PHA NEWS ONLINE - 13 March 2007

Vol X, No 1

PHA conference - closing date for abstracts extended

The deadline for abstracts for the PHA conference has been extended to Sunday 18 March. The conference this year will be held at the University of Auckland's School of Population Health (Tamaki Campus), from 4 to 6 July.

Day One will focus on Food and Nutrition and its impact on health outcomes. Day Two, Voices, aims to give space for a diversity of groups and populations, and encourage public health practitioners to debate how to integrate these new perspectives into their work. Day Three, entitled Urban Design, is concerned with just that: planning and designing cities that are healthy environments for populations.

A number of abstract categories have been developed. They are kaupapa Māori; systems and structures; workforce; inequalities; determinants of health and globalisation. These categories are guidelines not rules. Once you are clear which of the three days is your topic area, use the categories to help you think more specifically about what you want to communicate and explore. To submit an abstract online visit www.pha.org.nz.

We'd love to see you at the conference

Whether or not you're submitting an abstract, why not join us at our national conference in Auckland this July?

It's the only conference in New Zealand that focuses specifically on all of public health and the only public health conference. It's a 'must attend' for anyone who works in, or has an interest, in public health. The 2007 conference will have something for everyone including those who work in strategic management roles, researchers and academics, service providers, advocacy organisations, government and non-government organisations, District Health Boards, public health services, community workers, local and central government policy analysts and planners, and environmental health policy analysts and planners.

For further information visit www.pha.org.nz.

Food for thought: Planning a social marketing approach to improving nutrition

A social marketing campaign will bring a new focus to the public health nutrition sector this year. The Health Sponsorship Council (HSC), known for its Smokefree, Auahi Kore and SunSmart social marketing programmes, is set to launch the new programme in May.

The Healthy Eating programme will begin by targeting parents and caregivers, particularly in Māori, Pacific and lower socio-economic status households, with information about accessible, affordable and easy ways to provide healthy diets for children.

"Parents and caregivers are the best place to start," says Michelle Mako, Healthy Eating Programme Manager. "Evidence shows that parents have good control over their children's diets earlier in life, but as children get older parents and caregivers need new strategies to continue to influence their children's diets in a positive way."

The focus on children is consistent with the priority audiences for the Healthy Eating - Healthy Action (HEHA) strategy. The development of the programme is being informed by international social marketing evidence and key experts and stakeholders in this area.

The first major activity for the programme is the launch of a media campaign which will spotlight the issue and provide practical tips to help parents.

"We understand there are many barriers and challenges facing families and communities, making it hard to achieve healthy diets. But we believe that by affirming and supporting parents and caregivers, having a healthy diet can be made practical and do-able."

The advertising is just one part of a broader social marketing approach to improving nutrition. "The media campaign is by no means the only way we will be working to influence nutrition and eating behaviours. We understand that improving nutrition practices is a complex, multi-faceted challenge, and any real change will be the result of a long-term, comprehensive approach involving many people and organisations."

The HSC is working to ensure the programme supports other public health nutrition organisations and providers, and that it provides useful and complementary tools to work towards shared health goals. "Working with the sector is a key focus. We've been working hard to connect with our colleagues across public health nutrition so we can explore together how the programme will work for all of us."

The HSC has been contracted by the Ministry of Health to deliver the programme as part of the Government's HEHA strategy.

For further information about the Healthy Eating programme contact Michelle Mako at michelle@hsc.org.nz or Anna Passera at anna@hsc.org.nz.

Table of key dates

Introducing... our new website!

After nearly 12 months of analysis, development and user testing, we're delighted to introduce the new PHA website.

An analysis of the old site suggested it was structured in a non-intuitive way, which made things difficult to find; contained out-of-date information; was unappealing to look at; and had a large number of broken links.

This was backed up by the site statistics, which showed a low volume of traffic (only 30 or so New Zealand visits a day), a high loss of people from the home page, and relatively few repeat visits to the site.

