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Health Promotion Forum of New Zealand Runanga Whakapiki Ake i te Hauora o Aotearoa
Experts, Global, News, What is HP

Leaders pledge support for World Conference

The leaders of two highly regarded international bodies have signalled their support of the next World Health Promotion Conference. United Nations Development Programme (UNDP) Administrator the Rt Hon Helen Clark and Dr Colin Tukuitonga, Director-General of the Secretariat of the Pacific Community (SPC) have both indicated their organisations’ support of the Conference, to be held in Rotorua in April 2019.

Representatives of host organisation Health Promotion Forum met with both Ms Clark and Dr Tukuitonga during a conference in Tonga this month.

Ms Clark who, as New Zealand’s Prime Minister has spoken at Health Promotion Forum’s annual symposium, acknowledged the importance of planetary health and sustainable development and expressed her organisation’s interest in being involved.

Ms Clark was the keynote speaker on Monday at the Pacific NCD Summit in Nuku’alofa, June 20-22, for health ministers of the Pacific, which was organised by the Secretariat to the Pacific Community (SPC).

Dr Tukuitonga has expressed his wish for a strong Pacific presence at the conference and has pledged the involvement of his Pacific-wide organisation to support this aim.

The theme of the triennial conference of the International Union for Health Promotion and Education (IUHPE) is “Promoting Planetary Health and Sustainable Development for All.”

 

Pictured from left

  1. Ms Osnat Lubrani, UN Resident Coordinator and UNDP Resident Representative, UNDP Pacific Office,
  2. Dr Viliami Puloka, HPF Pacific Leader and Otago University Research Fellow,
  3. Rt Hon Helen Clark, UNDP Administrator and former Prime Minister of New Zealand,
  4. Ms Leanne Eruera, HPF Business Manager and 2019 Conference Project Manager,
  5. Mr Sione Tu’itahi, HPF Executive Director and IUHPE Vice-President.

hpf-and-undp

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Global, News

Health Promotion Forum of New Zealand – Runanga Whakapiki Ake i te Hauora o Aotearoa (HPF) has been successful in its bid to host the next World Conference on Health Promotion.  This will be the first time New Zealand has hosted the conference and represents the country’s recognised leadership in health promotion: particularly indigenous wellbeing.

Set to take place in Rotorua, April 2019, the triennial conference of the International Union of Health Promotion and Education (IUHPE) will receive 2,000-3,000 health promotion and education professionals from around the world.

The win was announced on May 27 (NZ time) at the closing ceremony of the 22nd world health promotion conference of the International Union for Health Promotion and Education (IUHPE) that was held on May 22-27 in Curitiba, Brazil.

“We are delighted by the IUHPE’s confidence in our ability to host one of the most important events in the health promotion calendar,” said HPF’s Executive Director, Sione Tu’itahi.  “We are also grateful for the hard work and expertise from our partners in preparing our bid.  Now the real work begins to plan and stage a top class conference that upholds our reputation around the world.”

HPF was supported by NZ Tourism and engaged the help of The Conference Company to conduct a thorough feasibility study before making its bid.  Rotorua was selected for its world-class meeting facilities and accommodation as well as for its reputation as the cultural heartland of New Zealand.  The area showcases initiatives in socio-economic development, sustainability, holistic wellbeing and environmental protection: all of which are aspect of health promotion.

The organisation received overwhelming support for its bid from influential New Zealanders including Sir Mason Durie, Rt Hon John Key, Hon Dr Jonathon Coleman, as well as tertiary institutes and key local Rotorua bodies.

Health Promotion Forum is the national umbrella organisation for health promotion in Aotearoa New Zealand.  It also plays a leading role in the development of health promotion in the Pacific region and internationally.

IUHPE is an international organisation that leads the on-going advancement of health promotion in the world.

sione-leanne-trev-curitiba

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Experts, Global, Policy, What is HP

Health Promotion Forum was fortunate to get some time with Emeritus Professor John Raeburn recently, to ask him about his more than 40 years as a health promotion advocate.

 

As one of two NZ delegates at the WHO’s first International Conference on Health Promotion, from which the Ottawa Charter emerged, Professor Raeburn made a small but significant contribution to the content of the document; the inclusion of a sentence emphasising the importance of empowerment.  This was the only time the word appeared in the Charter.  He has upheld the principles of community and health promotion ever since.

 

Invited to attend the 1986 Conference in Ottawa by the Ministry of Health, Prof Raeburn had recently returned from a sabbatical in Canada from his teaching role at the University of Auckland Medical School.  There he had been working alongside Ron Draper; head of the Health Promotion Directorate at Health Canada.  He considered this the ‘Mecca’ of health promotion and Ron Draper one of his heroes. “Canada actually invented health promotion in the 1970s,” says Prof Raeburn.  Little did he know that his year’s sabbatical would see him caught up in the preparations for the seminal Conference at which he was to later play such a significant role.

