For Hitesh Shah (not his real name), a 48 year old Indian from Auckland, a midweek afternoon 10 months ago proved to be a turning point. ``I was returning from work that day when I felt numbness in my arm and a crushing, intense pain in my chest,’’ he remembers. It was his first heart attack and it served him as a wake-up call to adopt a healthier lifestyle. ``I try to never miss my workout at the gym. And I avoid anything that would stress me out. It just isn’t worth it.’’ he says.
Shah’s is not an isolated case. According to the findings of Asian Health Chart Book published by the Ministry of Health, Indians have significantly higher rates of hospitalisation and mortality due to cardiovascular disease as compared to the total population in the country. This is especially true for new migrants who are mostly in good health when they arrive to settle in New Zealand. As they get accustomed to living in the country, they are more likely to experience high blood pressure, high blood cholesterol; and cardiovascular disease.
The community reflects what is known as `the healthy migrant effect’ where the health of migrants deteriorates over time. As new migrants get accustomed to new food habits and a different lifestyle, certain related lifestyle health issues creep in. For instance, data suggests that Indians appear to have a higher prevalence of obesity than any other social groups in the country.
This is echoed in an analysis of the New Zealand Health Survey by Dr Robert Scragg, Associate Professor at the School of Population Health at the University of Auckland. While published a few years ago in 2005, according to Dr Scragg the findings still hold true for the Asian community.
While the overall lifestyle pattern of the Asian community is generally good since they are less likely to smoke or drink alcohol, the lack of physical activity is a likely cause for an elevated risk of diabetes and cardiovascular disease. South Asians have higher prevalence of obesity compared to other Asians and this is a contributing factor to their increased risk of diabetes and heart disease.
Health experts working closely with the community unanimously share the opinion that this trend is a cause for concern.
``There is a need for an innovative approach to health communication if we are to deal with this trend effectively. There is a lack of evidence on the most effective community interventions and no recognized infrastructure to deliver Asian services in New Zealand,’’ says Dr Ranjna Patel, Director of East Tamaki Healthcare Group. She speaks from the experience of running Arrogya, which literally means well-being, a health awareness programme aiming to raise levels of awareness in the community using existing points of gathering, like places of worship.
``An understanding of the community and working with an insight into the culture often yields better results. Often, when I work with the community I come across people who say they need to exercise more in order to keep fit in New Zealand. It didn’t take them as much effort to work off excessive weight in their home country. Or that they find it hard to minimize the use of certain ingredients, like oil, for cooking if they are to move towards a healthier lifestyle,’’ she says.
The South Asian community constitutes 6 percent of the population in New Zealand and is predicted to grow to 12 percent by 2021. Asians beings treated as a different category with special needs was recognised after the first Asian health needs analysis for Counties Manukau. ``The analysis highlighted the issue and resulted in the formation of the South Asian Advisory group,’’ says Dr Geeta Gala, Public Health Physician at the Northern Cancer Network. ``All academic work on cardiovascular disease and diabetes now take Indians as a separate group and not classify them under ‘other’ group. This highlights the issue in this ethnic group.’’
It is imperative that health awareness is developed to engage with the community. Some of the suggestions by the experts are simple and effective. Like culturally appropriate, more visually based & activity related messages.
The preventive measures clearly are healthy eating and regular physical activity in order to reduce the risk of diabetes and heart disease. Finally, all the experts agree and recommend the old fashioned way of working up a sweat and exercising regularly as a way to leading a healthy and disease free life.