A new site structure and content were developed, with a focus on making the most frequently sought information the easiest to find. User testing was then undertaken, with five testers observed individually, one-on-one. Further amendments were made to the site to incorporate the user-testing results.

We now have a site that structures information in a more intuitive, user-friendly fashion. The PHA branding has been updated and modernised, and new features like a document archive and a feedback form have been introduced. The feedback form in particular will provide visitors with an opportunity to provide comments on website content.

We're confident the new-look website is user-friendly, informative and interesting to both regular and first time site visitors. And of course it was all done on the smell of an oily rag. Enjoy! - www.pha.org.nz

Cycling: a love story

Another Bike Wise Week has been and gone, and more and more New Zealanders are leaving the car behind and biking it instead. Here's one cyclist's story...

I may as well admit it. I'm in love.

It all started innocently enough. There I was, on a Sunday afternoon stroll, when she caught my eye through a shop window. She was sleek and shapely, and I knew right away she'd be good for me and that we'd be inseparable.

I told myself I wasn't ready for commitment, that I was just window shopping. But it was no good. It was love at first sight. I saw her, wanted her, had to have her.

Her name is Betsy. Or maybe Big Sue. I haven't really decided. When we're cruising through the city streets in the morning she definitely feels like a Betsy. But when I'm cranking up a hill, she's more of a Big Sue.

I know there are a lot of people out there who don't share the same special bond with their bike. Many cyclists don't even give their rides a name. But me, I love my bike. We now cruise into work together each day, me with a beaming smile, and her with gleaming rims. We whiz by the people stuck in their cars bored with listening to the radio, or slipping further into road rage. Now I get to work early, take a few victory laps around the block, then hop in the shower, refreshed and ready to tackle the day.

You don't need coffee in the morning when you cycle. Your blood is already pumping like gangbusters and your face is aglow from the wind and morning sun. It's all the energy supplement anyone could need. Just remember to have a good warm-down. You don't want to stand up for morning tea and pull a hamstring.

No more extortionist parking fees, no more complaining about parking tickets that clearly aren't my fault, and no more driving between petrol stations looking for the best price. The only reason I pay attention to petrol prices now is to gloat.

I do most of my own repairs, filling the garage with manly grunting even if I'm just "calibrating correct pneumatic air pressure" - that is, pumping up the tires. There's no weird mystery part on a bike that even mechanics don't fully understand. Everything is simple and fixable and a great excuse to get good and greasy.

I'm starting to feel optimistic about my carbon footprint too. I've stopped making excuses - now I'm making a difference. It feels good, and not just because I'm now friends with Ms Earth down there. Biking is great aerobic exercise that won't stress out your joints. Over the holidays cycling kept the flab (mostly) at bay, and I'm well into working off all those chocolates and mince pies.

I even find myself wishing there were more hills on the way to work, just so I could burn off a few more calories and enjoy a few more minutes worth of endorphins.

A bit of drizzle? Gusty northwesterlies? No problem, or at least that's what I tell my co-workers. "You biked? In this weather?" they marvel, and I dismiss it with a masculine chuckle. "This is nothing," I reply. "You should have seen the winter of 98."

I wasn't biking back in the winter of 98, but they don't know that, and it definitely was a bad year weather-wise. And if the weather really is terrible, you can always take a day off and hop on a bus.

So when I glide past the morning congestion, I give old Betsy (or Big Sue) a loving pat on the handlebars. If destiny hadn't thrown her my way, I would still be stuck in those lines of cars too, pumping out greenhouse gases, looking bored, feeling irritated, and making a fool out of myself singing along to the Stones.

Well, I still do that last one. But now more people get to hear me.

Thanks to HSC for permission to reproduce this story, supplied by Bike Wise and printed in the Otago Daily Times. The author wishes to remain anonymous for obvious reasons.

Māori health

Māori health advocate champions new training curriculum for Māori nurses

Nga Ngaru Hauora o Aotearoa (the National Māori Health Providers Association) was formed in 1997 from a small hui of providers who were concerned at the pace of change within the Māori health sector.

