title: “We thought we had more time”: An examination of climate and extreme weather framing in regional online newspapers in Aotearoa

authors: Morgan, Lauren

abstract: Climate change poses growing risks to health and wellbeing, yet public engagement with these challenges depends heavily on how they are communicated. News publications play a key role in shaping public understanding of climate-related risks and responses, with regional news outlets especially well placed to inform their audiences with locally relevant and contextualised coverage. 

While national-level media studies in Aotearoa have examined climate and health coverage, little is known about how regional newspapers frame these issues, especially before and after locally experienced extreme weather events. The underrepresentation of Indigenous perspectives and limited coverage of health-related impacts further highlights the need for research into whose voices are prioritised in regional reporting. 

This thesis examines how three regional online newspapers in Aotearoa New Zealand frame climate change, extreme weather, their relationship to health. The Waikato, Bay of Plenty, and Te Tairāwhiti/Gisborne regions were selected for their exposure to Cyclone Gabrielle, their diverse population compositions including significant Māori communities, and the presence of active regional online news publications. Drawing on a constructivist epistemology and community psychology principles of social justice, collective resilience, and ecological systems thinking, this research employs reflexive thematic analysis to inductively code and analyse media coverage spanning one year before and one year after Cyclone Gabrielle. The analysis identified narrative framing and underlying themes in how climate and health risks were communicated to local  audiences by the selected regional online newspapers. 

Findings reveal patterns in media framing that shaped whether climate change was portrayed as an immediate, localised concern or a distant, abstract issue, as well as disparities in whose voices, experiences, and knowledge systems were included. Themes emerged around political accountability, community resilience, and structural vulnerability, though coverage varied in depth and equity. Indigenous perspectives remained underrepresented, and economic and infrastructure concerns overshadowed impacts on health and wellbeing. However, examples of inclusive and locally grounded reporting demonstrated the potential for regional media to support more equitable climate communication and adaptation. 

Findings were interpreted using a holistic analytical lens informed by Bronfenbrenner’s ecological systems theory and the Social Determinants of Health framework. This approach illustrated significant implications for community engagement in climate discourse. The dominance of elite and institutional perspectives over grassroots experiences limits the visibility of community-driven adaptation efforts and obscures structural drivers of vulnerability, such as housing insecurity, economic inequality, and historical injustices rooted in colonialism. By excluding structural and health-related dimensions in climate discourse, regional newspapers risk unintentionally reinforcing inequities and limiting opportunities for collective action by marginalising those most affected. To support collective resilience regional media must move towards more consistent, health-focused, and community-led coverage, amplifying underrepresented  voices and addressing the broader structural determinants of vulnerability to climate impacts. 

This study contributes to climate communication research by centring regional media and offers practical insights for journalists, policymakers, and community advocates seeking to foster more just, inclusive, and community-responsive climate discourse in Aotearoa.

text: “We thought we had more time”: An examination of climate and extreme weather framing in regional online newspapers in Aotearoa Climate change poses growing risks to health and wellbeing, yet public engagement with these challenges depends heavily on how they are communicated. News publications play a key role in shaping public understanding of climate-related risks and responses, with regional news outlets especially well placed to inform their audiences with locally relevant and contextualised coverage. 

While national-level media studies in Aotearoa have examined climate and health coverage, little is known about how regional newspapers frame these issues, especially before and after locally experienced extreme weather events. The underrepresentation of Indigenous perspectives and limited coverage of health-related impacts further highlights the need for research into whose voices are prioritised in regional reporting. 

This thesis examines how three regional online newspapers in Aotearoa New Zealand frame climate change, extreme weather, their relationship to health. The Waikato, Bay of Plenty, and Te Tairāwhiti/Gisborne regions were selected for their exposure to Cyclone Gabrielle, their diverse population compositions including significant Māori communities, and the presence of active regional online news publications. Drawing on a constructivist epistemology and community psychology principles of social justice, collective resilience, and ecological systems thinking, this research employs reflexive thematic analysis to inductively code and analyse media coverage spanning one year before and one year after Cyclone Gabrielle. The analysis identified narrative framing and underlying themes in how climate and health risks were communicated to local  audiences by the selected regional online newspapers. 

