being non-transgender, transgender, or not sure about their gender, and those who did not understand the transgender question), and to describe their health and well-being.
Methods: Logistic regressions were used to examine the associations between gender groups and selected outcomes in a nationally representative high school health and well-being survey, undertaken in 2012.
Results: Of the students (n ¼ 8,166), 94.7% reported being non-transgender, 1.2% reported being transgender, 2.5% reported being not sure about their gender, and 1.7% did not understand the question. Students who reported being transgender or not sure about their gender or did not understand the question had compromised health and well-being relative to their nontransgender peers; in particular, for transgender students perceiving that a parent cared about them (odds ratio [OR], .3; 95% confidence interval [CI], .2e.4), depressive symptoms (OR, 5.7; 95% CI, 3.6e9.2), suicide attempts (OR, 5.0; 95% CI, 2.9e8.8), and school bullying (OR, 4.5; 95% CI, 2.4e8.2).
Conclusions: This is the first nationally representative survey to report the health and well-being of students who report being transgender. We found that transgender students and those reporting not being sure are a numerically small but important group. Transgender students are diverse and are represented across demographic variables, including their sexual attractions. Transgender youth face considerable health and well-being disparities. It is important to address the challenging environments these students face and to increase access to responsive services for transgender youth.
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Clark, T. C., Johnson, E.A., Kekus, M., Newman, J., Patel, P.S., Fleming, T., Robinson, E. (2014). Facilitating Access to Effective and Appropriate Care for Youth With Mild to Moderate Mental Health Concerns in New Zealand. Journal of Child and Adolescent Psychiatric Nursing, , 190–200 pp.
Abstract: PROBLEM: Youth with mild–moderate mental health concerns often go unrecognized,and find access to and the navigation of support services difficult.
METHODS: A quasi-experimental pre-/postintervention design was used to exploretheimpactof facilitatedaccesstofreecounselingsupportusingthefollowing outcome measures: Strengths and Difficulties Questionnaire (SDQ), Substance Abuse Choices Scale (SACS), Children’s Global Assessment Scale (C-GAS), alongside consumer feedback questionnaires.
FINDINGS: A total of 581 culturally diverse youth aged 10–24 completed the intervention. Those who completed reported significant improvements in global social andpsychiatricfunctioningmeasuredbyC-GAS(p.001);reducedriskof clinically significant mental health concerns measured by SDQ (p .001); and reductions in the use and impact of drugs/alcohol measured by SACS (p .001). Participants and their families/wha¯nau reported that the interventions were safe and appropriate, with perceived increased skill development around coping and communication.
CONCLUSIONS: This intervention appears to be an effective and acceptable strategy, particularly for Ma¯ori youth and those from lower socioeconomic groups, to reduce mild to moderate mental health symptoms and concerns. This approach could be replicated by other communities wishing to reduce mental health burden for youth by facilitating access to free,culturally appropriate,and accessible counseling via a multidisciplinary and collaborative triage approach.
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Clark, T. C., Fleming, T., Bullen, P., Crengle, S., Denny, S., Dyson, B., Fortune, S., Peiris-John, R., Robinson, E., Rossen, F., Sheridan, J., Teevale, T., Utter, J., & The Adolescent Health Research Group(2013). (2013). Youth’12 Prevalence Tables: The health and wellbeing of New Zealand secondary school students in 2012.174 pp.
Abstract: This report has been produced by the Adolescent Health Research Group (AHRG), which carries out the Youth 2000 Survey Series. This report describes the methods used and reports key findings of Youth’12: The national health and wellbeing survey of New Zealand secondary school students (Youth’12 survey). The report details the numbers and percentages of young people experiencing a wide range of risk and protective factors and engaged in a wide range of health behaviours. Comparative data from the Youth 2000 Survey Series in 2001 and 2007 are presented. This report is accompanied by a “Youth’12 Overview” report, which provides a briefer, less technical, summary document. These reports will be followed by publications detailing health status and changes for different groups in New Zealand and exploring important issues in more depth. All publications will be listed on our website: www.youthresearch.auckland.ac.nz.
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Clark, T., Robinson, E., Crengle, S., Fleming, T., Ameratunga, S., Denny, SJ., Bearinger, LH., Sieving, RE., Saewyc, E. (2011). Risk and Protective Factors for Suicide Attempt Among Indigenous MÄori Youth in New Zealand: The Role of Family Connection. Journal of Aboriginal Health, 7(1), 16–31.
Abstract: The purpose of this study was to (1) describe risk and protective factors associated with a suicide attempt for Māori youth and (2) explore whether family connection moderates the relationship between depressive symptoms and suicide attempts for Māori youth. Secondary analysis was conducted with 1702 Māori young people aged 12–18 years from an anonymous representative national school-based survey of New Zealand (NZ) youth in 2001. A logistic regression and a multivariable model were developed to identify risk and protective factors associated with suicide attempt. An interaction term was used to identify whether family connection acts as a moderator between depressive symptoms and a suicide attempt. Risk factors from the logistic regression for a suicide attempt in the past year were depressive symptoms (OR = 4.3, p < 0.0001), having a close friend or family member commit suicide (OR = 4.2, p < 0.0001), being 12–15 years old (reference group: 16–18 years) (OR = 2.7, p < 0.0001), having anxiety symptoms (OR = 2.3, p = 0.0073), witnessing an adult hit another adult or a child in the home (OR = 1.8, p = 0.001), and being uncomfortable in NZ European social surroundings (OR = 1.7, p = 0.0040). Family connection was associated with fewer suicide attempts (OR = 0.9, p = 0.0002), but this factor did not moderate the relationship between depressive symptoms and suicide attempt (χ2 = 2.84, df = 1, p = 0.09). Family connection acts as a compensatory mechanism to reduce the risk of suicide attempts for Māori students with depressive symptoms, not as a moderating variable.
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