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The PHA - an informed, collaborative and strong advocate for public health.

Health Topics

The PHA is actively involved in influencing public health policy in a number of areas. We do this by providing information, including submissions; encouraging research and discussion; and formulating positions and strategies towards sensible and effective public policy.

Access for people with different abilities

Disability is an important health issue for a significant sector of the New Zealand population. One out of every five New Zealanders reports having a disability resulting in some functional and/or role limitation. The impact of a disability extends well beyond the individual to their whānau/family and all those they come into contact with.

For further information, see the PHA's policy on access for people with different abilities ( 21Kb).

Alcohol

Each year alcohol-related problems cause nearly 800 deaths and drain over $16 billion from the economy. Government gathers over $400 million a year in alcohol excise taxes, and spends a small part of this on reducing alcohol problems.

For further information, see the PHA's policy on alcohol ( 36Kb).

Breastfeeding

Ministry of Health breastfeeding targets set for 2000 (to increase full breastfeeding at three months to 75 percent and to increase full or partial breastfeeding at six months to 70 percent) have not been met. Breastfeeding rates in New Zealand have remained static for some years, while there is a noticeable decline in breastfeeding rates from the time of discharge from hospital to breastfeeding rates at six weeks.

Increased breastfeeding rates could contribute to the following priority population health objectives of the New Zealand Health Strategy: improving nutrition; reducing obesity; reducing the incidence and impact of cancer; reducing the incidence and impact of cardiovascular disease; reducing the impact and incidence of diabetes; and improving oral health.

For further information, see the PHA's policy on breastfeeding ( 24Kb).

See also: World Breastfeeding Week 2008.

Climate change

Current patterns of carbon dioxide emissions by developed nations such as New Zealand are completely unsustainable. There is a potential risk of severe ecosystem disruption as the planet warms. Some Pacific countries, such as Kiribati and Tuvalu, are especially vulnerable to rising sea levels and to weather extremes.

For further information, see the PHA's policies on climate change ( 39Kb) and transport ( 54Kb).

Decriminalisation of prostitution

For further information, see the PHA's policy on the decriminalisation of prostitution ( 25Kb).

Direct-to-consumer advertising

The promotion of prescription medicines is generally seen as raising special ethical and regulatory difficulties such that DTCA is banned in all developed countries - except the United States and New Zealand - and promotion practices to health professionals are closely monitored. The introduction of a much more liberal interpretation of the existing legislation on the promotion of medicines in New Zealand has been accompanied by a striking increase in advertising activity in the principal media.

The body established to oversee this regime - the Advertising Standards Authority - has a predominantly commercial brief rather than a public health one. A Medsafe report shows almost complete failure of the regime to protect the quality of information of medicines advertising.

For further information, see the PHA's policy on direct to consumer advertising ( 13Kb).

Fluoridation of water

The lifetime benefit from drinking fluoridated water is estimated to be the prevention of 2.4 to 12.0 decayed, missing or filled teeth per person. Water fluoridation contributes to equity of health outcomes as the benefit of dental caries prevention is greater for people in lower socio-economic groups, Māori and children.

A New Zealand survey showed that fluoridation protected 5-year-olds in lower socio-economic groups (SES groups 4-6) from more decay than it did for those in higher socio-economic groups (SES groups 1-2).

Recent information has shown that water fluoridation is effective throughout a person's life time, preventing root caries in adults and older people, so that fluoride can be seen to be of benefit to anyone with their natural teeth, not just children.

For further information, see the PHA's policy on fluoridation of water ( 22Kb).

Food and nutrition

A balanced diet is essential for good health. Poor nutrition is a major source of ill health and death, and a cause of health inequalities. The PHA believes Government should develop integrated agriculture, food, marketing and transport policies.

Health food needs to be affordable for everyone. Health agencies should develop a specific Treaty-based food and nutrition policy for Māori.

For further information, see the PHA's policy on food and nutrition ( 21 Kb).

Gun control

Firearms have an important and legitimate role in New Zealand society. However there are significant risks associated with their misuse. There are on average 80 deaths and 65 hospital admissions each year as a result of intentional and unintentional use of firearms in New Zealand. The majority of those killed or injured by firearms are men aged 15-24 years. Over half the reported 'serious assaults' with firearms in 1996 were in the family violence category, indicating the impact of firearms on people in the home.

Māori rates of hospitalisation for firearm-related injuries are twice those of non-Māori. Death rates for non Māori are slightly higher than those for Māori.

For further information, see the PHA's policy on gun control ( 24Kb).

Health impact assessment

Health impact assessment is a formal approach used to predict the potential health effects of a policy, with particular attention paid to impacts on health inequalities. It is applied during the policy development process in order to facilitate better policy-making that is based on evidence, focused on outcomes and includes input from a range of sectors.

The Public Health Advisory Committee's Guide to Health Impact Assessment ( 1.1Mb) is for use - largely but not exclusively - by policy-makers in sectors other than health. Those likely to be affected by policy may also use it.

