PHA NEWS ONLINE - 3 March 2008

Vol XI, No 1

2008 conference preparations underway

Activity is building in the sunlit Bay of Islands for the annual Public Health Association (PHA) conference in July.

The Te Tai Tokerau (Northland) branch is hosting this year's conference at Waitangi's Copthorne Hotel from 2-4 July.

The theme of the conference is 'Tapu... Noa... Environmental, Physical or both'. Broadly translated, this refers to health and safety across social, cultural, political and physical environments. These finely-balanced concepts have been used by Māori for generations as a 'health code or system' which has practical applications for public health.

The four conference themes are:

• Te Ao Hurihuri: public health in the modern world
• Matauranga: filling your kete of knowledge
• Kaitiakitanga: our environment
• Manaakitanga: looking after yourself and each other.

It is significant that the 2008 conference is at Waitangi because Te Tiriti o Waitangi, the founding document of Aotearoa/New Zealand, is also a living document for public health practice.

Holding the conference at Waitangi will encourage us all to reflect upon the importance of Te Tiriti in our mahi and encourage us all to embrace its spirit and intention. The goal of the conference is Puta ki te whai ao, ki te ao marama. Participants will experience a journey of learning through reflection and personal commitment. We welcome you to be a part of this exciting journey of learning and exploration.

Mark 2-4 July 2008 in your diaries now! The PHA annual conference really is a must for anyone interested in the health of New Zealanders. It's also a great opportunity to network, share ideas and build skills.

Call for Public Health Champion 2008 nominations

Do you know someone who has made a special contribution to public health? Last year's champion was leading Māori health researcher Associate Professor Papaarangi Reid of Auckland University.

In commenting on her award, PHA National Executive Officer Gay Keating said, "Papaarangi has contributed immensely to making Māori health a national priority. Against the tide of popular opinion she has had the courage to look at the disparities between the health of Māori and non Māori. She is a strong scientific researcher. She has looked at the social determinants of health and the construction of ethnicity and indigeniety, which leads on to options for progressing equity."

The PHA is calling once again 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.

For more on the nomination process as well as information about past Public Health Champions, see the PHA website – http://www.pha.org.nz/phchampnomination.html. 

The closing date for nominations is 30 May.

PHA Executive Council

The PHA has recently welcomed a number of new council members. The full council is profiled below.

RICHARD EGAN
council president since 2007

Richard is a teaching fellow (health promotion) and a PhD candidate based in the Departments of General Practice and Preventive and Social Medicine, Dunedin School of Medicine. His PhD project is provisionally titled: Spiritual well-being concepts and practices in Aotearoa New Zealand palliative cancer care. Before working at the University, Richard spent five years at the Otago-Southland Public Health Unit. Richard is the chair of the Otago-Southland branch of the PHA and his main interest in public health lies in the area of health promotion, education, policy and spirituality.

MELANIE DALZIEL (Te Aupouri me Ngati Kuri)
Te Tai Tokerau, council member since 2005

Melanie is the general manager of a Māori health provider which delivers clinical, general practitioner and health promotion services to many areas, including to far north communities, giving her an understanding of the challenges presented by delivering health services to isolated, rural and low socio economic regions. A particular focus of Melanie's is in professional development and she recently graduated from Auckland University with a Post Graduate Diploma in Business (Māori Development). She is the mother of a five-year-old daughter.

SARAH HELM (Tuhahuriri, Kai Tahu)
Wellington, council member since 2007

Sarah is national executive officer of New Zealand Aotearoa Adolescent Health and Development (NZAAHD). She has worked in sexual health, trade unions, beneficiary rights and student unions. She believes that a hauora or wellness approach to public health would greatly improve the health of our diverse populations. Reducing inequalities is also a passion. Sarah is studying towards her Master's in Health Service Management, has a Certificate in Health Promotion, a Graduate Diploma in Journalism, and a Bachelor of Arts. She lives with her civilly united partner in Paekakariki.

