IN AOTEAROA AGEING THE NEW ZEALAND HEALTH WORK AND RETIREMENT STUDY Health and Ageing Research Team (HART) Massey University AGEING IN AOTEAROA To Our Participants © 2023 The authors Published by Health and Ageing Research Team (HART), School of Psychology, Manawatū Campus, Massey University hart@massey.ac.nz The reproduction of any content of this book is prohibited without permission of the publisher by the New Zealand Copyright Act. This applies to any form of reproduction. Concept: Susanne Röhr Authors (alph.): Fiona Alpass, Vicki Beagley, Rosemary Gibson, Hannah Phillips, Susanne Röhr, Christine Stephens, Brendan Stevenson, Polly Yeung Text editing: Carol MacDonald, Vicki Beagley Photos: private (pages 18, 19, 20, 262), Susanne Röhr (pages 10, 28, 31, 32, 38, 40, 42, 44, 46, 246, 248, 250, 254, 256, 258, 260), Anja Römer (page 252), otherwise sourced at pexels.com, oneshot.co.nz, shutterstock.com, truestock.co.nz, and stockphoto.com Design: Yvonne Sommer (Click Design Ltd), Susanne Röhr Cover art: Grant Finch (“Late Afternoon”, 2023) “H(ART) Collection 2023”: NZHWR participants featured with their artwork provided written informed consent to print their artwork and disclose their names in this publication. They remain the owners of their artwork. “Meet Our Participants”: NZHWR participants provided written informed consent to print their portraits and to share their stories in this publication. This is strictly separate from any NZHWR survey data, which remain de-identified in all cases at all times. First digital edition Released in June 2023 ISBN 978-1-7385873-1-5 AGEING IN AOTEAROA The New Zealand Health, Work and Retirement Study Health and Ageing Research Team (HART) Massey University CONTENTS Foreword 8 Preface 11 Introduction 15 Behind the Scenes 29 Meet Our Participants 37 Health and Age 49 Life Course 57 Housing and Neighbourhoods 65 Work 75 H(ART) Collection 2023 85 Caregiving 167 Measuring Māori Identity 177 Older Chinese in New Zealand 187 Social Connections 195 Loneliness 203 Alcohol Consumption 211 In Times of Crisis 221 10 NZHWR Key Messages 230 Future Avenues 233 Meet Our Team 245 HART Publications 265 8 9 FOREWORD A few years ago I was at a meeting on ageing involving Americans and Europeans. A US economist probed about older age in the Netherlands. “What happens to economic wellbeing if there is a shock?”, the American asked. “What kind of shock?”, responded the Dutch economist. “Say, catastrophic illness”, said the American. “That’s looked after by the health care system, free at the point of use. It doesn’t constitute an economic shock”, said the Dutch economist. “Job loss?”, asked the American. “We have a good pension system, that maintains a reasonable standard of living.” “Eviction?” “Tenants are protected.” The Netherlands is a “normal” country. People with lower income have a worse time of it through the life course, including worse health and functioning at older ages. But the social environment, and associated public policies, really matter for the quality of lives at older age. These policies provide a good deal more protection in the Netherlands than they do in the US. What is true for other countries is true for Aotearoa New Zealand, as illustrated in this important report from the New Zealand Health, Work and Retirement Study (NZHWR). When my colleagues and I began the English Longitudinal Study of Ageing (ELSA), twenty years ago, we pointed out that a typical view of older age was as a time of misery, relative poverty, social isolation, and poor health and functioning. This present report shows, as did ELSA, that life at older age is far from the typical picture of popular image. There is huge variation but it is not random. Circumstances through the life course have a cumulative effect in leading to inequalities in health, wellbeing, and functioning at older ages. The three domains that are the focus of this Aotearoa New Zealand study – health and wellbeing; social connectedness and participation; and economic wellbeing and participation – are closely related. My perspective is equity of health and wellbeing. It is clear that loneliness and social isolation, and poorer economic circumstances, are potent drivers of inequalities in health at older ages. This study provides rich detail: good quality work and satisfaction with housing are important to health and wellbeing at older ages. One key finding is that people who own their homes have better health and wellbeing than those who rent. Here, home ownership may be a proxy for generally better economic circumstances. But it may reflect something else. Security of tenure of housing may be part of psychological security. So may perceived safety of the neighbourhood. Indeed, one of the reasons that wealth at older age is related to better health is psychological security. Living