How is the COVID-19 Vaccination roll out going for tāngata whai ora in Aotearoa?
Tāngata whai ora are a priority group for the vaccination rollout. The risk of dying from COVID-19 may be up to twice as high for people with experience of mental health and addiction issues, and even higher for certain diagnoses.
The Ministry of Health released a snapshot of data on vaccination rates for people who have recently received mental health or addictions support. The data was shared in a spreadsheet. While the raw data helps tell a compelling and challenging story, that story is buried in the numbers.
Tūtohi have worked with Ministry of Health to use this data, combined with other sources, to create a series of data stories. These dynamic dashboards help lift the story out of the numbers and spreadsheets.
We hope that people will use them to carry this story forward and create change.
We also want to analyse and share how things evolve over time. The opportunity to see improvement and highlight what is working could help lift vaccination rates across Aotearoa, for all tāngata whai ora.
The lessons learned could also help in other areas, such as cancer screening.
Equally Well have issued a call to all champions to reach out to tāngata whai ora.
You can also pick up the conversation at Te Whāriki o te Ara Oranga, the new knowledge network for innovators, influencers and leaders driving change in mental health and addiction services.
Mental Health and Wellbeing Commission Board Chair fears people with mental illness and addictions are being left behind in vaccine rollout.
Tangata whai ora means a person (tangata) seeking wellness (whai ora). Although this is also sometimes seen as tangata whaiora, we have taken guidance from Te Reo Hāpai, which indicates that “whaiora” means “with wellness” whereas “whai ora” means “seeking wellness.” In the context of these data stories, tangata whai ora, and the plural tāngata whai ora, are more appropriate.
Where the data story uses the term general population this is an umbrella term for the people who did not meet the above criteria – in other words, people who were not supported by a mental health or addiction service between July and December 2021. This means that the tāngata whai ora cohort and the general population cohort are mutually exclusive. This is important to keep in mind when comparing to other population numbers – you will need to add together the general population count and the tāngata whai ora count to calculate the total population in a specific intersection of age, ethnicity and DHB.
We always compare tāngata whai ora to their matching general population cohort though – so if we’re looking at tāngata whai ora in Auckland over 65 years, then we’re comparing them to everyone else in Auckland over 65 years who was not recently supported by a mental health or addiction service.
Technical definition: In these COVID-19 vaccination data stories, the cohort we describe as tāngata whai ora includes all people:
aged over 12 years (at the date of data extract)
who are still alive
and who had an activity submitted to PRIMHD (the Programme for the Integration of Mental Health Data)
with a start date between July 1, 2021 and December 31, 2021
into any DHB mental health or addiction team
excluding any leave, did not attend, or health coaching activities (T37, T35 or T52)
excluding any Integrated Primary Access & Choice or Intellectual Disability teams (team types 24 and 26)
Each individual tangata whai ora is allocated to a single DHB based on their domicile, not where they received service.
Caveats and reminders: Age is calculated at the extract date for tāngata whai ora, so individuals with birthdays may age into the next category between one refresh and the next. This means that population counts for age categories may shift slightly, but the variation is expected.
DHB is determined based on domicile, not service delivery. This means that population numbers within a DHB may not crosscheck against other numbers provided against that DHB, from other resources or publications. If you are trying to compare with other data sources or resources, we recommend verifying exactly how a person is allocated to a specific DHB. Sometimes this is done by service delivery, as in “all people who are currently receiving service at this DHB” or “all people who received service at this DHB within this time period” (which may, again, be quite different depending on the time periods chosen). None of these methods are incorrect, but they are different, so it is important to clarify exactly what a dataset means when it talks about people by DHB.
Ethnicity is the prioritised ethnicity reported to the Ministry of Health. This method allocates individuals to a single ethnic group using the priority order of Māori, Pasifika, then Other (described as All other ethnicities or Everyone else within these data stories). This is in line with standards used in Ministry of Health statistics, as well as across the health and disability sector, and is intended to ensure that ethnic groups of policy importance are not swamped by the NZ European ethnic group. However, it is important to keep in mind that this methodology does not fully reflect a person’s identification and goes against the principle of self-identification. Statistically, we also see that certain groups are then over-represented – Māori tend to gain at the expense of Pasifika, and Pasifika tend to gain at the expense of Other. If you are trying to compare with other data sources or resources, we recommend verifying exactly how ethnicity has been recorded.
Total population counts provided by the Ministry of Health are the Health Service User population for 2020 (HSU 2020). The HSU population is a standard population estimate used for health statistics, which counts the number of people who received health services in a given year. A person is counted if their associated NHI either received public health service or was enrolled with a primary health organisation. Therefore, the HSU does not include everyone in Aotearoa, and is likely to miss highly marginalised groups. The Ministry of Health provides the following information on the HSU 2020 used for COVID-19 vaccine coverage reporting:
The HSU population estimate was generated from data on 5th July 2021 and captures health service users in the 2020 calendar year
The HSU population estimate uses 1 July 2020 to set age, and anyone who died prior to 1st July 2020 is excluded from the population, while anyone who has died from 1 July onwards is included
DHB of domicile was captured on 31 December 2020 as the latest address information we have for the individual
Ethnicity and gender information comes from the NHI status at 5th July 2021
Children under the age of 12 years have been excluded from the count, as there is currently no approval to vaccinate these ages
Where more individuals receive a COVID-19 vaccination than engaged with health services in 2020, we see vaccination coverage rates greater than 100% due to use of the HSU 2020 as the population denominator.
COVID-19 vaccination data provided by the Ministry of Health, current on Feb 28, 2022.
General population data is publicly available here and current on Feb 22, 2022.
Tāngata whai ora data is sourced through the Qlik app, COVID-19 vaccine uptake of PRIMHD service users. Please note the following caveats provided by the Ministry of Health team within the Qlik app:
These are not official statistics
Data may differ from published statistics, as the data available in the Qlik app is:
Refreshed regularly from the data marts (whereas published figures are not updated after publication)
Sourced directly from systems (whereas published figures may reflect manual adjustments made when preparing for media releases or daily briefings)
These data stories have been reviewed and verified by the research team at Te Pou.