Emerging needs,evolving services: The health of Pacific peoples in New Zealand

Abstract

From 0.1% of the total population in 1945 to 6.9% in 2006, Pacific peoples now resident in New Zealand highlight significant health policy and service delivery issues within an increasingly diverse society. Over the last decade, marked differences in the health status of Pacific New Zealanders and Palagi New Zealanders have been well documented, showing high levels of disparity and continuing negative trends. This paper provides a broad overview of the history of Pacific health and health initiatives in New Zealand from the 1940s through to the mid 2000s, highlighting the interface between Pacific peoples and the New Zealand health sector. While the New Zealand Government has become increasingly responsive to Pacific health needs, significant disparities remain between Pacific and Palagi populations. Furthermore, many of the encouraging health initiatives introduced in the past decade remain at risk due to a variety of factors, including a need to strengthen the Pacific health workforce and management expertise.     

Cultural case workers in child disability services: an evidence-based model of cultural responsiveness for refugee families

The medical/disabled category for quota refugees selected for resettlement in New Zealand allows entry to those who have either a medical condition that can be treated or helped in New Zealand or a disability that requires support. Children from refugee and other culturally and linguistically diverse backgrounds with impairments comprise an increasing proportion of the caseloads of Auckland region child health and disability services. For people from refugee backgrounds, the New Zealand disability system can be complex, difficult to understand and hard to navigate. Disability therapeutic, rehabilitative and support services are often non-existent in countries of origin. The interventions offered in western countries such as physiotherapy, occupational therapy and speech language therapy may be unknown and therefore poorly understood by refugee clients and families. This article presents the findings of an evaluation of the establishment of cultural caseworker positions in the Waitemata District Health Board Child Development Service.     

The only child 1 : A study of one hundred only children living at home with both parents,referred, to a child guidance clinic

This study examined differences in attachment typology, early histories of unresolved trauma and loss, and intergenerational patterns of substance abuse in a high-risk sample of African American, White, Mexican American, and Native American mothers involved with the child welfare system. The Adult Attachment Interview and Chemical Dependency Assessment Profile were used to collect data from 24 mothers who were in-patients at a substance abuse treatment center. Consistent with attachment theory mothers classified as secure/autonomous (46%) had positive early attachment relationships, although several mothers in this group had histories of unresolved trauma and loss. The insecure classification included 21% dismissing and 33% preoccupied. The unresolved classification included mothers from all racial/ethnic groups who had histories of trauma and loss. Results indicated prevalence of substance abuse in all racial/ethnic groups as well as patterns of intergenerational substance abuse in the aforementioned attachment classifications.     

Living in poverty: a qualitative inquiry of emaciated adolescents and young women coming from low-income families in a Chinese context

Anorexia nervosa (AN) is no longer a disease of the rich in the West. Hitherto, no study has been carried out in the West or in the Chinese context that documents the experiences of poor people suffering from AN. This qualitative study aims to identify the subjective experiences of seven Chinese emaciated adolescents and young women coming from low‐income families, their family difficulties and needs, and resilience in coping. The results of the study have shown that family poverty has significantly triggered the onset of AN for two emaciated adolescents, while factors such as parents’ marital discord and relentless pursuit of thinness have also been reported. Family difficulties experienced included problems in parenting, inadequate financial resources, and insufficient information and access to health and social services. Strong family motivation and filial piety are found to be important cultural assets conducive to recovery. Implications of this study for social work practice are discussed.     

The reality of net capital gains and annual profit on NZ primary producing businesses: data from a recent survey of all farm types

ABSTRACT

Annual net cash returns and net capital gains provide farmers with their actual and potential monetary rewards, respectively. This article reports on a national farm survey showing both actual and potential returns, on average, are not as high as might be imagined. This is supported by the findings of earlier studies and has implications for rural societies and their associated economies. Data on income, expenses and profit is presented as is data on farm value changes over the life of each farm. The information is adjusted for inflation to provide ‘real’ data. The profit and net capital gain figures are divided into groupings based on a range of criteria such as total farm capital, and labour compliment as a reflection of farm size. Statistically significant differences occur for some groupings such as farm type and farm size.     