a life of dignity requires a base of psychological security. As I illustrated, above, in the exchange between the Dutch and American economists, social policies can be crucial in providing that security. It is a message that this report emphasises. Healthy ageing has more to do with circumstances throughout the life course than it does simply with individual behaviours at older ages. Social policies that improve living and working conditions are the route to greater equity of health and wellbeing at older ages. Equity here implies dealing with the disadvantage associated with socioeconomic position. In Aotearoa New Zealand, it also means paying special attention to the disadvantage experienced by Māori at all ages. It is welcome that the gap in life expectancy has narrowed. Life expectancy for Māori has improved a little more rapidly than for non-Māori, but Māori disadvantage is still large. I come back to the theme of living a life of dignity through the life course. For Indigenous New Zealanders, as for other groups, this will include flourishing within cultural traditions and freedom from discrimination and racism, as well as having favourable socioeconomic conditions important for all New Zealanders. Social and environmental policies are crucial. A particular strength of the current report is that the evidence accrued from detailed longitudinal research is complemented by another kind of evidence: the texture of the lives of real people. Both types of evidence are important if we are to understand the causes of inequities in health and wellbeing at older ages, and the steps needed to make a difference. All of this is enhanced by the beauty of the artwork. This NZHWR study, with its perspective, rich longitudinal data and insightful case histories makes a welcome contribution to a growing movement to address the social determinants of health. Professor Sir Michael Marmot Director Institute of Health Equity UCL (University College London) 11 PREFACE Population ageing is a critical and unprecedented demographic change occurring worldwide. The Aotearoa New Zealand population of people aged 65 and over is projected to double over the next 30 years. Those over 65 will constitute 25% of the population by 2040, while the number of oldest-old (those aged 85 and over) will expand more than five-fold to constitute 5% of the population. This demographic shift has attracted attention to the importance of supporting the health and wellbeing of older persons. This century has seen changes in the focus of debates as well as real structural and attitudinal changes toward ageing. International policy responses previously focused on encouraging and facilitating older people to maintain positive health-related behaviours and to remain engaged in society and economic activity. However, the publication of the 2015 World Health Organization (WHO) Report on Ageing signalled a shift towards recognition of the social and physical environment as important supports for ageing well. Aotearoa New Zealand has responded rapidly to this shift with the launch in 2019 of Better Later Life – He Oranga Kaumātua 2019 to 2034 , the government’s strategy for the ageing population. The guiding principles of this strategy include valuing people as they age, recognising diversity, taking a whole-of-life approach, and taking collective responsibility for planning for later life. This collective responsibility includes paying attention to the social and physical environments in which people age, rather than the previous focus on individual responsibility. The Health and Ageing Research Team (HART) has contributed to the development of these shifts in focus. Our research has not focused on what older people can do to keep themselves healthy, but rather on what society can do to support the wellbeing of all, including older people as an important and integral part of our society. Thus, our findings are not directed towards individuals, who already know that eating well, exercising physically and mentally, and maintaining social health is good for us. Rather, our work is directed towards social policymakers who have the power to 12 13 influence the development of social and physical environments that support these healthy behaviours. Our research has shown that it is vulnerable groups with fewer resources and lifelong disadvantages who need additional support to maintain wellbeing into older age. We have also shown that deprivation in childhood impacts health in older age, through pathways such as education and employment that support or hinder people’s ability to maintain healthy practices. Moreover, our work indicates that it is the broader environment, such as attitudes to older workers or housing and neighbourhood design, that influences wellbeing. The New Zealand Health, Work, and Retirement study (NZHWR), a longitudinal survey, has been an important contributor to this knowledge. NZHWR data and findings have been used by multiple organisations and cited in numerous reports; including the New Zealand Ageing Strategy, for the Health Promotion Agency on older adults’ alcohol and other drug use harms, by the Retirement Commission, and the WHO towards operationalising the Healthy Ageing concept. HART members assisted The Ministry of Business, Innovation and Employment (MBIE) to develop the Mature Workers Employment Toolkit and are Project Steering Group members for The Ministry of Social Development (MSD) research “Age-related discrimination against older workers”. The NZHWR findings are shared directly with participants and the public through various media. Our over 670 stakeholders and end-users receive regular HART updates through newsletters, policy reports, seminar/webinars, and our Twitter @MasseyHART. An annual newsletter to NZHWR participants describes activities and key findings. The HART website is in plain language and relevant to a broad audience. The site has attracted 53,200 visits between July 2014 and December 2021. The website includes descriptions of the NZHWR study and metadata, associated journal articles, reports and newsletters, and links to recorded seminars/webinars, including presentations from visiting international scholars. The team leaders have shared findings with national media (over 130 interviews since 2017) and are frequently invited to discuss results with local interest groups (e.g., Age Concern, Royal Society, New Zealand Association of Gerontology). The ability to follow people across time has provided powerful evidence for the effects of environmental conditions (such as in the neighbourhood and at work) on loneliness, mental health, physical health, and quality of life. Such a study depends on the willingness of our participants to contribute their personal information for the sake of developing this knowledge. We acknowledge and thank our survey and interview participants for making this work possible by giving their time, patience and interest. We are pleased to dedicate this book to them. Professor Christine Stephens and Professor Fiona Alpass 15 INTRODUCTION The NZHWR study of ageing began in 2006. It was the first of its kind in Aotearoa New Zealand and remains the longest ongoing cohort of ageing research in the country. Every two years, the NZHWR study surveys thousands of New Zealanders aged 55 years and older to examine their experiences of health and wellbeing in consideration of their social, economic, and physical environments. This chapter looks back at the study’s beginnings, how it evolved, where it is at today, and provides a comprehensive overview of study-related figures and outputs. 16 17 Institute for Social Research and met with Dr Heidi Geyer and her team who gave a valuable overview of their data collection and data management protocols. These meetings provided many valuable insights into running a longitudinal study with similar warnings and recognition of how well the HART was doing with such limited resources in Aotearoa New Zealand. COMING OF AGE All the warnings were correct, but thanks to a succession of wonderful HART staff, Andy Towers, Jack Noone, Brendan Stevenson, Jo Allen, Hannah Phillips, and Vicki Beagley (the longest serving), the team has overcome these issues to the point at which they can celebrate 20 years of the HART and the NZHWR study in its 18th year. This development has also included an expansion of HART, welcoming more researchers of whom Brendan Stevenson, Andy Towers, Jo Allen, and Jack Noone remain valued members. In addition, there have been very important contributions from other academics, chiefly Mary Breheny, Joanne Taylor, Juliana Mansvelt, Sally Keeling, Ágnes Szabó, Polly Yeung, Steve LaGrow, Eljon Fitzgerald, and most recently Susanne Röhr and Rosie Gibson. Notably, the team is well supported by the HART Māori Advisory Group which is convened by Brendan Stevenson (Ngā Puhi, Ngāti Hine, Ngāti Pōrou) and currently includes Natasha Tassell-Matamua (Te Atiawa, Ngāti Makea ki Rarotonga), John Waldon (Tuhoe, Ngāti Kahungunu, Ngāti Pōrou), Roland Fitzgerald (Ngāti Pōrou, Rangitāne), Ruma Karaitiana (Rangitāne, Ngāti Kahungunu, Ngai Tara, Kāi Tahu), and Penny Poutu (Ngāti Maniapoto). The critical contributors to this team are the participants. Participants have been extraordinarily generous in sharing their time and many intimate details of their lives. The stories of triumphs and difficulties shared over the years are met with appreciation and sympathy. Participants also share their suggestions for areas of research which the HART tries to take on board. The work of the whole team has been recognised by ongoing funding from HRC, MBIE, and other bodies which signals the