Findings reveal patterns in media framing that shaped whether climate change was portrayed as an immediate, localised concern or a distant, abstract issue, as well as disparities in whose voices, experiences, and knowledge systems were included. Themes emerged around political accountability, community resilience, and structural vulnerability, though coverage varied in depth and equity. Indigenous perspectives remained underrepresented, and economic and infrastructure concerns overshadowed impacts on health and wellbeing. However, examples of inclusive and locally grounded reporting demonstrated the potential for regional media to support more equitable climate communication and adaptation. 

Findings were interpreted using a holistic analytical lens informed by Bronfenbrenner’s ecological systems theory and the Social Determinants of Health framework. This approach illustrated significant implications for community engagement in climate discourse. The dominance of elite and institutional perspectives over grassroots experiences limits the visibility of community-driven adaptation efforts and obscures structural drivers of vulnerability, such as housing insecurity, economic inequality, and historical injustices rooted in colonialism. By excluding structural and health-related dimensions in climate discourse, regional newspapers risk unintentionally reinforcing inequities and limiting opportunities for collective action by marginalising those most affected. To support collective resilience regional media must move towards more consistent, health-focused, and community-led coverage, amplifying underrepresented  voices and addressing the broader structural determinants of vulnerability to climate impacts. 

This study contributes to climate communication research by centring regional media and offers practical insights for journalists, policymakers, and community advocates seeking to foster more just, inclusive, and community-responsive climate discourse in Aotearoa.

year: 2025

title: Women’s empowerment, spousal communication and reproductive decision-making in Malawi

authors: Kavinya-Chimbiri, Agnes Mary

abstract: This study is focused on the relationship between women’s power, spousal interactions and reproductive decision-making. It examines the nature of Reproductive Decision-Making Processes (RDMP) and the effect of spousal interactions and power relations on women’s capacity to make autonomous reproductive decisions or to negotiate desired reproductive outcomes. The study questions whether or not women’s empowerment and spousal communication really matters for the spread of family planning in Malawi?

The major findings of the study show that social dynamics at the national, the community, the lineage and the family levels affect the nature of RDMP and their outcomes. A number of indices are identified as having a significant impact on women’s power to participate in RDMP and influence their outcomes. These factors include non-egalitarian lineage or marriage system, women’s perceived autonomy, spousal communication about family planning and exposure to modern ideas and lifestyles.

This study demonstrates that changes in the social context, particularly in the lineage power structures and relationships, influence women’s capacity to participate in deciding to space births, stop child bearing and use family planning methods. For example, the social change that has been taking place in Malawian societies has had an impact on family dynamics and structures. Urbanisation has continuously attracted men and women to migrate to cities leading to the fragmentation of lineages. De facto female-headed households have been on the increase. This has allowed married women to consider making autonomous reproductive decisions to space births using modern contraceptive methods. The reproductive decision-making power of lineage heads has been weakened. Nevertheless, married women are still not able to make autonomous decisions or convince their husbands to use modern contraceptive methods for the purpose of limiting family sizes.

The empirical findings of the study provide a paradox for research and public policies. Contrary to theoretical beliefs and the ‘Cairo Model’, less gender egalitarian lineage and marriage systems permit married women to make autonomous reproductive decisions, whereas more gender egalitarian lineage and marriage systems enable married women to negotiate desired reproductive behaviours and outcomes. In order to meet the needs of these categories of married women, public policies will require analyses that would provide in-depth understanding of the relationship between social change, spousal power relations, reproductive decision-making and family planning.

The few reproductive decision-making power variables identified in this study: lineage, type of union, perceived autonomy, perceived negotiating power, spousal communication and exposure to modern ideas, have only measured the degree of women’s reproductive decision-making power. A more in-depth understanding of why most married women do not have the capacity to make autonomous decisions or to influence their husbands to use modem family planning methods for limiting family sizes is essential. This thesis has partially brought about that understanding. But more in-depth analyses of the impact of men’s power, women’s power, couple power, higher levels of spousal communication and levels of socio-economic development on the nature and outcomes of reproductive decision-making processes is called for. There is need to develop more cultural and socio-economic-based women’s power measures that would allow for more gender and cultural-sensitive research, analyses and policy planning and implementation.

text: Women’s empowerment, spousal communication and reproductive decision-making in Malawi This study is focused on the relationship between women’s power, spousal interactions and reproductive decision-making. It examines the nature of Reproductive Decision-Making Processes (RDMP) and the effect of spousal interactions and power relations on women’s capacity to make autonomous reproductive decisions or to negotiate desired reproductive outcomes. The study questions whether or not women’s empowerment and spousal communication really matters for the spread of family planning in Malawi?