The vision of Nga Ngaru Hauora is to contribute to the improvement of Māori health and wellbeing through the development of:

• workforce development strategies/opportunities
• research
• policy
• networking.

The organisation ensures all its work is underpinned by the values, practices and institutions of Tangata Māori, Hapu and Iwi. "An important objective is to encourage networking and linkages across the sector," says Chief Executive Sharon Lambert.

A major focus over the last three years for Nga Ngaru has been the collaboration with the National Council of Māori Nurses and the development of a new nurse training curriculum.

The curriculum is currently moving through the New Zealand Qualifications Authority approval process. Sharon is optimistically anticipating the first intake of students mid 2007.

Te Whare Wananga o Awanuiarangi in Whakatane has been chosen as the training establishment to deliver the new curriculum called Te Ohanga Mataora Paetahi (Bachelor Health Sciences, Māori (Nursing)).

"The entire curriculum has been designed and developed within a Māori/indigenous framework which is evident throughout," explains Sharon. Students will be required to complete the paper 'Tikanga hauora me tona Reo' as well as the other compulsory clinical competencies.

The nursing profession has a history of incorporating cultural awareness and safety into its professional practice and training. This commitment has not translated into an increase in qualified Māori nurse practitioners however. Sharon reports the opposite has occurred over the past decade.

"Numbers of registered Māori nurses have continued to decline since the mid-90s."

Sharon says that Nga Ngaru wants to build the capacity of Māori health providers in the community who are interested in taking clinical placements from the nursing training, Te Ohanga Mataora Paetahi. Providers in the primary and community services will be targeted.

Sharon Lambert, Ngati Kahungunu ki te Wairoa, is the Chief Executive Officer of Nga Ngaru Hauora O Aotearoa.

IT and public health work together to benefit Māori

Like any sector, public health knows only too well about the importance of technology.

Arataki Communications Limited (ACL) describes itself as a "100 percent Kiwi owned Communications Technology Service", and has been doing some unique work with Māori health providers around the country.

ACL's recent work has included information and communications technology (ICT) capacity reviews for some 20 health providers under contract to Poutiri Charitable Trust, a Māori development organisation in the Bay of Plenty region.

Many of the service providers are rurally based and as Ngaire explains, "Rural communities often share similar ICT problems that their urban counterparts don't face, such as power cuts, additional costs and limited access to broadband."

Another example was a review of the current IT capacity of Ngai Te Ahi/Ngati He Hauora, a Poutiri Trust service provider located in Tauranga servicing their local Iwi and other parts of the community.

"They had the equipment, it just wasn't set up correctly and effectively. Staff were too busy doing their hands-on work with clients to have the time to figure it out. The problems have been resolved and staff have been taught how to manage it for themselves," says Ngaire.

Currently the government is seeking submissions for the Telecommunications Digital Strategy, Community Partnership Fund. In partnership with Poutiri Trust, ACL have submitted a proposal to create Community Technology Centres (CTCs).

Located in 14 of the 20 health provider buildings under the Poutiri Trust umbrella, the CTCs would be high-tech computer lab facilities allowing rural communities to utilise technology and online services. The CTCs would be used to deliver training and support in the use of technology and strengthen and inform the community's health and social networks.

Ngaire envisages "numerous possible applications such as video and audio conferencing services for people with disabilities or establishing local internet based radio stations".

"The key is to promote community use of the facility, through community ownership," she says.

"Meanwhile the health providers housing the centres benefit from the use of the high-tech facilities during their working hours - and they encourage the community to utilise their health services."

Health Impact Assessment publication launched

The Public Health Advisory Committee (PHAC) has released An idea whose time has come: New opportunities for Health Impact Assessment in New Zealand public policy and planning.

The document encourages central and local policy makers to consider the impact their activities have on people's health.