value of the longitudinal study as an investment for Aotearoa New Zealand. The HART has also been gratified by the development of links to international research groups and most recently to joint work with the WHO in support of the United Nations Decade of Healthy Ageing (2021–2030). Massey University recognised the contributions of the HART in 2012 with the award of the Research Team Medal. One of the greatest pleasures comes from introducing research students and early career academics to the HART world and watching them succeed. In the future, Chris, and then later, Fiona are preparing to hand the leadership of the team over HOW IT ALL BEGAN As social scientists working in the School of Psychology at Massey University, Fiona and Chris were aware of a global demographic shift. Populations were ageing in ways that meant there would soon be more people over 65 than children in the world. This new phenomenon had many social and economic implications which were important to Chris as a health psychologist and to Fiona as an organisational psychologist. At the same time, they were lucky to meet Dr Nancy Pachana, a clinical psychologist with a focus on gerontology who was interested in working with older people and researching their needs. Now a Professor at the University of Queensland, at the time Nancy was a vibrant member of the School of Psychology at Massey University who encouraged all to take ageing seriously as a topic for psychology. Following Nancy’s departure, Chris emailed members of the School to ask who would be interested in forming a group to discuss research on ageing. Helen Pennington, a developmental psychologist who has since retired, and Fiona answered, and the HART and the NZHWR study were born. The initial study was based on a survey that Fiona was developing about retirement. The pilot survey was funded by the School of Psychology. But the team wanted to make this a longitudinal study focused on the long journey into older age and developed a bid to the Health Research Council (HRC) for funding two waves of a biennial survey, with the aim to establish a cohort whose members they could follow up in the future. The bid was successful, and they were able to hire Andy Towers, a research officer and data manager. For the first wave of the NZHWR study, 6,661 participants were recruited and 3,454 of these agreed to be contacted again. At the same time, the HART began developing a broader team of local, national, and international collaborators. One of the first advisors was Professor Christina Lee from the University of Queensland, who was the National Coordinator on the Australian Longitudinal Study on Women’s Health at that time. She had been part of this longitudinal study since its initiation in 1995. Christina visited Massey University with a great deal of useful advice, and they formed a very helpful collaboration with the Australian group. Christina also had some warnings about the difficulties of running a longitudinal study which prepared them for the work ahead: the problems of good data management at every level, the importance of maintaining relationships with participants, and the difficulties of maintaining ongoing funding because of a lack of sustained funding for any longitudinal studies. In 2006, Fiona and Andy also visited the home of the Health and Retirement Survey, an extraordinarily large longitudinal study of older people in the United States. Here they were hosted by Professor Bob Willis of the Survey Research Center at the University of Michigan’s 18 19 20 21 to Susanne and Rosie, who are already leading the research into exciting new and important areas of knowledge. The HART will be recruiting more midlife participants so that they can focus on the critical factors that affect ageing in today’s rapidly changing social and physical environment. As we develop the study we plan for a stronger focus on cognitive functioning and brain health under Susanne’s leadership, the greater use of data from other sources such as the Ministry of Health and Accident Compensation Corporation (ACC), and the wider use of technology to collect information with our participants. THE NZHWR STUDY: FACTS AND FIGURES At its core, the study is a survey of the experiences of ageing in Aotearoa New Zealand completed every two years by a large sample of New Zealanders aged 55 years and over, who are randomly selected from the electoral roll. An over-sample of people of Māori descent is undertaken to ensure adequate representation of this important group. The survey is designed to investigate ageing within three broad areas: health and wellbeing (e.g., physical, emotional, cognitive); social participation (e.g., family support, social capital, participation); and economic participation (e.g., meaning of work, employment, retirement). Each survey also has