The major findings of the study show that social dynamics at the national, the community, the lineage and the family levels affect the nature of RDMP and their outcomes. A number of indices are identified as having a significant impact on women’s power to participate in RDMP and influence their outcomes. These factors include non-egalitarian lineage or marriage system, women’s perceived autonomy, spousal communication about family planning and exposure to modern ideas and lifestyles.

This study demonstrates that changes in the social context, particularly in the lineage power structures and relationships, influence women’s capacity to participate in deciding to space births, stop child bearing and use family planning methods. For example, the social change that has been taking place in Malawian societies has had an impact on family dynamics and structures. Urbanisation has continuously attracted men and women to migrate to cities leading to the fragmentation of lineages. De facto female-headed households have been on the increase. This has allowed married women to consider making autonomous reproductive decisions to space births using modern contraceptive methods. The reproductive decision-making power of lineage heads has been weakened. Nevertheless, married women are still not able to make autonomous decisions or convince their husbands to use modern contraceptive methods for the purpose of limiting family sizes.

The empirical findings of the study provide a paradox for research and public policies. Contrary to theoretical beliefs and the ‘Cairo Model’, less gender egalitarian lineage and marriage systems permit married women to make autonomous reproductive decisions, whereas more gender egalitarian lineage and marriage systems enable married women to negotiate desired reproductive behaviours and outcomes. In order to meet the needs of these categories of married women, public policies will require analyses that would provide in-depth understanding of the relationship between social change, spousal power relations, reproductive decision-making and family planning.

The few reproductive decision-making power variables identified in this study: lineage, type of union, perceived autonomy, perceived negotiating power, spousal communication and exposure to modern ideas, have only measured the degree of women’s reproductive decision-making power. A more in-depth understanding of why most married women do not have the capacity to make autonomous decisions or to influence their husbands to use modem family planning methods for limiting family sizes is essential. This thesis has partially brought about that understanding. But more in-depth analyses of the impact of men’s power, women’s power, couple power, higher levels of spousal communication and levels of socio-economic development on the nature and outcomes of reproductive decision-making processes is called for. There is need to develop more cultural and socio-economic-based women’s power measures that would allow for more gender and cultural-sensitive research, analyses and policy planning and implementation.

year: 2002

title: Epidemiological evidence that can help to improve timely diagnosis of colorectal cancer in New Zealand.

authors: Hirsz, Malgorzata

subjects: Colorectal cancer

abstract: Incidence rates of colorectal cancer (CRC) in New Zealand (NZ) are among the highest in the world. The long-term survival rates in NZ are poor, which has partially been attributed to late diagnosis. Considering that CRC is a curable disease if diagnosed early, conducting research targeted at the improvement of early diagnosis is therefore important. This thesis provides statistical models for the calculation of CRC incidence rates in the entire NZ population and population strata defined by age, gender, ethnicity and diabetes status, and a model for CRC risk in individual patients referred to the secondary care. The models presented here could assist health professionals in the selection of patients for further investigation to facilitate earlier diagnosis. The empirical part consists of three independent observational studies, briefly described below.

Sub-study 1. The objectives were, first, to describe trends in CRC incidence in the NZ population and, second, to investigate whether there are any strata defined by gender and ethnicity with especially increased incidence rates of CRC. To address these objectives, I analysed data from the New Zealand Cancer Registry (years 1994–2018) using an age- period-cohort (APC) model. The overall CRC incidence rates in NZ decreased between 1994 and 2018 by an average of 1.31% per year. However, the decrease was observed only in patients 50 years and older. In those 30-<50 years old, the incidence rates increased between 1994 and 2018 regardless of gender and ethnicity. The increase was similar for proximal, distal and rectal cancers. The APC analyses revealed very strong cohort effects that could explain nearly the entire trends in CRC incidence, pointing out generations born in the 1970s and 80s being affected by the increased incidence rates, rather than individuals 30-<50 years old. The cohort effects were different in Ma ̄ori and non-Ma ̄ori populations. In non-Ma ̄ori born between approximately 1939 and 1955, incidence rates decreased sharply. By contrast, those Ma ̄ori generations have not benefitted from the sharp decrease in rates. However, CRC incidence increased substantially in both M ̄aori and non-M ̄aori groups born in the 1970s and 80s.

