Reducing Inequalities

  • Work in 09/10 involves:
  • Demystifying Cancer Toolkit
  • Addressing inequalities pilot funding 08/09
  • Addressing inequalities pilot funding 09/10
  • Pacific Communities
  • Reducing inequalities is one of the two dual goals of the NZ Cancer Control Strategy (Ministry of Health, 2003). The Cancer Control Action Plan 2005-2010 (Ministry of Health, 2005) outlines numerous actions with respect to reducing inequalities across the cancer control continuum to be undertaken at national, regional and district levels.

    Planning for the reduction of cancer control inequalities has previously been undertaken in an ad hoc manner based on historical trends, with inadequate coordination of services or funding.

    The need to better plan and to develop strategies to reduce inequalities in cancer control in NZ has been identified by the Cancer Control Council (CCC) in their report, ‘Mapping Progress’. The 2007 report notes that some progress has been made in the area of inequalities; however, it also acknowledges that, on a regional and national level, there is still much work to be done.

    In particular, the report has identified the need to reduce inequalities experienced by both Maori and Pacific people in the area of cancer control, both being populations whose incidence of cancer disease is much higher than that for the rest of the nation.

    The Government’s health policy allows for the expansion of cancer control services to better address the inequalities affecting certain
    demographic groups within the NZ populace. Developing a plan to tackle these inequalities will enable cancer networks to identify and focus on priorities at a regional level.

    In the Central Cancer Network area:

  • Māori have higher rates of cancer than non-Māori
  • the most common cancers for Māori are stomach and lung cancers
  • the most common cancers for Pacific people are breast and prostate cancers
  • there is a higher rate of cancer mortality for Māori in the Central Cancer Network area than for Māori nationally
  • malignant cancer is the highest cause of death for Māori and Pacific people
  • The reducing inequalities work programme objectives are to:

  • ensure programmes and services are accessible to Māori and Pacific people across the cancer care continuum
  • identify and focus on regional inequality priorities and initiatives
  • provide leadership via strategic plan development that will maximise opportunities to address inequalities
  • monitor and evaluate current and new initiatives aimed at reducing inequalities
  • Work in 2009/10 involves:

  • engagement with stakeholders at a district level to identify actions to improve engagement with Iwi/Maori
  • develop an engagement plan for contact with Pacific communities
  • complete and report on a stocktake of breast and cervical screening services in the region
  • work with stakeholders to identify and address issues of cultural competency across the cancer control continuum
  • work with providers of the addressing inequalities pilot funding project
  • work with Cancer Society Divisions and Centres to develop Maori responsiveness plans/frameworks
  • facilitate and support the development of Demystifying Cancer Programmes focussing on the needs of Maori and Pacific
  • assist the cancer Society and cancer service providers to develop processes to support the integration of Cancer Society support services into patient pathways
  • develop a care coordination framework and stocktake tool to assist districts to identify current care coordination coverage and opportunities for improvement.
  • Demystifying Cancer Toolkit

    A Demystifying Cancer approach brings together communities and cancer service providers in a series of workshops delivered in a community setting, to present on and discuss cancer, the cancer journey and cancer services.

    This Toolkit has been developed to support districts to plan, deliver and evaluate Demystifying Cancer workshops as one means of addressing inequalities in cancer control for those communities where there are high incidences of inequalities. In New Zealand, it is often the Maori community, Pacific communities and rural communities who experience such inequalities.

    The Toolkit assists organisations who wish to run a programme of Demystifying Cancer workshops to recognise the distinct needs, issues and approaches that work best for Maori communities, and for Pacific communities. However the principles that underpin the planning, delivery and evaluation of these workshops can be applied to any group that experiences inequalities in cancer control, such as rural communities.

    Recently Completed Activities

  • Hawkes Bay Engagement and Reducing Inequalities Discussion Document
  • Matatuhi Arahi Service Plan for Maori
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    Addressing Inequalities Pilot Funding 08/09

    As part of its Crown Funding Agreement with the Ministry of Health CCN receives funding to investigate and address systemic causes of cancer inequalities. CCN recognises the opportunity to work with organisations/ groups within the region to pilot innovative projects and as part of this work has allocated $73,000 in the 2008/09 budget to support two to three projects in the region that will investigate and/or pilot strategies to address systemic causes of cancer inequalities.

    CCN sought expression of interest from organisations within its area to receive pilot funding for addressing inequalities funding.

    The applications were scored against the published criteria and the following three projects were selected to be progressed:

  • HVDHB / CCDHB - Pacific translations for patient information and service directory development
  • Te Aitanga a Hauiti Hauora - Targeted approach to support increased BreastScreening rates in Tairawhiti
  • Mary Potter Hospice - Development of generalist palliative care services for Maori and Pacific
  • These projects are currently underway and are due to be completed early/mid 2010. It is expected that deliverables and/or learnings from these pilots will be transferable across the region. Overall investment in these three projects totalled $81K.

    One of the criteria of the projects is that the learnings of the project are shared with a wider audience.

    Addressing Inequalities Pilot Funding 09/10

    With respect to 2009/10 funding, the Governance Group have agreed an approach which supports local cancer networks by providing $10K one-off funding per district to identify and coordinate specific activities to address inequalities.

    The following criteria will apply to the funding:

  • The activity/ies is designed to address a clearly identified, existing cancer inequality/ies
  • The activity/ies aligns with existing cancer control policy, guidelines and/or best practice
  • The activity/ies is over and above those that have already been identified for funding in the DAP or service plans for 09/10
  • The local cancer network collectively supports the approach
  • CCN Management Team is satisfied that the proposed activity/ies will contribute to addressing inequalities and add value
  • By devolving this pilot funding to the Local Cancer Networks CCN is seeking to support the following outcomes:

  • Districts are supported to address identified inequalities
  • Local cancer networks are better supported to function effectively
  • Gains are made across the entire CCN region
  • Local cancer networks will be required to provide a brief report on the outcome of the activity/ies at their conclusion.

    More information

  • Reducing Inequalities in Cancer Control Fact Sheet
  • Pacific Communities

    The CCN Pacific Communities Stocktake Report has been completed and is available for your information and consideration in terms of the role that is played in reducing inequalities for Pacific people in cancer control.

    The purposes of this report are :

    1. To determine the make-up of Pacific communities within the Central region in order to identify potential groups, networks and specific communities to be engaged with
    2. To identify the extent of current strategies, programmes and activities in place aimed at reducing inequalities specifically for Pacific communities within health and the cancer control continuum, in order to identify initiatives that could be supported , or where there are gaps
    3. To identify specific information about Pacific peoples’ cancer incidence as one factor for prioritising key issues for Pacific people and cancer in the Central region

    The report makes recommendations regarding possible engagement processes that could be used across the region and in specific DHB areas, to support strong engagement between cancer services and Pacific communities, as well as specific projects for reducing inequalities. A number of Pacific community groups, Pacific health providers and individuals working within health services were identified during the compilation of the report, as potential stakeholders in the work to reduce inequalities for Pacific people in cancer control. One of the next steps from this work will be to have conversations with them to ascertain what roles they wish to play in this work.

    The draft Implementation Plan identifies initiatives for CCN and regional stakeholders to undertake progress the recommendations.

    Recently completed Pacific Activity

  • CCN Pacific Communities Stocktake Report
  • CCN Pacific Communities Projects Draft Implementation Plan
  • Last updated 26th April 2010

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