 

The other New Zealand delegate to the Conference was a Canadian man called Larry Peters, who was asked to go in his capacity as the first director of the Health Promotion Forum (Larry later went back to Canada and worked in the Health Promotion Directorate).

 

What was the experience of participating in the conference like?

It was a mixed experience, and I wrote an article about it for a public health magazine in New Zealand when I got back, which was essentially a critique. I’ll start with the negative aspects.  It was mainly organised by WHO, who did things in a very grand style with multiple flags and so on, much formality, and participants invited from all around the world. (It wasn’t open to everyone – governments were asked to send representatives). The conference process was awful. 

 

First of all, it was organised out of Europe, and the organisers succeeded in somehow alienating most of the developing world, with the result that most of the attendees were European, white and from industrialised countries.(Only 46 countries were represented).  

 

Second, it was conducted in a very disempowering and top-down way – the opposite of “real” health promotion!  They went through the motions of having a participatory workshop format, but the European bureaucrats had already decided the outcomes beforehand.

 

Third, they didn’t tell us until almost the end of the several-day conference that they had a charter in mind, and it was clear that it had already been pre-written by them. So we were basically there to rubberstamp it.  Well, the anger that surged around the huge room when the hundreds of delegates realized what had happened was spectacular.  

 

WHO then had to back down somewhat, and then said they’d accept some of the workshop material. They also said that, although the Charter was ready to be printed, if people wanted to scribble something down and hand them into the printing room, they would be considered for inclusion as well. 

 

I hurriedly wrote a sentence down on the back of an envelope (literally) and handed it in. You can imagine how delighted I was to find that whole sentence in the final Charter.  My passion has always been the community dimension of health promotion, and the empowerment of ordinary people, and I’m happy to say that the only time that the term “empowerment” appears in the Charter is in that sentence. It’s in the community action stream (of course!) and says: “At the heart of this process [of community action] is the empowerment of communities, their ownership and control of their own endeavours and destinies”.  The sentiments expressed in the sentence are as important to me now, 30 years later, as they were then, and sums up for me the very essence of the health promotion enterprise.

 

And also on the positive side, on a wider level, thanks to the various changes done at the last moment, the world got a health promotion charter that still remains a brilliant document.  And I have to say, that when the conference participants heard what WHO had finally came up with after they had incorporating the workshop materials, there was thunderous applause.  What a transformation!  By some miracle, WHO had got it right.  Once again, it’s proof of how important it is to have full-scale participation.

 

Did you realise at the time how seminal the conference and charter would be? 

Yes I think we were all aware that we were at a history-making event.  When Larry and I got back to New Zealand, we spent the next year going around the country promoting the Charter, with the result that New Zealand had arguably the biggest uptake of the Charter of any country in the world, including Canada.

 

You talk about health promotion moving away from the focus of changing lifestyles and behaviours to one of policy ‘changing society so that people and communities can more easily live healthy lives’.  How far do you think NZ (and global) society has come?  

 

This question is a slightly tricky one for me. I have over the last few years presented in various settings a critique of the Ottawa Charter,  including one memorable occasion in Canada when I was invited to do a keynote on this topic at a conference to mark the 25th anniversary on the Charter.  I was nervous, because the Ottawa Charter is like a sacred document in Canada. Happily it went down well. 

 

Part of my critique is that the movement of health promotion away from the older style of health promotion which emphasised changing lifestyle, behaviour and community, threw the baby out with the bathwater. It’s not by chance that the first action stream in the Charter is to do with policy – that was definitely the main interest of WHO.  However, my main interest, and clearly that of most of the participants at the conference, was in people.  In the late 90s, I published a book co-authored with Canadian grandfather of health promotion, Irving Rootman, called “People-Centred Health Promotion”, which makes just this point. 

 

My argument is that the focal point of health promotion should be community, a stance that enables one both to look “up” to the larger picture of policy and environment, and “down” to the more intimate and personal level of personal skills and family life.  Community is where people do their lives, and is the great meeting point of those two perspectives.

 

My fear has always been that health promotion would increasingly become preoccupied with policy – with statistics and abstract documents – and as far as most academic health promotion is  concerned, that’s definitely the case.  The result has been, I believe, a major gap between grassroots practitioners of health promotion and communities, and academics and policymakers.  And largely, the public likes a lifestyle/community approach, and is turned off by policy approach.  I’m not saying we shouldn’t have policy in health promotion – of course we should.  But we equally need the community and people level. 

 

My favourite image, which I’ve shown in multiple PowerPoint presentations, is a picture of a gannet in the sky with its wings spread, with one wing labelled “policy”, and the other “people”.  This balanced approach is the one I strongly advocate. 