Sub-study 2. The objective was to estimate the IRR for CRC in patients with diabetes compared to those without diabetes, with relation to diabetes duration and use of insulin for diabetes control. Registration in the Virtual Diabetes Register (VDR) in the years 2014–2018 was used as a marker of a diabetes diagnosis. Tables with counts of the entire NZ population stratified by age, gender, and ethnicity were obtained from Statistics NZ. In total, data from 310,710 patients with diabetes, corresponding to 1,277,284 person- years and 2512 incident CRC cases were analysed using a Poisson regression model. Diabetes was associated with an overall increased CRC incidence of 13% compared to non-diabetes [IRR=1.13 (95% CI: 1.08, 1.18)]. The IRR was especially high in the first three months after diabetes diagnosis [IRR=2.55 (95% CI 2.02, 3.21)], likely due to detection bias. The association was equally strong in males and females. However, in the analysis by ethnicity, the incidence of CRC was increased only in non-Ma ̄ori patients and restricted only to those younger than 75 years.

Sub-study 3. The objective was to develop a predictive model for CRC risk in individual patients referred to secondary care. To develop such a model, I extracted information from free text included in e-referrals from GPs’ to the Gastroenterology and General Surgery departments in the Waikato Hospital from 2015-2018, including: symptoms; test results; and family history of CRC. The reference test was a full colonoscopy with visualisation of the cecum. Data from 3015 patients, 20-<90 years old were analysed using a logistic regression model. The final model included the following predictors associated with increased CRC risk: anaemia, rectal bleeding, palpable mass in abdomen or rectum, weight loss, age and gender, and a decreased CRC risk: family history of CRC, abdominal pain, and inflammatory bowel disease. The model discriminates patients with low CRC risk well. According to the final cross-validated model, around 20% of patients from our cohort had performed colonoscopy despite a very low CRC risk (less than 1.5%).

In conclusion, the APC analysis revealed an alarming pattern. According to the fitted APC model, the combination of increasing age and cohort effect in generations born in the 1970s and 80s will bring a wave of CRC diagnoses in the near future when the young generations with high CRC incidence rates will replace the old generations with low CRC incidence. The results from this study could therefore help policy-makers to plan the needs for gastroenterology services.
Secondly, CRC incidence rates in diabetes have been found to be slightly increased com- pared to non-diabetes but only in non-Ma ̄ori individuals younger than 75 years.
Third, the results suggest that males underutilise health services. As shown in sub- study 3, males underwent fewer colonoscopies than females, despite having a higher risk of CRC. The higher detection bias in males than in females (sub-study 2) could also suggest underuse of health services by males, but the difference was not statistically significant.
Finally, based on the fitted models for CRC incidence in sub-studies 1 and 2, population- wide CRC screening for Ma ̄ori and patients with diabetes, based on the incidence, instead of age alone, would be proposed to start at age 57.5 years if the screening in the general population starts at age 60 years.

text: Epidemiological evidence that can help to improve timely diagnosis of colorectal cancer in New Zealand. Incidence rates of colorectal cancer (CRC) in New Zealand (NZ) are among the highest in the world. The long-term survival rates in NZ are poor, which has partially been attributed to late diagnosis. Considering that CRC is a curable disease if diagnosed early, conducting research targeted at the improvement of early diagnosis is therefore important. This thesis provides statistical models for the calculation of CRC incidence rates in the entire NZ population and population strata defined by age, gender, ethnicity and diabetes status, and a model for CRC risk in individual patients referred to the secondary care. The models presented here could assist health professionals in the selection of patients for further investigation to facilitate earlier diagnosis. The empirical part consists of three independent observational studies, briefly described below.