a section providing a more in-depth examination of an issue of current concern in Aotearoa New Zealand. For example, in 2016, the survey had a focus on housing and neighbourhood quality, and in 2021, on COVID-19, and in 2022, the inclusion of questions from the WHO Study on global AGEing and adult health (SAGE). In addition to the biennial survey, the study has conducted off-wave surveys to assess retirement (2009) and social connectivity (2013), conducted over 1,903 face- to-face assessments of cognitive performance (2010 and 2012), in-depth qualitative interviews on a range of issues, including aspects of employment and caregiving, and over 800 telephone interviews regarding participants’ early and mid-life experiences (2017). The majority of participants have provided consent for the study to link to their anonymised national health records. To date, the study has involved 12,949 participants. The centrepiece of the study remains the original cohort. In 2006, 6,661 New Zealanders responded to the initial survey, and around 46% of these indicated that they were interested in participating in a longitudinal cohort and were re-approached for participation every two years. These original participants were aged 55-70 years, had an average age of 61 years and 54% were female. When asked what ethnic groups they belonged to, 50.7% responded New Zealand European, 46.5% Māori, and 2.8% other ethnicities. 22 23 6,661 participants Aged 55-70 Average age 61 54% women 50.7% NZ European, 46.5% Māori, 2.8% of other ethnicities THE ORIGINAL 2006 COHORT LOCATION OF 2006 COHORT Waikato 672 Lakes 257 Tairawhiti 170 Whanganui 151 Southland 186 West Coast 58 South Canterbury 85 Waitemata 650 Otago 285 Wairarapa 75 Northland 438 Nelson Marlborough 214 Taranaki 211 Midcentral 272 Hutt 198 Hawke’s Bay 316 Counties Manukau 561 Capital and Coast 352 Canterbury 618 Bay of Plenty 471 Auckland 394 24 25 NZHWR IN NUMBERS 12,949 total participants 16 years of observation 9 biennial surveys 111 publications 55+ reports 18 book chapters 1 book All districts of Aotearoa New Zealand are represented in this sample of respondents. In 2022, which saw the 9th biennial NZHWR survey, 1,156 participants of the original cohort continued to respond to the survey. Additional cohorts have been recruited to the study over time to both broaden and maintain the capacity of the NZHWR and to investigate how different age groups are impacted by events and policies that have occurred during their life course. Over the study duration, the majority of the participants have moved from being engaged full-time in the workforce into retirement, or at least its modern equivalent. The continued participation of these older New Zealanders in the study has allowed the development of a resource which is unique in its ability to describe key transitions associated with later life. The continued primary aim of the NZHWR study is to grow the scientific knowledge- base on issues of ageing in Aotearoa New Zealand. Now in its 18th year, the longevity of the study has paid off in terms of cumulative productivity. The outputs of the study have been growing steadily, with peer-reviewed results and insights published and disseminated through 111 journal articles, over 55 reports and 18 book chapters. In addition, several doctoral and masters students, supervised by HART members, have completed research theses utilising NZHWR data. The development of research skills relevant to ageing in these students remain some of our most important achievements as their progress represents a meaningful increase in research capacity in the field of ageing in Aotearoa New Zealand. The study has provided annual reports to funding bodies, as well as reports to Treasury and the Health Promotion Agency. The reports provided insights into, for example, the economic issues for older persons, their connectedness to health and social resources in a digital age, choices around housing, and the experiences and recovery following the Canterbury and Seddon earthquakes of 2010, 2011, and 2013. Reports tailored to provide information relevant to policy issues for older people, such as the acceptability of tele-health, the balance of work and care provided by older caregivers, and the impact of housing tenure on the wellbeing of older adults, have been disseminated to end-users. The project has enabled local researchers to engage in high-profile international collaborations with world leaders in ageing research, placing Aotearoa New Zealand research on a world stage and promoting discussion around issues of ageing for older New Zealanders in these settings. 