It is a companion document to the PHAC's 2005 publication A Guide to Health Impact Assessment: a policy tool for New Zealand. It is also related to the 2006 PHAC publication Health is everyone's business, which emphasises that effective action to improve health and reduce health inequalities will involve collaborative effort across sectors.

An idea whose time has come discusses what health impacts are, the benefits of health impact assessment (HIA), what the PHAC has learned from its work on HIA, describes some HIA case studies and considers what is needed to make HIA a routine part of policy-making in New Zealand.

Copies are on the National Health Committee's website: www.nhc.govt.nz/phac, or can be ordered from moh@wickliffe.co.nz.

Public Health Bill update

The Public Health Bill is intended to replace New Zealand's fragmented and outdated legislation for public health.

Present legislation is now more than 50 years old and is out of date, inflexible and has major gaps (for example, it does not provide general strategies for prevention and early detection of health and disability conditions). The 1956 Health Act is largely based on organisational arrangements that have long since been superseded and, in relation to border health, on assumptions about overseas travel that are outmoded.

A new bill would enable people at all levels of the health system - national, regional and local - to deliver public health services in response to key health issues with effective public health strategies. Such strategies range from surveillance of possible health risks, prevention, early detection, monitoring and management. Key health issues include communicable disease, environmental health, non-communicable diseases risk factors and health information, including registers. Underlying concepts are those of risk management and proportionality; and a central theme is ensuring that public health powers are exercised within a human rights framework. Border health protection has been brought into the 21st century.

The major causes of population ill-health at present, and the major drivers of health care expenditure, are those broadly categorised as non-communicable diseases, such as cardiovascular disease, diabetes, cancers, mental ill health and addictions. However, public health legislation has traditionally focused on communicable diseases and environmental health, for example, tuberculosis, drinking-water safety and sewerage. Although communicable diseases and environmental health issues remain significant, they are no longer the major causes of death in New Zealand (six percent of deaths in New Zealand today are due to communicable diseases).

Reducing the impact of non-communicable diseases in the population requires intervention at a number of levels, as well as co-ordinated efforts across key sectors and settings that can support outcomes, such as improved nutrition and physical activity. Legislation alone is not the answer but, as experience with tobacco control has shown, appropriate legislative provisions can be part of effective public health action in a way that also reduces inequalities.

It is proposed that the Bill include principles and provisions for making codes or guidelines to address non-communicable disease risk factors. The codes and guidelines would not bind affected parties, although compliance with at least the spirit of their provisions may be taken into account in some circumstances.

The Director-General will be able to make non-binding codes and guidelines to promote public health, for example, in relation to:

• exposure to, or access or use by, the public or specific groups to products and services relevant to non-communicable disease risk factors
• matters relevant to advertising, sponsorship or marketing (direct or indirect) of products and services with an impact on non-communicable disease risk factors
• the performance, composition, contents, additives, design and construction of goods, things or services or processes that impact on non-communicable disease risk factors.

The Public Health Bill is expected to be presented to Cabinet sometime between April and September this year before entering the Select Committee process.

Child wellbeing report shows NZ scoring badly on nearly everything

The Public Health Association is calling for action on child wellbeing in the wake of a new report which shows children here are worse off than their counterparts in many other industrialised countries.

The 7th report on the wellbeing of children and young people in the world's advanced economies shows New Zealand consistently scoring in the bottom third of countries on a number of measures including immunisation, spending time with our kids, teenage pregnancy, and having parents out of work.

The report by the UNICEF Innocenti Research Centre is worrying reading, with New Zealand lagging behind other economically poorer industrialised countries in some measures.

PHA Director Dr Gay Keating says it is therefore no surprise that we are in the bottom four for children surviving the first year of life, and the worst of all industrialised countries in keeping our children alive to adulthood.

"New Zealand ranks 24th out of 24 developed countries in the number of our children who die from accident and injury. We need a major rethink now to show that we value our children.

"This can be shown in a number of ways - government laws that shun physical punishment, a family-friendly culture from employers that includes flexible and child-friendly work hours, child-friendly environments in sports clubs, and a focus on effective parenting.