 

So as to the question about how far NZ and global society has come in regard to these issues, I see that health promotion is probably going backwards, and has lost its broad public constituency, mainly because it has got lost in the arid desert of too much policy. 

 

Community development is your passion.  In an increasingly populous and multi-cultural society how do you think we are progressing with this area of health promotion?

 

I don’t think we are progressing at all well. In short, I feel health promotion has gone too far in the policy direction, and needs to go back to its heartland, which is community. 

 

There was a time in the ‘70s and ‘80s when there was fantastic progress, with all sorts of great community initiatives around.  One of the best contributions of government here was something called CHIFS; the Community Health Initiatives Funding Scheme, which supported communities coming up with their own empowering projects.

 

What changed all that was the arrival around 1985 of “Rogernomics”, followed by “Ruthanasia” in the ‘90s, which is to say that both Labour and National governments swung far to the right by adopting wholeheartedly the fashionable new economic policies of neoliberalism. These were first introduced by Maggie Thatcher in the UK, who was famous for a statement that “there’s is no such thing as society”. Rather, she said, there are ony individuals, and unequal ones at that.

 

Such a philosophy is harmful to community and empowerment of ordinary people, and we still largely live under this system globally and In New Zealand today. So community remains an unpopular concept. But at least now many are more aware of how damaging to society this approach is, and how it favours corporates and the wealthy, and makes the already miserable life of the poor and disempowered even more miserable.

 

On the other hand, this is offset in Aotearoa by the bicultural and multicultural nature of our society, where Māori and Pacific people in particular see society very much in “true” community terms.  This is a perspective where people are indeed the most important thing in life, and where life is about cooperation, whanau, aroha and connectedness with others.  So definitely, the saving grace in Aotearoa is the health promotion approach of these populations, and also in other cultural populations.   So it’s a mixed bag here.  Because government policy is not generally supportive of community and the less well off, it’s an uphill battle. At the same time, we in this country have a deeply embedded belief in the value of community, which for health promoters applies to health and wellbeing in particular.  A well-connected and well-liked local community means healthy and happy people.  (There’s lots of research to back that statement up).  However, for the present time, in spite of positive aspects, at a general level, the community approach to health promotion is currently on the back foot, and has been so for at least two decades.

 

Talking about your Public Health Champion award 2015, you are quoted as saying that health promotion is the area of public health with which that you identify most.  What are your thoughts behind seeing health promotion as a subset of public health?

 

 

This is a fascinating question, and when I was working at the University of Auckland’s School of Population Health, I was continually aware of it; surrounded as I was by public health people such as epidemiologists.

 

Because it has its roots in disease prevention and medical approaches to health, mainstream public health has always had an uneasy relationship with the ‘upstart’ called health promotion, which is largely a non-medical enterprise, and operates out of an entirely different model. 

 

I’ve worked hard over the years to make the point that public health is a combination of three components – protection, prevention and promotion – and it’s important to distinguish the three of them. 

 

One of the other things that has put health promotion on the back foot for decades is the fact that it frequently gets confused with prevention, and therefore is based on concepts of disease rather than concepts of health and well-being. And, while I definitely think that health promotion is part of public health, it has yet to carve out its full identity within that context.  I constantly see health promotion being seduced off in the direction of disease-oriented prevention, largely because it doesn’t have a strong kaupapa to the contrary

 

At the same time, I also think that health promotion goes well beyond what is conventionally regarded as public health. All sorts of things affect our wellbeing outside what’s conventionally regarded as public health. For example, at the simplest level, going to Weight Watchers, playing rugby, being on a marae, or having a good time with friends, all contribute to health and wellbeing in their various ways (again supported by research evidence).  In a way, the whole of life can be either health promoting or health destroying. 

 

So yes, while public health has an arm called “health promotion”, I really think that it’s only one expression of health promotion, which is much wider than that. But I can’t say that seems to be a popular view either. Of recent years, I have become enamoured of the concept of wellbeing promotion rather than health promotion, and I think this represents a more inclusive type of health promotion than the public health version currently provides.

 

You were recently involved in the publication of the Manifesto of Planetary Health.  Can you tell us more about this paper and the project?

Well, this question relates directly to what I was just talking about – I see planetary health as also a great new inclusive concept that will benefit both health promotion and public health, and could well be the future.

 

I was lucky to be involved in this project through my friendship with Robert Beaglehole and Ruth Bonita, who were asked by the Lancet to participate in the authorship of the trailblazing one page article that is the Planetary Health Manifesto.  When I saw the first drafts, I thought it was very light on community, and too heavy on policy and government action.  So me being me, I pulled out all the stops and kept inserting references to community in the document.  And if you now read that document, it almost looks as though community is the number one consideration, so naturally I’m very pleased with all that.