Inequalities

Social and economic factors have a fundamental impact on health. Key social and economic determinants of health inequalities include: income, education, employment, occupation, housing and racism. All central and local government policies should have reducing health inequalities as an objective. Inequalities should be monitored regularly at national and regional levels.

Central and local government policies should promote housing options for families that reduce the incidence of overcrowding. They should aim to better align state housing stock with areas of high deprivation.

Addressing health inequalities is one of the key directions in the PHA's Strategic Plan 2004-2009 ( 30Kb).

See also:

• the PHA's policy on inequalities ( 23Kb)
• The Health Equity Assessment Tool: A User’s Guide ( 355Kb).

International health

The New Zealand Government and people should actively work with United Nations and the World Health Organization to achieve the Millennium Development Goals. Government development assistance should increase to at least 0.7 percent of GDP, and New Zealand assistance should focus more strongly upon the Pacific and South East Asia, and less on other parts of the globe.

Health assistance should focus on primary prevention and primary care, supported by assistance for local capacity development. New Zealand should regulate or eliminate the export of hazardous products to developing countries (e.g. tobacco products and fatty meat products). Health worker training and organisational capacity-building programmes should be supported to maintain in-country capacity and capability.

For further information, see the PHA's policy on international health ( 26Kb).

Māori health

Advocating public health policy for Māori is one of the key planks of the PHA's strategic plan. As a group, Māori have higher health needs and the PHA affirms the importance of a specific focus on Māori, both in health services, as well as in other areas that affect health such as housing and education.

The PHA has a Māori Caucus which is represented by three members on the PHA's Executive Council.

Effective public health policy for Māori

The Public Health Association has, within its rules and regulations an intention to carry out its mandate "in the spirit of the Treaty of Waitangi." This document is a checklist for the PHA's development of policy, as well as policy implementation and evaluation.

This checklist, developed by the Māori Caucus, is to be used in the development of policy within the PHA. It is also to be used by the PHA when considering policy developed by other agencies.

The checklist is built on a framework recommended by Cunningham and Taite. It covers both the policy itself, and the process for developing policy.

Effective health policy should:

• support health gains for Māori (policy outcomes)
• be responsive to Māori needs and expectations (policy outcomes and policy development process)
• be analytically sound (policy development process).

Click here to view the full checklist ( 142Kb).

Key documents

• Treaty of Waitangi
• Ottawa Charter ( 18Kb)
• Te Pae Mahutonga ( 28Kb)

Nuclear disarmament

New Zealand has made a large contribution to international nuclear disarmament efforts in the past three decades. It mounted substantial opposition to French nuclear testing, promoted a South Pacific nuclear-free zone, enacted a national nuclear-weapon-free zone in legislation, and contributed to getting nuclear weapons declared to be generally illegal by the International Court of Justice. More recently the New Zealand Government has been active with other 'new agenda' countries in the promotion of a convention on the elimination of nuclear weapons (a model convention has been drafted).

For further information, see the PHA's policy on nuclear disarmament ( 34Kb).

Physical activity

For further information, see the PHA's policy on physical activity ( 21Kb).

Taxation and health

For further information, see the PHA's policy on taxation and health ( 137Kb).

Tobacco control

Tobacco smoking is the single largest cause of preventable death and disease in New Zealand and causes more than 4,700 avoidable deaths each year. It has been estimated that 80,000 tobacco-related deaths will occur in New Zealand over the next 20 years if nothing more is done.

Smoking rates among Māori and Pacific people are greater than in the population in general with one in two Māori smoking and one in three Pacific people smoking compared with one in four of the general population. One in three Māori deaths are attributable to smoking.

For further information, see the PHA's policy on tobacco control ( 17Kb).

Transport

Governments should promote public transport, walking and cycling, as these forms of transport offer greater gains for health than reliance on transport via private motor vehicles. Use of private motor vehicles can be reduced by user charges, car sharing and limiting urban sprawl.

Health damage from motor vehicles could be reduced by control measures aimed at reducing exhaust emissions. Health organisations should develop and promote information on the health impact of transport systems.

For further information, see the PHA's policy on transport ( 54Kb).

Designing healthy communities

Here is a PowerPoint from a seminar by Billie Giles-Corti from the Centre for the Built Environment and Health on "How can we make communities healthy by design?"
( 1.6Mb).

Violence

All violence is unacceptable. This policy addresses violence in the family/whanau. Family/whanau violence is a significant public health issue with far reaching health implications. Family/whanau violence involves an unequal distribution of power and the use of this power as a means of dominating and controlling.

It includes:

• partner abuse
• child abuse/neglect
• adult abuse/neglect (abuse/neglect of older people, people with disabilities or of parents by their children)
• sibling abuse.

For further information, see the PHA's policy on violence ( 45Kb).

See also:

• Learning Our Way Forward; Implementation of New Zealand's Family Violence Strategies March 2008 ( 1.3Mb)