"We need early support for all parents of young children, which means funding effective parenting education and support systems universally - not just targeted to some segments of society. Intensive intervention services for families under pressure are essential, and these services should be available across the country."

Dr Keating says it is crucial children's health and wellbeing is prioritised now to prevent a knock-on effect in future generations. She says children who miss out now risk developing long-term physical and mental health issues.

"The health of our children is the responsibility of us all. Investing in our children now will reward us a thousand-fold in the future. If we ever needed a wake-up call, this report is it."

PHA welcomes the passing of Section 59 through second reading

The Public Health Association applauds the progress of the Green Party MP Sue Bradford's bill to repeal Section 59 of the Crimes Act. It passed its second reading vote on 21 February 70 votes to 51.

The aim of the Bill is to remove the defence of 'reasonable force' from Section 59 of the Crimes Act, which says 'Every parent or person in place of a parent of a child is justified in using force by way of correction towards a child if that force is reasonable in the circumstances.' The Green Party wants to remove the message that sends - that it is legitimate in some circumstances to beat children, when it is against the law to beat adults, including spouses, police and employees.

Under Section 59, it is up to a jury to decide if the force used is 'reasonable' in the circumstances. This was interpreted by a jury in Napier to mean it was reasonable for a father to hit his eight year old son eight times with a piece of wood 30cm by 2cm - leaving linear bruising visible for days. A jury in Hamilton considered it reasonable for a father to hit his 12 year old daughter with a piece of hosepipe, leaving a raised 15cm-long lump with red edges on the girl's back.

The PHA's director, Dr Gay Keating, says physical punishment is part of the 'violence continuum'. "Not only is there a risk of children being injured by mistake or on purpose, but of becoming aggressive themselves, developing a poor relationship with their parents, and becoming violent parents. It is far better not to hit at all and the law should reflect this fact by not excusing any assault.

"Research and child development tells us that positive parenting techniques work best in helping children learn how to behave well as they grow up. Smacking and hitting are far less effective. So parents can find themselves hitting more often and harder when mild physical discipline no longer works."

Dr Keating said removal of Section 59 would protect New Zealand's children from physical abuse, and send a strong message that violence should not be part of a child's upbringing.

"The Unicef report on child wellbeing which starkly describes New Zealand's poor - appalling even - record in caring for its young should be enough for thinking New Zealanders to support the repeal of Section 59. In itself, repeal would not transform New Zealand overnight, but it would be a step toward making the nation a safer place for its children."

The bill will be further debated in the House and we now wait to see what success the National Party MP Chester Borrows will have with his amendment. The amendment seeks to define 'reasonable force' and Sue Bradford says she will withdraw the bill rather than have it succeed with the Borrows' amendment.

There has never been a better time for PHA members to contact their local MP or list MP to reiterate their support for the Bill as it stands at present. To send an email to your local MP, use the following email address format:  firstname.lastname@parliament.govt.nz.  

National office roundup

Media

Since the last newsletter, three media statements have been released:

• Child wellbeing report shows New Zealand scoring badly, 14 February
• Child health must be priority, says PHA, 14 February
• Child maltreatment report 'wake up call' says PHA, 17 January.

An opinion-editorial from Gay Keating about the UNICEF report that showed New Zealand children rate badly in a number of child wellbeing indicators was published in the Dominion Post on 2 March.

A letter was sent to the Dominion Post, supporting news that three new drug treatment units for inmates will open over next two years.

We also worked with the Injury Prevention Network to comment on the UNICEF child wellbeing report.

PHA Director Gay Keating was quoted widely in the media on child health issues, including on TVOne News, Newstalk ZB, Radio NZ and Radio Live.

Internal communications

A considerable amount of time has been spent on the development of the new website; and the weekly PHA bulletin continues to be distributed.

Staff

Welcome to Jem Diedrichs who is the PHA's new office manager. She replaces Bella Bartley, who has been filling the office manager position temporarily since Noeline Holt left.

