Improving vaccination coverage Turner has been involved in research into how the structures and organisation of general practice are associated with immunisation coverage in New Zealand. A 2010 paper, co-authored by Turner concluded that while practice immunisation coverage and timeliness did vary widely in New Zealand, "organisational and structural aspects of general practices are key determinants of general practice immunisation delivery". Turner co-authored an Immunisation Advisory Centre (IMAC) study in 2011 that assessed the effectiveness of the
cold chain management for delivery of childhood vaccines from national stores to delivery sites in New Zealand. In 2018, IMAC collated a synopsis of strategies used since the
1918 influenza pandemic to deal with unanswered questions about how to manage future
pandemics. The data indicated that the burden of the disease in 1918 in New Zealand was inequitably carried by vulnerable populations such as the
Maori,
Pacific Island and
Asian communities. In a related research project, Turner and
epidemiologists Nick Wilson and
Michael Baker presented data that showed the birth rate for Maori dropped disproportionately after the 2018 pandemic, confirming the importance of pregnant women being vaccinated against seasonal influenza to reduce the rate of
stillbirths. In a later discussion about this research, Turner reiterated the importance of protecting pregnant women from any infection, and if vaccines were in short supply, prioritising them for "access to antivirals and ventilators in hospital intensive care units if they get sick".
Advocacy for children In her role as spokesperson for Child Poverty Action Group, Turner commented in the media on the relationship between low income and poor child health, and in 2008 co-authored a research report which stated that poverty was causing "devastation" in the health sector, with data showing New Zealand children had "higher rates of preventable illness and deaths from injuries than children in almost any other OECD country". The report drew attention to the fact that Maori and Pasifika children were disproportionately affected by this. In 2012, Turner, as a member of the
Children's Commissioner Expert Advisory Group on Solutions to Child Poverty, contributed to a major report that explored how
child poverty in New Zealand could be reduced. Turner later said she was disappointed at the response by the New Zealand government and that they had only focussed on a few areas instead of taking a fully systemic approach to reducing child poverty. This report supported the findings in a previous paper, endorsed by the New Zealand Medical Association and co-authored by Turner, which contended that overcrowding, poor nutrition, exposure to tobacco and stress contributed to creating a social environment in which the population was vulnerable and likely to have less access to health care services. Commenting on a report released by The Asthma Foundation, Turner said it confirmed concerns that poverty and deprivation impacted greatly on respiratory disease in New Zealand children, and the underlying causes needed to be addressed to ensure that children and families had adequate income, good housing and easy access to health care. In 2015 after the Children's Commissioner released data showing that at the time, there were 305,000 children living in poverty in New Zealand – an increase of 45,000 from the previous year – Turner said that child poverty was now a national issue, not just for individual parents, and there appeared to be an unwillingness to resource a solution to the problem.
Closing equity gaps Turner co-authored a paper in 2019 summarising the findings of a
retrospective cohort study of New Zealand children (born 2006–2015), which identified that hospitalisation rates for infectious diseases since 1989 had increased disproportionately for Maori and Pacific children and those who were
socioeconomically most deprived, but that those children who received the
pneumococcal conjugate vaccine (PVC) between 2008 and 2014, were less likely to be hospitalized. The paper concludes that the use of PVC was associated with "reductions in ethnic and socioeconomic
disparities in hospitalization". Turner co-authored another report on a research study that showed
foreign-born migrant children living in New Zealand had an overall lower vaccination rate than NZ-born migrant and non-migrant children. It was acknowledged that there needed to be an improvement in the way such data were gathered, highlighting the importance of having "better national surveillance and migrant-specific data related to vaccination coverage to help uncover health inequities among children living in NZ and inform
immunisation policy and practice". A follow-up paper on this research highlighted that to get a better understanding of migrant health, data must be disaggregated to locate hidden trends, provide information about
subsets and make vulnerable groups more visible. Much of Turner's research and writing has been on the importance of people getting accurate information about immunisation, particularly to reassure parents that vaccines were safe. Turner has been actively involved in media discussions of vaccine safety including the
Meningococcal vaccine in 2004 and the
cervical cancer vaccine
Gardasil in 2009. Turner has highlighted the importance of building trust between the public and those delivering health programs, either government-funded, or at the level of general practice. She noted that the decision-making process for consent can be influenced by anti-vaccination views, but while making vaccinations mandatory would be helpful, there was a risk that some families might be less inclined to discuss their concerns openly, impacting engagement their with, and trust in, healthcare professionals. ==Commentary on COVID-19 in New Zealand==