The new report highlights a number of urgent health concerns among Asian communities, including inadequate nutrition, low physical activity, poor access to primary care, and racism.

A bumper report on Asian health in Aotearoa, presented to parliament by community health service The Asian Network Inc (TANI) this week, has advocates calling for a targeted strategy to address health needs of Asian communities. The report, authored by Zhenqiang Wu, Sally F Wong and Robert Scragg of Waipapa Taumata Rau, University of Auckland, analysed two decades of data from the New Zealand Health Survey on the health of South Asian, Chinese and “other Asian” communities. 

The key findings

• Obesity has doubled among Asian New Zealanders, from 26% to 53%, in less than a decade.
• Along with Māori and Pasifika, in all three Asian groups, children and adults were significantly less likely to eat the recommended five-plus servings of daily fruit and vegetables than NZ Europeans.
• Weekly fast food consumption among all three Asian groups has increased from around half in 2006 to over 90% in 2021.
• Chinese adults (41.2%) were the most likely of all ethnic groups to have ever been a victim of an ethnically motivated verbal attack, followed by Māori (29.6%), South Asian (23.8%) and other Asian (23.2%), compared to European and other (13.9%).
• Asian adults are less likely to have a usual health practitioner to visit when unwell.
• And in some better news, Asian adults have the lowest levels of smoking tobacco, and consumption of alcohol and cannabis. 

Surprised that Asians aren’t as healthy as you think? Those preconceptions might come down to the lack of disaggregated data on Asian health, as well as something known as the “healthy immigrant effect”.

The report tackles the monolith of “Asian health” by digging right into subgroup data. Why’s that important? Because true health disparities among Asian subgroups may be masked when data for “Asian” people (which covers more than 40 ethnicities) is collected as a combined group. Currently, Asian people make up 17% of New Zealand’s population, and that’s predicted to grow to over a quarter by 2043. If the status quo is maintained, gaps in healthcare are likely to widen.

When we collect disaggregated data we understand sub-group differences, for example, how South Asian students experience higher rates of poverty, while East Asian students have higher mental health needs.

What’s the healthy immigrant effect?

If you’re able to immigrate to a new country, chances are you’re younger, healthier and more educated or skilled than those who stay at home. New migrants then present as having a health advantage over the domestic-born population in the host country.  

As the WHO’s Dr Kumanan Rasanathan wrote in a foreword to the report, “Asian peoples in New Zealand have now predominantly been resident more than 10 years or born in the country, resulting in waning of the healthy immigrant effect (most responsible for the comparatively positive health indicators for Asian peoples) with acculturation often leading to increasing levels of health risk factors.” 

As health policies specific to Asian people remain unchanged while migrant health worsens, blind spots develop in the health system. 

The need for an Asian health strategy

At 167 pages, the report is a bid for Asian health to take a higher priority in Aotearoa. Health research and advocacy groups have time and time again called for health system reform that accounts for specific needs within Asian and ethnic communities and investment into its research. For example,  

• In this statement on health system reform for Asian and ethnic communities from the 2022 Health Forum on International Collaboration with Asian Countries. 
• In this letter written by The Centre for Asian and Ethnic Health to Pae Ora expressing concern around the frequent lumping of Asian and ethnic minority health data, lack of mention of ethnic health strategies despite clear evidence of needs, and lack of Asian and ethnic minority leadership. 
• In these recommendations from the Asian caucus of the Public Health Association.  

Yet there remains no strategy for Asian communities in the New Zealand Health Strategy 2023. “We rightly have strategies for Māori, Pacific, disabled people, rural and women’s health,” said Vishal Rishi, director of TANI. “But what is missing is a strategy for Asian health in Aotearoa.”  

Rishi said he hoped the report would be met with a “high-level strategy, backed with appropriate investment”. Without that and appropriate resources to empower primary care and community care, “our health system will continue to struggle to meet the needs of our communities,” he said.

The NZ Health Survey results are looked at “with enough statistical power to make meaningful comparisons between the main Asian ethnic groupings”, he said. Rishi told The Spinoff that the strength of this report was that the authors were able to drill down for insights into communities that would otherwise not be visible without the extra analysis made possible by oversampling. 

Based on this report, researchers have already identified actionable insights, including recommendations on interventions targeting intergenerational nutritional behaviours, co-development of culturally tailored, non-stigmatised mental health services, health professional education and advocating for responsible media representation and anti-racist policies.

Rishi believes that should be the final prompt before action. “We have more than enough information to improve our response to the health needs of Asian communities here in New Zealand.”