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This page provides a little bit of detail about some leading public health issues and why we think they are important. Where we can we’ll provide links to more information – either produced by the PHA or by somebody else. We also provide some links to other important documents and/or organisations.

Alcohol

Alcohol imposes a heavy burden on the health system. In a 2011 declaration the United Nations affirmed alcohol as one of the four major risk factors in the four major noncommunicable diseases: cardiovascular disease; diabetes; cancer and chronic respiratory disease.

The PHA endorses the general strategies outlined by the Law Commission as effective ways to reduce alcohol harm. These include: reducing availability; increasing price; increasing the purchase age; and limiting marketing and sponsorship. The PHA supports the blood alcohol limit for driving having been lowered to 0.05 and thinks there is merit in investigating the effectiveness of further reductions.

We also endorse measures to ensure women are supported to have alcohol-free pregnancies such as: reducing alcohol marketing targeted at women and better access to information and contraception to lower the high rate of unplanned pregnancies in New Zealand.

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Children

The PHA is concerned that all children in New Zealand have the very best start in life. Children matter because they are human and deserve full human rights. They also deserve additional protection because of their vulnerability. We believe children are our future and that children who do not get the very best start in life will have more problems when they are adults. The more children grow up without unequal access to good health, the greater the cost will be for society in years to come.

For some time, however, New Zealand has been grappling with high levels of childhood hardship, preventable disease, and marked inequalities. We therefore support implementing best practice recommendations to address child poverty, prevent child abuse and improve child health outcomes.

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Climate change

The World Health Organization has described climate change as the defining issue for public health for the 21st century. There has been substantial research, both here and overseas, into its potential impacts on health. These impacts include: the direct biologic consequences of extreme weather events and air pollution; risks mediated by biophysically based processes and systems, including food yields, water flows, and infectious disease vectors; and more diffuse effects such as mental health, displaced, disadvantaged, indigenous and ethnic minority populations, and consequences of tension and conflict relating to declines in basic resources (e.g. food, water, living space).

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Fluoride

The PHA supports community water fluoridation as an effective, ethical public health measure which protects and promotes oral health, and reduces inequalities in New Zealand. Preventing tooth decay with community water fluoridation is almost 30 times cheaper than treating decay.

The New Zealand Oral Health Survey found 40 percent less tooth decay in communities with water fluoridation. Very good research has not found any evidence of harmful health effects from community water fluoridation at optimal levels such as those in New Zealand.

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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.

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

We need something here on obesity?

Housing

Poor quality housing is a public health issue for New Zealand. At present, the costs of cold, damp and unsafe housing are most often borne by rental housing tenants and the New Zealand health system. Therefore the PHA supports the introduction of a housing warrant of fitness that includes minimum standards for heating, insulation, ventilation and air quality.

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Inequities

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

The PHA believes in the value of public debate regarding the impacts of social and economic factors on health inequities. This debate should link particularly with the issues of Māori health and the health of children.

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Institutional racism

Institutional racism is defined as an entrenched pattern of differences in access to resources and power determined by race, which advantages one sub-population while disadvantaging another. The elimination of institutional racism is a key enabler in addressing health inequities.

Health inequities between indigenous and non-indigenous peoples are a well-documented ‘wicked’ public health problem. Research suggests that a key contributing factor to these inequities is the cumulative effect of the uneven and unfair distribution of the determinants of health.

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Māori wellbeing

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 as within its rules and regulations an intention to carry out its mandate “in the spirit of the Treaty of Waitangi. We also take Te Pa Māhutonga as our model for Māori health promotion.

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Physical activity

There is a global trend of decreasing levels of individual physical activity. In New Zealand, lack of physical inactivity is third only to smoking and diet as a modifiable risk factor for poor health. It is associated with around 10 percent of all deaths.

The PHA believes physical activity policies and programmes should promote changes to the built environment that advantage all citizens, and take into account the needs of
lower socioeconomic groups and other sectors of the population currently at risk of not getting enough physical activity

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Sunbeds

New Zealand has the highest incidence of melanoma in the world. Melanoma is the fourth most commonly registered cancer here, the most commonly registered cancer in men and the second most commonly registered cancer in women in the age group 25-44 years.

The World Health Organization’s (WHO’s) International Agency for Research on Cancer (IARC) classified UV radiation from tanning beds as “carcinogenic to humans” concluding that the risk of melanoma is increased by 75 percent when exposure to tanning beds occurs before the age of 30.

The WHO encourages governments to formulate and enforce effective laws governing the use of sunbeds. New Zealand currently has voluntary standards for sunbed operators, but surveys by Consumer NZ have found that the tanning industry has a high level of non-compliance with these.

The PHA therefore calls for government regulation of the sunbed industry.

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Tobacco control

Tobacco smoking is a significant cause of death and suffering for thousands of New Zealanders each year. Therefore we support the Government’s goal of making New Zealand smokefree by 2025.
This would help reduce health inequalities and allow New Zealand’s health system to focus its resources on other areas of health improvement.

We believe achieving the 2025 Goal will require a multi-pronged approach. We therefore support the introduction of plain packaging and recommend that excise taxes on tobacco are increased by 20 percent each year. This will help put smoking out of reach for children. We also believe the extra revenues should be set aside entirely to increase a wide range of free quit smoking services – particularly for Māori whose smoking rates are not reducing as significantly as those for other populations.

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Trade agreements

Trade is a health issue. The PHA supports a fair regime of trade/investment law that:

  • supports health, social and environmental goals, as well as economic development
  • prioritises equity within and between countries as a necessary condition for improvement in global population health
  • is consistent with international law relating to health, the environment, and human rights.

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