Inequity in cardiometabolic hospital admissions and blood screening in New Zealand Indigenous Māori with psychosis

被引:0
|
作者
Monk, Nathan J. [1 ]
Cunningham, Ruth [2 ]
Stanley, James [2 ]
Fitzjohn, Julie [3 ]
Kerdemelidis, Melissa [4 ]
Lockett, Helen [5 ,6 ]
Mclachlan, Andre D. [7 ]
Porter, Richard J. [3 ,8 ]
Waitoki, Waikaremoana [9 ]
Lacey, Cameron [8 ]
机构
[1] Univ Otago, Dept Maori Indigenous Hlth Innovat, Christchurch, New Zealand
[2] Univ Otago, Dept Publ Hlth, Wellington, New Zealand
[3] Te Whatu Ora Hlth New Zealand Waitaha, Specialist Mental Hlth Serv, Canterbury, New Zealand
[4] Te Whatu Ora Hlth New Zealand Waitaha, Serv Improvement & Innovat, Populat Hlth Gain, Canterbury, New Zealand
[5] Univ Otago, Dept Publ Hlth, Wellington, New Zealand
[6] Te Pou, Auckland, New Zealand
[7] Waikato Inst Technol, Ctr Hlth & Social Practice, Hamilton, New Zealand
[8] Univ Otago, Dept Psychol Med, Christchurch, New Zealand
[9] Univ Waikato, Fac Maori & Indigenous Studies, Hamilton, New Zealand
来源
BJPSYCH OPEN | 2024年 / 10卷 / 05期
关键词
Psychosis; indigenous health; health equity; cardiometabolic health; blood screening; YOUNG-PEOPLE; FOLLOW-UP; MORTALITY; HEALTH; SCHIZOPHRENIA; METAANALYSIS; DISORDERS; DISEASE; RISK;
D O I
10.1192/bjo.2024.759
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Background People with psychosis experience worse cardiometabolic health than the same-aged general population. In New Zealand, Indigenous M & amacr;ori experiencing psychosis have greater risk of cardiometabolic and other physical health problems.Aims To identify a cohort of adults accessing secondary mental health and addiction services in New Zealand, with a previous psychosis diagnosis as of 1 January 2018, and compare odds of hospital admission outcomes, mortality and receipt of cardiometabolic blood screening between M & amacr;ori and non-M & amacr;ori in the following 2 years.Method Crude and adjusted logistic regression models compared odds of hospital admission outcomes, mortality and receipt of cardiometabolic blood screening (lipids and haemoglobin A1c) between M & amacr;ori and non-M & amacr;ori, occurring between 1 January 2018 and 31 December 2019.Results A cohort (N = 21 214) of M & amacr;ori (n = 7274) and non-M & amacr;ori (n = 13 940) was identified. M & amacr;ori had higher adjusted risk of mortality (odds ratio 1.26, 95% CI 1.03-1.54), and hospital admission with diabetes (odds ratio 1.64, 95% CI 1.43-1.87), cardiovascular disease (odds ratio 1.54, 95% CI 1.25-1.88) and any physical health condition (odds ratio 1.07, 95% CI 1.00-1.15) than non-M & amacr;ori. Around a third of people did not receive recommended cardiometabolic blood screening, with no difference between M & amacr;ori and non-M & amacr;ori after covariate adjustment.Conclusions M & amacr;ori experiencing psychosis are more likely to die and be admitted to hospital with cardiovascular disease or diabetes than non-M & amacr;ori. Because of the higher cardiometabolic risk borne by M & amacr;ori, it is suggested that cardiometabolic screening shortfalls will lead to worsening physical health inequities for M & amacr;ori experiencing psychosis.
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页数:9
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