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Warning: this story discusses suicide
Researchers are calling for more kaupapa Māori targeted public health interventions, after a study found Māori and Pacific women are disproportionately affected by suicide involving heavy alcohol use.
The study, conducted by the University of Otago in Christchurch, was the first in New Zealand to analyse coronial data on alcohol-related suicides with a focus on sex-specific characteristics and factors that contribute to alcohol being recorded as a cause of death.
It found ethnicity was the strongest predictor of suicide involving alcohol for women.
"Just over one quarter (26.6 percent) of the 1211 female suicides had acute alcohol use identified, with ethnicity the characteristic most predictive of suicide risk involving acute alcohol use," the report said.
It found Māori women were 35 percent more likely than European women to have alcohol involved in their suicide, while Pacific women were at a 75 percent greater risk.
This disparity was not observed in males, the report said.
Dr Jaimie Dikstaal, co-author of the study, said while the findings do not fully explain why Māori and Pacific women are at greater risk, the data is clear in identifying those "most in need of support".
"When we're talking about Māori or Pacific females having a higher risk of their suicide involving acute alcohol use, it reflects the cumulative risk factors that Māori often experience at an inequitably higher rate."
Although the report did not provide evidence on why Māori and Pacific women were more likely to be affected by suicide involving acute alcohol use, Dikstaal said researchers could hypothesise based on other literature.
According to the report, "females of Māori and Pacific ethnicity may be disproportionately impacted by historic and current risk factors including racism, socio-economic disadvantage, trauma, discrimination, and cultural disconnection".
Dikstaal said "this may influence alcohol motivations, consumption, and suicidal behaviour.
"With the right research, it's something that can be looked at, but our study was more focused on identifying what's there, what relationships exist, rather than exploring causality."
Dikstaal said more research was needed to identify the causal pathways and structural determinants for alcohol use and suicide because "people experience exposure to alcohol differently".
Dikstaal said this should include kaupapa Māori-led research.
"People have different cultural norms around alcohol; there aren't necessarily blanket solutions, and we don't want to only do blanket solutions when we know there's a particular group that could benefit from a more specific intervention."
Dikstaal said "it is important to note that being Māori or a Pasifika female isn't inherently a risk factor for alcohol use or suicide", but there was a need for public health strategies designed by and for these communities.
"Targeted interventions mean that any supports, policy changes, or programmes need to be designed by and for the groups most at risk-in this case, Māori and Pasifika females.
"These interventions need to be informed by kaupapa Māori and indigenous theory."
Dikstaal said while population-level interventions were necessary to address New Zealand's broader alcohol and suicide issues, tailored solutions were crucial.
"Twenty-six point six percent of all suicide deaths in New Zealand involve acute alcohol use. But if we're going to have population level interventions to address alcohol use, we don't know that they will necessarily work for this group that we know need it the most.
"We need to act because we've been able to identify the group who could benefit the most from extra support or help, whatever that may look like."
The authors of the study have called for population-level interventions to occur alongside targeted interventions designed by and for Māori and Pacific women, "to help address Aotearoa New Zealand's alarming rates of alcohol-related suicides".
"This would be a valuable component of the Draft Suicide Prevention Action Plan, which is currently undergoing consultation by the Ministry of Health," Dikstaal said.
"We have an opportunity to advocate for influence at a national level."
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