Thursday, 17 January 2019 Uptake of hearing-health services among older people of Pacific Island ethnicity in New Zealand Ravi Reddy Section of Audiology

Older Pasifika Peoples 19% of the population (880,350) had hearing loss in 2016 57% of people aged over 65, compared to 8% aged 15 to 44 Affects communication, social interaction & cognitive decline Delay of approximately ten years in seeking assistance Pasifika: low rate of uptake, high rate of not attending appointments Pasifika population projected to triple in the next 20 years

Ecological Model Policy Organisation Community Interpersonal Individual

“Hearing is important for Church, community meetings & family”. Individual level Value of hearing Knowledge about hearing loss Attitudes Beliefs Awareness of services Acceptance/Denial “Hearing is important for Church, community meetings & family”. “I am not seeking help for my hearing because I am seeking ‘Le Atua’ – God”.

Interpersonal level “In our ‘aiga’ (families), it is important to look after our elders” “There is a big change in the ‘va’ (relationship), between parents and their children”. Family support

Community level Stigma Taboo Language Cultural consideration “…Our people are embarrassed & shy to get their hearing tested”.

Organisational level “I was reluctant to seek further help for my hearing loss because I have heard it is really expensive”. Cost Location Role of GP’s

Policy level Model of service Subsidies Accessibility “I think that they do not seek the help because they don’t have transport, or a translator... you know like a help person” “I believe that doctors should be able to visit people in need, in their homes as well” “Awareness of services needs to be increased, especially through local radio stations”

Conclusion Multiple level factors - interrelated Community appropriate awareness Reorientation of hearing health services “…some people it’s just that they ‘mo’umo’u nofoa’ [waiting around for too long and end up not doing anything”.

Thank you