Round the branches

News from Te Taitokerau

Te Taitokerau is already busy planning for Conference 2008, which will be held in Waitangi. The theme for the conference is "Tapu and Noa: Physical? Environmental? Or both?" Lisa McNab says that the concepts of tapu and noa can be used as a risk management tool, and they are keen to use the conference to show how Māori thinking can be applied to the context of public health.

Apart from conference, the branch has started a recruitment drive. Branch members are busy visiting the managers of various organisations, explaining the benefits of PHA membership. They want to broaden local understanding of public health, and draw all Māori community workers into the public health whānau in Northland.

Public Health Champion 2007

Do you know someone who has made a special contribution to public health?

The PHA is currently calling for nominations for the public health champion award. The purpose of the award is to identify outstanding individuals, profile the issue or work of the individual, and raise the profile of the PHA.

The recipient will have made an outstanding contribution to public health in the past 12 months and may:

• be well known in a local public health community
• be a well known national public health figure
• have been regularly in the news on a major public health issue.

For further information, see the PHA website - www.pha.org.nz.

 Closing date for nominations is 31 May 2007.

Last year's Public Health Champion was Philippa Howden-Chapman.

JR McKenzie Trust applications invited

The PHA is pleased to announce the JR McKenzie Trust has offered limited funds for scholarships for people to attend the Public Health Association 2007 conference to be held in Auckland July 4-6.

The scholarships will cover:

• Full registration to conference
• Accommodation at $40 per night (any difference to be made up by scholar)
• One ticket to conference dinner (extra tickets at scholar's own cost)
• 60 percent travel at the lowest economy airfare or other (ie traveling by car or train), whichever is the lower amount
• One year's membership to PHANZ.

Please send your application by Friday 18 May 2007 in writing to PHA, P O Box 11-243, Wellington, fax 04 472-3059, email: pha@pha.org.nz (put the word "scholarship" in subject line). For further information, see the PHA website: www.pha.org.nz.

The PHA needs you!

Why not become a member of the Public Health Association of New Zealand?

The PHA is a non-party political voluntary association, providing a major forum for the exchange of information and stimulation of debate about public health in New Zealand.

Our more than 300 members take a leading part in promoting public health and influencing public policy through submissions, seminars, the annual conference and a communications and media strategy. We are a member of the World Federation of Public Health Associations.

In addition, our members who are from the health sector, government agencies and NGOs receive a newsletter and weekly bulletin, have access to research and reports and take part in local branch events.

For further information contact Jem at the PHA on office@pha.org.nz or phone 04-472-3060.

SHORE and Whariki Five Day Evaluation Course

	Centre for Social and Health Outcomes  Research and Evaluation and Whariki Research Group Massey University Auckland FIVE DAY EVALUATION COURSE For health promotion practitioners and those wanting to refresh and further develop their evaluation skills
Date: 16-20 April 2007 Time: Daily 9.30am - 4.00pm	Venue: Massey University, Albany Cost: $200

The five day programme includes a mix of theory, practical skill development and application to work-place situations. A broad range of evaluation issues that face public health and health promotion practitioners.

NB: The course is limited to people who have done some initial evaluation training or have project planning experience. Topics will be presented interactively using a team approach and utilising the practical experience of invited speakers. Topics covered include:

• Highlighting evaluation in context of Te Tiriti o Waitangi
• The practical, political, ethical, contextual and cultural issues of evaluation
• Expanding knowledge and understanding of types of evaluation and evaluation methodologies including programme logic models
• Developing realistic and appropriate health promotion programme evaluation plans
• Increasing practitioner skills in applying evaluation methods.

We hope the course will assist participants to form partnerships and networks with other practitioners.

Please register your interest by email or fax for a place on the course. Final confirmation and registration must be received by 5pm 10 April 2007.

Contact: Channel Lee, Course administrator for further information.
Email: c.j.lee@massey.ac.nz, Phone: 09 366 6136 Fax: 09 366 5149.

This course is funded by the Ministry of Health.