Sub-study 1. The objectives were, first, to describe trends in CRC incidence in the NZ population and, second, to investigate whether there are any strata defined by gender and ethnicity with especially increased incidence rates of CRC. To address these objectives, I analysed data from the New Zealand Cancer Registry (years 1994–2018) using an age- period-cohort (APC) model. The overall CRC incidence rates in NZ decreased between 1994 and 2018 by an average of 1.31% per year. However, the decrease was observed only in patients 50 years and older. In those 30-<50 years old, the incidence rates increased between 1994 and 2018 regardless of gender and ethnicity. The increase was similar for proximal, distal and rectal cancers. The APC analyses revealed very strong cohort effects that could explain nearly the entire trends in CRC incidence, pointing out generations born in the 1970s and 80s being affected by the increased incidence rates, rather than individuals 30-<50 years old. The cohort effects were different in Ma ̄ori and non-Ma ̄ori populations. In non-Ma ̄ori born between approximately 1939 and 1955, incidence rates decreased sharply. By contrast, those Ma ̄ori generations have not benefitted from the sharp decrease in rates. However, CRC incidence increased substantially in both M ̄aori and non-M ̄aori groups born in the 1970s and 80s.

Sub-study 2. The objective was to estimate the IRR for CRC in patients with diabetes compared to those without diabetes, with relation to diabetes duration and use of insulin for diabetes control. Registration in the Virtual Diabetes Register (VDR) in the years 2014–2018 was used as a marker of a diabetes diagnosis. Tables with counts of the entire NZ population stratified by age, gender, and ethnicity were obtained from Statistics NZ. In total, data from 310,710 patients with diabetes, corresponding to 1,277,284 person- years and 2512 incident CRC cases were analysed using a Poisson regression model. Diabetes was associated with an overall increased CRC incidence of 13% compared to non-diabetes [IRR=1.13 (95% CI: 1.08, 1.18)]. The IRR was especially high in the first three months after diabetes diagnosis [IRR=2.55 (95% CI 2.02, 3.21)], likely due to detection bias. The association was equally strong in males and females. However, in the analysis by ethnicity, the incidence of CRC was increased only in non-Ma ̄ori patients and restricted only to those younger than 75 years.

Sub-study 3. The objective was to develop a predictive model for CRC risk in individual patients referred to secondary care. To develop such a model, I extracted information from free text included in e-referrals from GPs’ to the Gastroenterology and General Surgery departments in the Waikato Hospital from 2015-2018, including: symptoms; test results; and family history of CRC. The reference test was a full colonoscopy with visualisation of the cecum. Data from 3015 patients, 20-<90 years old were analysed using a logistic regression model. The final model included the following predictors associated with increased CRC risk: anaemia, rectal bleeding, palpable mass in abdomen or rectum, weight loss, age and gender, and a decreased CRC risk: family history of CRC, abdominal pain, and inflammatory bowel disease. The model discriminates patients with low CRC risk well. According to the final cross-validated model, around 20% of patients from our cohort had performed colonoscopy despite a very low CRC risk (less than 1.5%).

In conclusion, the APC analysis revealed an alarming pattern. According to the fitted APC model, the combination of increasing age and cohort effect in generations born in the 1970s and 80s will bring a wave of CRC diagnoses in the near future when the young generations with high CRC incidence rates will replace the old generations with low CRC incidence. The results from this study could therefore help policy-makers to plan the needs for gastroenterology services.
Secondly, CRC incidence rates in diabetes have been found to be slightly increased com- pared to non-diabetes but only in non-Ma ̄ori individuals younger than 75 years.
Third, the results suggest that males underutilise health services. As shown in sub- study 3, males underwent fewer colonoscopies than females, despite having a higher risk of CRC. The higher detection bias in males than in females (sub-study 2) could also suggest underuse of health services by males, but the difference was not statistically significant.
Finally, based on the fitted models for CRC incidence in sub-studies 1 and 2, population- wide CRC screening for Ma ̄ori and patients with diabetes, based on the incidence, instead of age alone, would be proposed to start at age 57.5 years if the screening in the general population starts at age 60 years.

year: 2021