Parental substance misuse and child care social work: findings from the first stage of a study of 100 families

Parental misuse of drugs or alcohol is known to be a common issue for child care social workers, yet there has been surprisingly little British research on the topic. The study reported here attempts to address this gap. All files going for long‐term allocation in four London boroughs over on average 1 year were examined (290 files). Parental substance misuse (PSM) emerged as a major feature of social work caseloads. Of the 290 cases, 100 (34%) involved concerns about parental substance misuse. The families involving substance misuse were more vulnerable on a variety of measures: the children were younger, the parents had more individual problems and the families lived in more difficult social situations. PSM cases tended to be ‘heavy end’ at the point of allocation: they accounted for 62% of all children subject to care proceedings and 40% of those placed on the child protection register. There was a fairly even spread between alcohol and drug misuse, and a number of cases involved both. Substance misuse specialists were rarely involved in working with families, primarily because parents said that they did not think that they had a problem. Suggestions for ways in which policy and practice with PSM might be improved are made in light of these findings.     

Factors associated with the preventive healthcare service use among older adults in Korea: Focusing on age variation

The importance of preventive health examinations for older adults has been well emphasized due to an increase in chronic diseases associated with age. In this study, we estimated the preventive health examination participation rate and its associated factors among the elderly with specific focuses on the moderating effects between age and socioeconomic status. We used data drawn from the first to sixth waves (4164 people) of the Korean Longitudinal Study of Aging for the elderly aged 65 and over. A generalized linear model was used to address research questions. The results showed that the participation rate decreased as older adults age. The interaction between age and education was also significant, indicating that older adults with higher education were more likely to use a preventive health examination compared to those with lower education. There were no significant interaction effects between income and age. Based on the findings, implications for theory and practice were discussed with specific focuses on age‐specific approaches in preventive healthcare services for older adults.     

Dealing in Toxins on the Wrong Side of the Tracks: Lessons from a Hazardous Waste Controversy in Phoenix*

Objective. The controversial expansion of a hazardous waste facility in a poor, minority neighborhood in Phoenix illustrates the unanticipated consequences of siting hazardous facilities in vulnerable communities, and the need to recognize neighborhood health/safety issues such as drug‐related crime as environmental justice struggles. Methods. Qualitative methods include participant observation, document analysis, Census data, GIS mapping, and interviews. Results. South Central Phoenix's history reveals a disproportionate share of poverty, pollution, and drug crimes. Most commercial hazardous waste facilities in Phoenix were sited in minority areas. Residents contended that the siting, permitting process, and expansion of the facility and the drug crimes that later occurred there were all due to environmental racism. Conclusions. The expansion of the facility exacerbated environmental injustice in Phoenix through distributional and participative injustice, and was criminogenic. The dual impact on the community of hazardous waste and drug crime argues for a more holistic understanding of environmental justice.     

Factors associated with loneliness among the institutionalised elders in Shanghai,China: the role of social support

Studies have shown that loneliness is increasingly prevalent among the aged, especially those who live in institutions. This study examines the role of social support and differences in loneliness among institutionalised elders, using a face-to-face questionnaire interview in a Shanghai institution. Results show that the prevalence of loneliness among participants was relatively high. Gender, subjective appraisals of relationship with nurses, frequency of being visited by children, frequency of being visited by friends, and subjective appraisals of relationship with roommates were significant predictors of loneliness. The quality of social support was indicated as a significant factor for predicting loneliness rather than its quantity. It is striking that frequency of being visited by children was found to be positively associated with loneliness. This counterintuitive finding suggests that the function of family for those institutionalized elders may be negative under China’s cultural norms, beliefs, and perceptions, which is incongruent with theoretical assumptions in Western countries.     

从荒岛贼穴到聚落街庄——以涠洲岛为例看明清时期华南海岛之开发

明清时期华南海岛开发中权力和利益的纠葛错综复杂,显示了国家政权扩张与地方社会之间长期调适过程的实态。涠洲岛所在北部湾海域自古盛产珍珠,民间以采珠和渔捞为业。明代先后在涠洲岛和沿海地区添设采珠内监衙门、游击将军和守海水寨,竭力垄断珠池,打击民众非法私采。涠洲岛及其周边海域成为明政府与珠盗周旋角力的舞台。清代以后,涠洲岛上偷渡私垦活动屡禁不止;同时多股洋盗在粤西和安南之间出没,冲击海防秩序,使官府的海岛经营策略长期处于封禁和开放的两难境地。至清末法国传教士协助大批广东客民移居岛上,迫使清政府放弃封禁政策,涠洲岛稍具规模的聚落街庄得以逐渐形成,国家行政构架构最终在岛上稳固起来。基于这个漫长的历史过程,促成了涠洲岛生本土信仰与外来宗教、渔民村庄与客家聚落混融共处的独特的历史遗存和社会文化结构。     