LISA McNAB (Te Paatu, Ngati Kahu, Te Rarawa)
council member since 2005, Māori Caucus

Lisa is the chair of Te Tai Tokerau (Northland) branch of the PHA and the Māori Caucus representative with the Obesity Action Coalition. She is the manager of the health promotion team at Te Hauora o te Hiku o te Ika, Kaitaia and is currently very busy making plans for the 2008 PHA conference to be held in Waitangi in July! Lisa's particular interest in public health centres on Māori participation at all levels, hapu and whānau development and making public health everyone's business and responsibility.

CHARLOTTE PAUL
Otago-Southland, council member since 2007

Charlotte Paul is a professor with the Department of Preventive and Social Medicine at the University of Otago in Dunedin. She has conducted research on HIV/AIDS, women's cancers, contraceptive safety and screening and has published widely on these topics, as well as on research ethics and social inequalities. Her recent main areas of interest in public health have been the epidemiology of sexually transmitted infections and sexual behaviour and cervical cancer. She is involved in new projects on socioeconomic inequalities and disability and on monitoring the safety of medicines.

DEBBIE PETERSEN
Waikato, council member since 2007

Debbie has been involved in health most of her working life, and for the past 11 years, in public health, mainly in health promotion. She worked for the Waikato District Health Board, where she held a number of positions ranging from flax roots delivery through to workforce development coordinator and lastly health promotion advisor for Primary Health Organisations. In 2006 Debbie started her own community development consultancy business – offering services such as project scoping, evaluation, facilitation, coaching and mentoring. Debbie believes the most pressing issue in public health today is inequalities between groups.

PETER THOMAS (Te Rarawa me Ngapuhi)
Māori Caucus, council member since 2007

Peter is a senior health promotion advisor/policy analyst with the Māori health provider, Hapai te Hauora Tapui in Auckland. He has a particular interest in Māori public health and Māori health development. He has served on national governance and national advisory committees with a particular focus on Māori health inequalities and disparities. He has been a member of the PHA for a year and believes one of the most pressing public health issues today is the level of alcohol and drugs in some Māori communities.

JOHN WALDON (Ngai Tuhoe – Ngati Koura, Ngati Manawa me Te Urewera – Kahangunu, Ngati Porou)
Central Districts, council member since 2005

John is a research officer in the Research Centre for Māori Health and Development at Massey University. He began his research career in health in 1988 as laboratory manager of the Hepatitis Foundation before starting in his present position at Massey University in 1994. He has been a member of the PHA since 1995 serving as branch chair, vice president and on the Executive Council. John's research interests are centred on child health, he has a MPH (Otago) and is about to complete his PhD in child health self assessment.

VIVIEN DALY
Canterbury, council member since 2006

Vivien is the manager of population health at Pegasus Health in Christchurch – a collective of 96 general practices. She has been a member of the PHA for 12 years holding the positions of secretary and chair of the Canterbury branch over many years. She has a long term interest in health promotion, coordinating and then managing a community group which was active in alcohol health promotion and tobacco control over 11 years. She also spent time researching adolescent sexual health at the Christchurch School of Medicine. She is currently particularly interested in the potential of the area where health promotion meets primary care.

SITALEKI FINAU
council member since 2006 – Pacific branch representative

Professor Sitaleki 'Ata'ata Finau was schooled in Tonga and New Zealand and trained in medicine at the University of Queensland. He has a long and varied career in clinical medicine, public health, community health, epidemiology and research in Australia, New Zealand, Tonga, Fiji and Hawai'i. He was Senior Lecturer Pacific Health and co-director of the Pacific Health Research Centre at Auckland University – Faculty of Health Medicine. He was Professor of Public Health at the Fiji School of Medicine in Suva for five years before becoming the first Director for Pasifika at Massey University. He is also the Director of Health in Niue.

KATHRINE CLARK (Ngapuhi me Ngati Kahu)
Auckland, council member since 2005

Kathrine is the chief executive officer of the health provider Hapai te Hauora Tapui. She is currently doing a Masters in Health Science, with Auckland University, focusing on public health, and has a Post Graduate Diploma in Health Management and has completed Post Graduate papers in Evaluation. She has a long history of working with Māori communities and in health promotion and community development. Among her many roles in health Kathrine is also chair of the Auckland branch of the PHA.