26 27 The continued primary aim of the NZHWR study is to grow the scientific knowledge-base on issues of ageing in Aotearoa New Zealand. Now in its 18th year, the longevity of the study has paid off in terms of cumulative productivity. Importantly, the development of research skills relevant to ageing in PhD and masters students remains one of the most valuable achievements as their progress represents meaningful increase in capacity in ageing research in Aotearoa New Zealand. 29 BEHIND THE SCENES Conducting a longitudinal cohort study like NZHWR is a complex endeavour and requires a multidisciplinary team. Typically, scientific publications and reports are the visible elements of a study. But there is a lot of work going on “behind the scenes” to eventually get to those. Vicki Beagley and Hannah Phillips are the Research Officers of the NZHWR study and are responsible for the technical aspects of the study. In sharing what they do, they provide an exclusive insight into running NZHWR. 30 31 The surveys and consent forms are scanned with a specialised scanner that has been calibrated to record the responses to each survey question. The qualitative responses from within the survey, including any written text that a participant has added, are entered manually into another program to be combined with the rest of the survey data at a later point. The scanner generates a PDF copy of each survey and consent form, which are backed up on two secure hard drives. The physical copies of the surveys and consent forms are secured in a locked room and eventually destroyed once archiving is complete. Meanwhile, Hannah prepares to receive and clean the data to make them available for researchers to use. After scanning, the data are stored in hundreds of text files. These data must be imported into statistical software to build the dataset. The qualitative data are imported and combined with the scanned data, and each participant is linked with their original longitudinal ID code, so their responses can be merged across all survey waves. Their reported gender and date of birth are compared with previously held records to ensure the same person is responding across waves and the text data have been linked to the correct participant. Each variable is checked for any out-of-bounds responses, and should any arise, the PDF for that particular survey is checked to amend the record. Once the dataset is complete, it is made available for researchers to use. Vicki and Hannah have different but fully complementary roles. Hannah creates the datasets from each survey wave, manages the participant database and is responsible for sharing the survey data responsibly with external researchers. Vicki organises the printing, mailing, receipting, and scanning of the surveys, and interacts directly with the participants. If anyone dials the HART’s 0800 free phone number, Vicki will answer the call. Vicki and Hannah work together on the annual newsletter which is usually sent out in November. Vicki gathers all the required information and draws up the draft newsletter, and Hannah does all the formatting, editing, and preparations for printing. Every second year, the NZHWR survey is developed across many meetings and after consultation with the Māori Advisory Group. Hannah and Vicki work together with the team to format the questions and fit them together onto the survey pages. After the draft survey has been prepared, Vicki organises for 20 to 25 people to read and fill out the survey and advise of any errors or areas that need amending. The survey is revised and adjusted many times by Hannah for clarity and to correct any identified errors. Vicki liaises with the staff at the printing service in Wellington as well as the Massey University mail room to advise them of the large volume of incoming mail. The first 30 receipted surveys are put through quality assurance where the data is both scanned and entered manually, then both sets of data are compared to ensure the scanned data is accurate. Due to the strict confidentiality requirement, Vicki and Hannah are the only team members with access to the participant database. To maintain a representative sample, as the existing participants age, every two years a new cohort of participants, aged 55 and older, is selected from the electoral roll to add to the sample. All existing participants who are deemed to still be active in the study are recruited for the new survey wave. The participants are allocated a new ID code specific to that wave of the survey, and the participant lists are encrypted and sent securely to the printing service with the survey materials ready for distribution. RECEIPTING PROCESS, SCANNING AND QUALTRICS Each participant has a longitudinal ID code for linking their data across waves, and Hannah and Vicki are the only members of the team who can link the two together. This ensures that the participants’ identifying information (e.g., name, address) are stored separately from their survey data and are not able to be connected. Upon receipt, the surveys are stamped with their receipt date, then entered into the database management system to mark that the participant has returned the survey. If required, the participant’s contact details and activity status are updated. 