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    Bowel screening in New Zealand: are men and Pacific peoples being left behind?
    (Taylor & Francis Group, 2022) O’Connor L; Braithwaite-Flores A; Jagroop-Dearing A; Dearing CG
    Colorectal cancer screening participation is influenced by several factors including ethnicity and gender. Results from the first 6 months of a new screening scheme were examined in the Hawke’s Bay region of New Zealand. All residents aged between 60 and 74 years of age who participated in the scheme by returning a faecal immunochemical test kit were included. Participant ethnicity was compared with 2018 Hawke’s Bay Census data. Participants who returned a normal (negative), abnormal (positive) and a spoilt kit (defined as being unable to be processed for testing), were collated and compared for gender and ethnicity. A total of 3444 residents participated in the scheme. Overall, participant ethnicity proportions did not represent the Census population for Hawke’s Bay District Health Board residents. The proportions of Māori and Pacific peoples participating were lower than expected. The odds of returning a spoilt kit were six times higher (p = 0.013) for Pacific peoples and four times higher for men (p = 0.040). This short communication suggests that bowel screening programmes in New Zealand need to collate kit return rates and spoilt kits with the numbers of kits that are actually sent out to ensure equity for bowel screening in New Zealand.
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    Lowering hospital walls to achieve health equity
    (BMJ Publishing Group Ltd, 2018-09-20) Matheson A; Bourke C; Verhoeven A; Khan MI; Nkunda D; Dahar Z; Ellison-Loschmann L
    Hospitals have evolved to become integral and dominant components of health systems, although their functions, organisation, size, degree of centralisation, and resourcing varies across countries. Despite this diversity, hospitals are generally focused on providing services for sick people rather than prevention. Although many have shown the capacity to quickly adopt new technologies, especially for diagnosing and managing illness, achieving institutional change to tackle the systemic causes of health inequities has proved much more difficult. We argue that the actions of hospitals contribute to health inequities. This is important given that hospitals hold an inordinate share of power, resources, and influence within health and community systems—while primary care and prevention are consistently undervalued and underfunded. We draw on four opportunistically selected country case examples to show the role that hospitals can play in overcoming systemic barriers to health equity. Each example highlights health sector actions taken for particular population groups: women and children in Pakistan and Rwanda and the indigenous peoples of Australia and New Zealand.