GABRIELLE BAKER (Nga Puhi)
Māori Caucus, council member since 2005

Gabrielle is the acting Māori health policy manager at the Ministry of Health. She joined the Māori Health Directorate in 2005 as a senior policy analyst after working in other parts of the Ministry of Health, most significantly on the review of the Health Act 1956 and the Health (National Cervical Screening Programme) Amendment Act. She has a Bachelor of Laws, Bachelor of Arts and a Post Graduate Diploma in Public Health.

At the 2007 AGM, the Asian members of the PHA asked for an Asian representative on council. The PHA Executive Council agreed to this request and a remit at the 2008 AGM will ask for a change to the constitution ("rules") to enable an Asian Caucus representative on council. In the meantime, the PHA Asian members have asked Norberto Ricacho to represent their interests.

NORBERTO RICACHO
Asian Caucus, Co-opted

Norberto is a lecturer in Health Science and Microbiology at Unitec NZ and formerly worked for ESR. He is the Convenor for the NZ Microbiological Society Special Interest Group in Public Health centred on food, water and foodborne diseases. His membership with PHA started when he was granted a JR McKenzie Scholarship for the 2006 PHA conference. He co-presented a paper for the Asian Network at last year's conference. He obtained a Postgraduate Certificate in Effective Practice (Evidence-Based Medicine) from the University of Auckland in 2000.

Read more about Norberto below.

The Māori Caucus, in the interests of succession and continuity, have identified the following two PHA members as people they would like to become Māori Caucus representatives in the future. They attend council meetings as observers.

MANAIA PAKI KING (Waikato, Ngati Haua, Ngati Koroki Kahu Kura)
Māori Caucus, Observer

Manaia is a lawyer, a portfolio manager in the Public Health Operations Team and the Māori public health issues leader with the Ministry of Health. He believes the most important issue facing public health officials today is their ongoing ability to be able to implement public health interventions which protect not only the health status of people but also their cultural values, practices and norms. Manaia is about to complete his Post Graduate Diploma in Public Health and will commence his PhD studies in the area of public health law later in 2008 through the University of Auckland.

CAROL WRATHALL (Te Atiawa Manukorihi Hapu)
Māori Caucus, Observer

Carol is the kaiwhakahaere, national Māori manager for the Injury Prevention Network of Aotearoa New Zealand (IPNANZ). She supports the Māori membership of IPNANZ and is involved in advocacy, priority injury issues for Māori, workforce development and advises at national level on a range of priority injury areas. Carol is a board member of WEAV (Wellington Ending Abuse and Violence) and a trustee for Te Whare Rokiroki, Wellington Māori Women's Refuge. Carol's particular interest in public health is centred around Hauora Māori, specifically the way that the burden of injury, minimal or nil rehabilitation and the lack of access to appropriate health services can reduce positive outcomes for Māori.

The next council meeting is Friday 14 March at 9am at the Health Sponsorship Council, 120 Featherston Street, Wellington. Any member of the PHA is welcome to attend.

Welcome to Norberto Ricacho

Norberto was brought up in the Philippines and attended the University of the Philippines hoping to join the medical profession. The medical training was very closely aligned to public health practice so when he was two years into a Master of Science in Medical Microbiology, the College of Public Health asked him to join its faculty staff and he left medical training for good to begin lecturing on public health.

Half way through his Master of Science at the university he was granted a scholarship to the University of Sydney's School of Public Health and Tropical Medicine where he graduated, having majored in microbiology, before returning to the University of the Philippines to continue being a lecturer.

In 1992, he travelled to Dubai where he headed the Public Health Microbiology Department for four years. During those years his wife and three young children remained in Manila so he applied for the whole family to migrate to New Zealand.

"I had an acquaintances who had come to New Zealand and they told me it was a very nice place," he says.

Arriving in Aotearoa in 1996, Norberto was disappointed that it took him a long time, given his qualifications, to find a job, but finally he secured a three-month contract as a microbiologist with an Auckland laboratory. This opened doors for him and in 1997 he joined ESR. In 2000 he moved to Unitec's School of Health Sciences where he continues to lecture today in Microbiology and Bioscience.