The rhetoric versus the reality: a critical perspective on practice with fathers in child care and protection work

Within social work training and practice there is a firm emphasis on anti-discriminatory practice. At the same time, however, fathers are often marginalized or ignored in child protection practice. In suggesting a framework for practice we argue that it is essential to address the anomaly between the rhetoric and the reality of such practice if we are to provide a coherent child protection service. This paper addresses the limitations of current models of practice and traces the theoretical strands that influence them. It is essential that social work practitioners understand the role terms they use and the aim of engaging fathers. By beginning to unravel the differences between role and gender and unpicking the diverse (but overlapping) dimensions of fatherhood, it is contended that there is no definitive, dominant discourse regarding fatherhood in the same way as there is about motherhood. However, in conceptually recognizing these roles it is suggested that intervention can be planned in a way that explicates the specific aim of engaging men.     

Research Review: The role of grandparents in intergenerational support for families with disabled children: a review of the literature

The family in late modernity faces demographic change. However, it is still apparent that intergenerational relationships and exchanges of resources are valued. There is a growing literature on the important role that grandparents play in their children’s families. In contrast, there is limited research exploring the support grandparents provide to families with disabled children. This is an important gap in our knowledge, as families with disabled children frequently face additional caring responsibilities and emotional demands. From the studies that do exist, it is clear that grandparents’ support to families with disabled children is generally valued. However, the literature remains partial: past studies are small‐scale, focused upon parents’ perceptions of support (especially mother’s), and frequently based upon North American data. Recognizing these limitations and the fact that grandparents themselves have support needs which require consideration, this paper identifies key areas where important issues remain unanswered and further research is required. It argues that research is needed to begin untangling the different support needs of parents, grandparents and other family members, and the different effects of grandparent support that different family members’ experience. Exploration of grandparents’ own support needs also indicates the need for wider policy and service consideration.     

Social functioning and mental health among children who have been living in kinship and non‐kinship foster care: results from an 8‐year follow‐up with a Norwegian sample

Studies have shown relatively high rates of emotional and behavioural problems among children living in out‐of‐home care. This study reports the prevalence of social problems at an 8‐year follow‐up for a group of children/young adults. Predictors for prevalence and change in emotional and behavioural problems at the follow‐up are examined. A prospective cohort design with 233 children who had been living in foster care was used. Forty‐eight per cent (n = 111) of those interviewed at baseline were located and interviewed at follow‐up. Mean age was 17.4 (standard deviation = 2.9) years. Mental health symptomatology was measured with Child Behaviour Checklist and Adult Self‐Report. Linear and generalized mixed model analyses were used. Changes in internalizing and externalizing problems from baseline to follow‐up was associated with gender. Boys showed more problems at a young age, whereas girls developed more problems later. Predictors for social problems at follow‐up were mental health at baseline, kinship care and care placement away from the local community.     

The nature and culture of social work with children and families in long‐term casework: Findings from a qualitative longitudinal study

Social work in the United Kingdom is preoccupied with what social workers cannot do due to having limited time to spend with service users. Yet remarkably little research has examined what social workers actually do, especially in long‐term relationships. This paper draws from an ethnographic study of two social work departments in England that spent 15 months observing practice and organizational life. Our findings show that social work some of the time has a significant amount of involvement with some service users and the dominant view that relationship‐based practice is rarely achieved is in need of some revision. However, families at one research site received a much more substantial, reliable overall service due to the additional input of family support workers and having a stable workforce who had their own desks and were co‐located with managers in small team offices. This generated a much more supportive, reflective culture for social workers and service users than at the second site, a large open plan “hot‐desking” office. Drawing on relational, systemic, and complexity theories, the paper shows how the nature of what social workers do and culture of practice are shaped by the interaction between available services, office designs, and practitioners', managers', and service users' experiences of relating together.     

