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1. Introduction
Tuvalu is a small island nation in the South Pacific that has gained recent notoriety due to the destruction being wrought by rising sea levels and climate change. In light of these effects, Tuvaluans are predicted to immigrate to countries like New Zealand, a country that already hosts a significant portion of the global Tuvaluan population (“Data and statistics on Environmental migration”, 2021; Ethnic Group Profiles - 2013 New Zealand Census, 2013; Rigaud et al., 2018).
While previous studies and New Zealand Government surveys have looked at health and health care for Pacific Islanders in New Zealand, no published studies have specifically examined the health-care experience for Tuvaluan immigrants. Tuvaluan health statistics are typically collected alongside statistics of other Pacific Islander groups, such as the Samoan and Tongan people, who vastly outnumber the Tuvaluan population in Auckland (Ministry of Health NZ, 2021). While Tuvaluans share several overlaps with other Pacific Island communities of Auckland, such as Polynesian/Micronesian ethnicity and similar chronic disease concerns, it is important to consider the unique qualities of the Tuvaluan population for several reasons. The size of the community is significantly smaller than other Pacific Island communities and the Tuvaluan community is more tightly knit than those communities. Additionally, the threat of climate change is particularly salient for Tuvalu, which is a low-lying island atoll nation more susceptible to rising sea levels than other island nations with higher elevations.
The primary motivations of Tuvaluan immigrants to migrate are currently for financial or educational opportunities, but displacement due to climate change is a growing impetus. In anticipation of increased Tuvaluan migration to New Zealand over the coming decades, we sought to understand the views of recent Tuvaluan immigrants toward health behaviors, health care and the process of immigration in New Zealand to identify gaps in the existing system and improve health outcomes in the future. We aimed to identify important challenges faced by recent Tuvaluan migrants to New Zealand to inform initiatives that can facilitate the successful resettlement of future populations of environmentally-displaced Tuvaluans.
2. Materials and methods
2.1 Research setting and context
The country of Tuvalu is divided among nine islands, eight of which are inhabited, each with its own identity, culture and dialect. The Tuvaluan community in...