Norberto has been active in the Filipino migrant community in Auckland for many years and feels that it's one of the reasons he was considered for the Asian Caucus representative on the PHA Executive Council.

For his part, Norberto was keen to join the council because he says the Asian community has yet to become proactive about its health. "Much can still be done to harness the potential in the Asian community so that they can make a concerted effort towards improving and raising their own health standards. My membership of the PHA council gives me the opportunity to bring up important issues with the PHA about Asian health, to keep it in front of an influential lobby group," he says.

Norberto believes one of the greatest issues that will soon confront the Asian community is the ageing of its people. "Right now, most of our elderly are looked after by their children, but I can see that as our community becomes more 'kiwinised' this may stop and there are few rest homes that would be culturally sensitive to our elderly people."

He also says mental health is a big issue for New Zealand Asians – particularly migrants. "It is very hard coming to a new country. It is hard to find employment and people are often separated from their families back home. We need to be putting more resources into this area."

Norberto also acts as the Convenor for the NZ Microbiological Society's Special Interest Group in Public Health Microbiology and as a Board Member of the NZ Association for Food Protection.

NSU Screening Symposium 2008

14-15 April, Te Papa Tongarewa, Museum of New Zealand, Wellington

Get screened and live forever?

A forum to explore the opportunities, challenges, benefits and harms of screening.

How much can screening achieve? Are we heading in the right direction and where do we draw the line? The 2008 Screening Symposium will pose these questions, challenge people to think about what screening can and cannot achieve, and create a forum for debate and discussion.

Reducing inequalities is a primary focus for the National Screening Unit and it is the intention of the NSU conference organisers to have the reduction in inequalities reflected across all symposium sessions.

The symposium is a 'must attend' for anyone who works in screening or in an area affected by screening, or who has an interest in the issue.

Registrations are welcomed as the NSU looks forward to delivering a full and challenging programme in April 2008.

Visit http://www.nsu.govt.nz/2468.asp.

Peter Crampton takes up role as Dean

In early February, Professor Peter Crampton, a long time PHA member, took up his new role as Dean and Head of Campus at the University of Otago, Wellington.

Peter started his career in general practice and become involved in public health and policy from early on. His PhD, awarded in 2001, concentrated on the role of the non-profit sector in providing primary health care services to vulnerable populations. In 2002/2003, he spent 12 months at Johns Hopkins University, Baltimore, Maryland, after being awarded a Harkness Fellowship in Health Policy.

Peter has worked in Otago's Department of Public Health in Wellington since 1996 and was appointed professor and head in 2004. His current research is focused on social indicators and social epidemiology, health care policy, and primary health care organisation and funding.

Vice-Chancellor Professor David Skegg says that Professor Crampton will be an ideal person to lead the University's Wellington campus.

"As an experienced member of Otago's Wellington campus, an excellent researcher and a first-rate teacher, Professor Crampton brings many valuable skills and qualities to the position. His leadership ability has been recognised for some time and I am looking forward to the contributions he will make to the University in this new role."

Call for action to address growing Asian health disparities in New Zealand

by Dr Kawshi De Silva, Chairperson, Asian Health Foundation of New Zealand

Health inequalities are growing between New Zealand's Asian population – the third largest and fastest growing ethnic group – and other groups. Nearly 77 percent of New Zealand Asians are migrants who have lived here less than ten years. Evidence shows the health of these migrants has become worse since migrating here. As New Zealand citizens the rights of Asian people have not been fulfilled and we believe it is time for the government to support and commit resources to the monitoring of the health of all population groups in New Zealand.

Asian health issues include:

• the high risk of cardiovascular disease amongst south Asians who are three times more at risk of developing heart disease than Europeans
• the low rate of cervical screening of Asian women, particularly in Auckland where the rates are lower than for Pacific women. Research indicates that Asian women also present later for breast cancer detection and therefore have a poorer prognosis
• the growing Chinese sex industry in the Auckland region where Chinese women present at clinics with higher rates of chlamydia and HPV than women of other ethnic groups. There is increasing concern that HIV could become a major issue for the community
• the poor understanding of sexuality and contraception which is reflected in the high rates of termination of pregnancy for Asian women. Sexual and physical abuse is also increasing with limited services available to support those at risk.