32 33 Originally the surveys were hand-delivered to a typist who manually entered the data into a computer program, but since 2018 this work has been conducted using a specialised scanner and software. One huge challenge for Vicki was to master the scanning program which, to put it mildly, is very “clunky”. However, with each survey wave it got easier and the process became more accurate and streamlined. The most recent 2022 survey was a lot of work, but she found it very enjoyable as most of the computer problems had been ironed out and everything ran very smoothly. COVID-19 caused many problems in all aspects of the survey and data collection in 2020 and 2021. As Aotearoa New Zealand was entering its first lockdown, the 2020 survey was partway through its design process, and the whole team had to quickly adapt to working collaboratively from home. Designing, testing, printing, and distributing the survey had to occur remotely. Receipting and scanning the surveys would have been particularly challenging, but the day before lockdown, Vicki grabbed all the hardware and set herself up in her dining room, and the surveys were delivered each day by the mail room staff. Although it was a bit cumbersome getting surveys to and from work (and dealing remotely with computer issues), the system worked very well. Hardly any time at all was lost, when things could have come to a complete standstill. As Vicki deals directly with the survey, she gets a lot of satisfaction from the many positive comments that participants write on the back of the survey. With the increasing use of the internet, emails, and mobile phones, it has become easier than ever to track those whose addresses have changed as in earlier years there was only a landline, and if people moved, they relinquished their phone number. The retention rate is therefore much higher now than in the first few years of the study. Vicki enjoys working with the team and tells people she has the “best bosses in the world”. The main IT and admin support staff also make her job enjoyable, as nothing is ever a problem for them, and they respond positively to any requests. There is a lot of variety in the work, especially during years when surveys are not sent out, due to the interesting studies she helps conduct. Vicki also really enjoys interacting with the participants and chatting with them when they call to receive or share information. Hannah loves the challenges and problem-solving that arise from data management and gets a lot of satisfaction from figuring out a way to write a piece of syntax to solve a problem. She enjoys learning about other researchers’ work when they submit data requests and is always on hand to help answer any questions about the data as needed. When a researcher contacts the study to use the data for their analysis, Hannah checks their request and ensures that they are not requiring identifying information. If ethnicity data is required, the request must be justified and approved by a member of the Māori Advisory Group before the data can be shared. Hannah compiles the dataset and generates a set of unique ID codes for use only within that dataset to protect the participants’ identity and ensure that the data cannot be linked with other datasets. The dataset is then encrypted and securely shared with the researcher. The survey is usually sent out biennially. During “non-survey years”, there are various smaller studies conducted, and Vicki usually manages these. One memorable study was the “Lifecourse History” study. Initially, Vicki phoned 1,200 participants who had been active since 2006 to gauge their interest in being part of this study. Interview sheets were sent to those participants who agreed to take part. Vicki coordinated the study and had 13 students across Aotearoa New Zealand conducting telephone interviews that lasted one to three hours. The goal was to complete at least 500 interviews, but the study concluded with more than 800 completed. Vicki was struck by the willingness of these participants to share their stories, some of which were deeply personal, and some were telling their experiences for the very first time. 34 35 In 2012, a participant interview took place in a boat in the beautiful Wyuna Bay near Coromandel township. Another participant was born in the same town as both of Vicki’s in-laws. Asking about her married name, the participant laughingly told Vicki that she used to babysit her husband, and that her father was the Master of Ceremonies at the wedding of Vicki’s in-laws. Aotearoa New Zealand is but a village. 36 MEET OUR PARTICIPANTS 37