The Common Assessment Framework: the impact of the lead professional on families and professionals as part of a continuum of care in England

This paper utilizes data gathered as part of an exploratory study to assess the costs and impact of the Common Assessment Framework (CAF), to examine the impact that the lead professional role had on families and workers. The study found that both families and workers believed the lead professional to be central to the CAF process, providing a range of support, coordinating multi‐agency responses to need and acting as a single point of contact between families and workers. The paper highlights the need for consideration to be given to inter‐agency working, data sharing, training for workers and the capacity implications for those taking on the role. The extent to which the lead professional might be more integrated into the continuum of support for vulnerable children and families is also examined. The paper highlights the need to consider the lead professional's role in not only preventing the need for more intensive services, such as those provided by statutory social work, but also maintaining outcomes achieved once a child protection plan is closed, or a child is reunified with his or her birth family after a period of being in care. The implications of the findings for policy and practice are discussed.     

On hope,loss, anger,and the spaces in between: Reflections on living with/in adoption and the role of the social worker

This article explores the findings of a study on the role of the social worker in adoption with a focus on ethics, concentrating on the perspectives of adopted people, birth parents, and adoptive parents. Their reflections challenge policy attempts that are framed around “new beginnings” for children. The focus on hope in such policy projects fails to understand that hope inevitably coexists with anger and loss. The concept of ethical trespass, with its recognition of the inevitability of harm, is explored in terms of its possibilities for recognizing the lived realities for multiple stakeholders. The mitigation of ethical trespass requires social work practices that are characterized by humility, honesty, and reflexivity.     

Non‐take up of the supplemental child benefit for children with a disability in Belgium: A mixed‐method approach

Families with disabled children run a great risk of being poor. Although policies providing poor families with financial benefits should be effective in reducing poverty, the actual effectiveness is often jeopardized by the issue of non‐take up (NTU). Yet, NTU of benefits aimed at disabled children is for the most part uncharted territory. In this article, we fill this gap using a mixed‐methods approach to (a) estimate the magnitude and characteristics of NTU in the Belgian “supplemental child benefit” by drawing on a large‐scale administrative dataset on childhood disabilities and (b) explore the determinants of NTU by means of semistructured interviews with experts and parents. We estimate an NTU rate of at least 10%, a substantial figure given that the benefit is not income tested. This mainly concerns children with “less visible disabilities” (autism spectrum disorder and other intellectual and psychological disorders) and results from insufficient information provision about the benefit's existence and eligibility criteria; process costs, for instance, the complexity of the procedure; and the way the scale to assess a child's disability is constructed.     

Seeking Safety and Humanity in the Harshest Immigration Climate in a Generation: A Review of the Literature on the Effects of Separation and Detention on Migrant and Asylum-Seeking Children and Families in the United States during the Trump Administration

In recent years, families with children from the Northern Triangle countries of Central America constitute a large and growing proportion of migrants and overall filed asylum claims. In an effort to deter overall immigration through the U.S.–Mexico border, the executive branch under the Trump administration has made substantial changes to federal immigration and asylum policy in recent years. Given the sensitive nature of early development and the hardship and trauma that many migrant children have experienced, immigration policies that do not prioritize child wellbeing, and in fact, neglect or harm it, can have lifelong negative consequences on physical and psychological wellbeing. In light of the scope of children and families affected by these policies and potential magnitude of their effects, the present review aimed to: 1) outline federal immigration policies under the Trump administration that primarily impacted migrant children and families; 2) review the research base regarding the effects of these policies on physical safety and health, development, mental health, family wellbeing, and education; and 3) provide policy recommendations to prevent further harm, mitigate the great harm already done, and prioritize child wellness moving forward. Findings from the review indicate that even short experiences of detention, particularly when children are separated from parents and caregivers, are associated with serious, lasting negative effects across every domain of functioning. The practices of separation, detention, and removal to temporary encampments compound traumatic experiences that migrant families are often fleeing, which in turn may set up already vulnerable children for a trajectory of continued marginalization. Future directions for research and implications for policy and practice are discussed.     

The effects of child maltreatment on childhood behaviour problems in South Korea: findings from the fifth Korea Child and Youth Panel Survey (the 2014 KCYPS)

The study examines the effects of child maltreatment on children behavioural problems in South Korea. We found that 11.5% of children experienced physical abuse, 28.7% experienced emotional abuse and about 35% experienced neglect. After controlling for all socio-demographic factors, children who experienced physical abuse, emotional abuse and neglect were more likely to develop internalised as well as externalised behavioural problems such as depression, aggression, underage smoking, underage drinking and engaging in cyber delinquency. The results point towards a need to develop social welfare interventions to mitigate physical/emotional abuse and neglect so as to prevent behavioural problems in South Korean children.