Other concerns include mental health issues, problem gambling, diabetes, obesity, physical inactivity and poor access to health services.

There are only a few government policies which have identified Asian health as a priority. We are particularly disappointed that the Ministry of Health's Health Targets and Moving Towards Healthier Futures has not identified the future needs of the Asian population.

The Government needs to commit to adopting a strategy for New Zealand Asians which will include a comprehensive health needs assessment and the development and implementation of culturally appropriate strategies and approaches. This strategy needs to be linked to existing central strategies and policies. We believe this will give the necessary impetus to those District Health Boards with significant Asian populations to plan appropriate services and allocate funding toward Asian health needs.

The capacity of the current workforce needs to be built to deliver effective and culturally appropriate services to the Asian population. There is a gap in the understanding by the health sector of the values and attitudes of Asian people towards health and a lack of infrastructure to deliver culturally suitable services.

We are concerned that any further delay in addressing Asian health will result in the widening of health inequities for this group and an impact on the New Zealand health dollar. We need to focus on prevention and early detection by working alongside mainstream services within the current systems. But to achieve this, we need adequate funding to enable established mainstream and community providers to target at-risk Asian populations.

If we are to address growing health disparities we need to develop an action plan based on the following recommendations that:

• the government of the day is committed to addressing Asian health needs
• the Ministry of Health develops a central strategic plan to address Asian health issues and that a National Asian Advisory Committee is formed – representing the Ministry of Health, NGOs, and researchers and representatives from the Asian community – that will assist in developing that strategy and provide ongoing input around research, infrastructure and workforce development
• the strategy outlines key health priorities aligned to the Minister's health targets and also addresses other health issues unique to New Zealand's Asian population
• mainstream services are utilised to deliver health services to at-risk Asian populations
• sustainable resources are allocated to identified health priorities such as HEHA, chronic disease management, problem gambling, sexual health and mental health
• Asian health is made a priority for those District Health Boards with growing Asian populations
• there is appropriate Asian leadership at the regional and DHB level by appointing Asian representatives to DHBs and/or appointing an Asian advisory group to appropriate DHBs.

Round the branches

News from Southland

The Otago Southland branch, all fifteen or so active, interested and committed members, have been planning for the year and meeting for the first time this year in early February.

In conjunction with Otago University's Department of Preventive and Social Medicine, the year's public health seminars are being organised and looking good. Local and visiting public health academics are on the agenda. Further, a local meeting to discuss the Public Health Bill was held on 14 February. We are looking forward to the PHA conference in the far north.

Richard Egan

National Office roundup

Media News

Since our last newsletter the following media statements have been released.

Feb 08 – Community health focus of Public Health Bill meetings
Nov 27 – Government obesity response won't help most at risk
Nov 26 – Health, housing, education sectors must work together to address poor child health
Nov 23 – Health and environment groups slam campaign against tougher emissions standards
Nov 21 – Health groups call on Government to act against obesity
Nov 09 – Some school handwashing facilities appalling
Nov 01 – People with lower incomes face increased risk of obesity-related illness and death

Public Health Bill

PHA Chief Executive Officer Dr Gay Keating is in the forefront of encouraging people and organisations to submit feedback on the Public Health Bill with submissions to the Select Health Committee closing on 7 March.

She has been conducting a series of nationwide workshops on the Bill, to explain it and its significance to the future health of New Zealanders and to allow a forum for people to discuss it.

Gay says, "The Public Health Bill is the most significant public health legislative reform for decades.

"The new Bill will allow for the management of a wide range of risks to people's health including some provisions relating to illnesses such as cancer, diabetes and heart disease. However, the focus will continue to be on diseases you can catch. Some of these you can catch from other people – for example, hepatitis, tuberculosis, acute gastroenteritis. Others you can catch from the environment around you such as drinking water or poorly controlled sewage.

"Under the existing Health Act, health officers have limited ability to protect the community from communicable diseases. If someone is deliberately spreading a disease like hepatitis, for example, their workmates are currently not able to be warned because of privacy issues.

"On the other hand the old law often used a sledgehammer to crack a walnut. The new proposals include much better protection of the rights of sick people by requiring the health authorities to use the least restrictive options and increasing appeal provisions.

"The Public Health Bill seeks to better balance individual rights and privacy issues with the rights of the community to not be exposed unnecessarily to ill health."

She says the Bill, if passed, would also result in a better balance between health and profits.

"Currently, the balance is tipped in favour of big business, enabling them to make money while the health of New Zealanders suffers. The ongoing advertising of fast food to children is a good example of this.

"The Bill would enable action to be taken, giving health priority over the profits of industry."

Dr Keating says strong public health measures are essential if people are to live healthy lives.

"Without strong public health laws we would live in a country in which it was perfectly OK for people to drink and drive, be exposed to asbestos at work, to have raw sewage running in the drains, eat food from cockroach-infested restaurant kitchens, drink contaminated water, place children in vehicles unrestrained, and dump rubbish in the school playground.

"The Public Health Bill will bring public health legislation into the 21st century, so we can continue to protect the health of our communities."

If you want to make a submission, but are unsure how to go about it or what to say, go to www.pha.org.nz/news.html#phbill.

Please note that submissions close on 7 March.

New branding for the PHA

Thanks to all those who returned their comments on the proposed new PHA branding. It has now been officially adopted and includes a Māori translation – Kāhui Hauora Tūmatanui. It will soon be on the website, will be added to stationery as reprints are required and, of course, is featured for the very first time in this newsletter!

The icon portrays the fact that the PHA is all about people and the public. The incorporation of the stylised koru in the mind and body of each figure highlights the importance of total health and wellbeing.

The use of the koru, which is a Māori design element, also relates to the fact that Māori are a priority within the aims and goals of the PHA. Consequently this also makes the icon uniquely New Zealand in origin and appearance.

Clean simple type faces have been used to ensure clarity at a range of sizes. This also increases the life span of the logo as it decreases the effect of changes in styles and trends that will occur in the future. In addition, this type face has been specially tweaked so that it is original and unique to the PHA, and therefore less susceptible to plagiarism.

The green represents growth, harmony, balance, freshness, renewal, health and life. The silver represents strong foundations, the earth, distinction, elegance and style.

Twenty-five-year-old year old Waikato District Health Board graphic designer Tamara Miles (Raukawa/Nga Puhi) designed the logo. Tamara has a BA in Visual Communication and apart from her work in the visual communications department of the DHB, also does some freelance design work.

"My aim was to build on the excellent reputation of the PHA by strengthening its public image," says Tamara. "I wanted the logo to be simple, clean, clear and above all lasting. When I heard my concept presentation had been selected as the final logo I was really excited. It is great to be recognised, especially for doing something I love!"

Toilet poster competition!

Usually the PHA places emphasis on healthy public policies and supportive environments, but there's always a place for developing person skills.

One of the basic skills is personal hygiene, and research last year found almost 20 percent of men, and 8 percent of women didn't wash their hands after going to the toilet. Hand hygiene is a first defence against the spread of coughs, colds, the flu, tummy bugs and food poisoning, and when the influenza pandemic hits, hand hygiene is going to be one of the most important ways of keeping ourselves and our families alive.

There is a wide variety of hand hygiene reminder posters out there. But we don't have a poster here at the toilets in the office in Wellington!

To help correct that, we're encouraging readers to have a look around them and send in an example of what they think might be the best poster for the toilets in the PHA's national office.

We'll choose the one we think is best and tell everyone about the wonderful resource you found. We'll also send the winner a $10 voucher that can be redeemed at any of the 30 Trade Aid shops across the country.

Send a copy of the resource that you think is the best to:
Public Health Association of NZ
PO Box 11-243
WELLINGTON.

To see what $10 will buy you from Trade Aid, go to www.tradeaid.co.nz.

The competition closes at the end of March 2008.