 

And what is planetary health? It’s a concept designed to revolutionise public health, which is seen as having lost ground both professionally and in terms of public engagement.  It’s quite clear that the greatest threats to health and well-being in the future are quite different from what they were 30 years ago, or even 10 years ago.  Global warming, terrorism, globalisation, ferocious inequity , ever-growing populations, food and water shortages, new and damaging addictions like gambling and designer drugs, robotization and fewer jobs, are just some of the factors that are going to deeply affect everyone’s health in the future.  This manifesto is designed to bring public health kicking and struggling into the 21st century.  But its goals won’t be achieved, in my view, simply by government policy being developed in a top-down way, and dumped onto populations.  Without community participation, and indeed community leadership rather than just “consultation”, we won’t get anywhere.  The only way to change the world, in my view, is by local people working with the things that concern them most, in their own settings and culture, in partnership with government.

 

How do you see the manifesto impacting on New Zealand health and Health Promotion?

Well so far it’s not very advanced.  The manifesto was only published in 2014, and it’s not very well known here yet.  I and others have given a few workshops and presentations on it, and I must say there’s been a very positive response to it at those.  So definitely, there’s a huge potential for public-health people and other people of good will to become passionately involved in this enterprise.  But we’ve got a long way to go yet.

 

I understand you are writing a book about spirituality.  Can you tell us more about this?

Have you got all day?  Briefly, ten years ago when I was leaving the University of Auckland, I wanted to spend more time meditating and doing “spiritual” things, given that I had a strong interest in Zen and Taoism.  I have a property in the wilds of Great Barrier, and had the romantic vision of spending lots of time there in the bush in the pursuit of – whatever it is one pursues in such a setting. But when the time came, I got cold feet, and wondered whether spirituality was simply a psychological entity dreamed up by humans to provide us with hope and happiness in a stressful world. (My background is as a psychologist). I then got to thinking that there were large numbers of people in the 21st century labelling themselves spiritual, and many declare themselve “spiritual but not religious.”  I decided I wanted to know what they meant. What is this thing called spirituality? It’s definitely not religion, although religion has elements of it of course. So what is it?   It’s taken me all those years to figure it out , and I’ll give just a clue as to what that might be.  I believe it’s in our genes, the result of millions of years of evolutionary development at both the prehuman and human level, and it serves very important survival and well-being purposes.  Unsurprisingly, I believe it also has a very strong community dimension in it’s background.  But at this point I’ll say no more, partly because I’m still working on it, but also partly because once I start on this topic, it could take all day!

 

And does it relate to health promotion?  Yes indeed it does, and also to planetary health.  For several years at the University of Auckland, I used to teach a postgraduate course called Spirituality and Health, and it had a strong health promotion bias.  It used to attract students from every kind of background, from atheist to fundamenalist, and all cultures, and this enabled me to develop a concept of spirituality as it related to health promotion.  But don’t get me started on that either!

 

 

We thank Professor Raeburn for his valuable time, warmth and considered replies.

 

March 2016

Jo Lawrence-King

– See more at: http://www.hauora.co.nz/prof-john-raeburn-health-promotion-advocate.html#sthash.ZfAKn7KJ.dpuf[/vc_column_text][/vc_column][/vc_row]

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Competencies, Global, What is HP

The International Union of Health Promotion and Education (IUHPE) has recently acknowledged the New Zealand Health Promotion Competencies as equivalent to its own European Competencies.  This is a promising step towards the ultimate aim of global competencies and accreditation; which would offer health promoters the potential to broaden employment opportunities and the exchange of knowledge and experience around the world.

iuhpe-tick

HPF’s Executive Director Sione Tu’itahi was excited about this significant step and its potential implications for health promoters of Aotearoa.  “Imagine when New Zealand health promoters can travel anywhere in the world and transfer their competencies to work in any member country,” he said.

The IUHPE has its own European-wide competencies; developed out of its CompHP project.  New Zealand was represented by past HPF Health Promotion Strategist Helen Rance on the Global Advisory Committee that developed these European competencies.  The IUHPE has also developed a European accreditation process to sit alongside the competencies.  It identifies performance criteria to meet the competencies. Within this process individual practitioners submit a portfolio of evidence rather like nursing; identifying their evidence in meeting each competency.  This submitted to their National Accreditation Organisation, which assesses the evidence successful accreditation means they can be called a European Health Promoter with the registration lasting three years. Academic institutions that deliver health promotion courses can also become accredited following a similar process.

Because the European and Aotearoa competencies were developed concurrently, the frameworks consist of the same nine competency domains.  The detail below each competency domain heading is different in the Aotearoa context, from that in the European domains as ours prioritise health promotion knowledge and practice that is specific to this country’s context.  In order to formalise the IUHPE recognition of the New Zealand Competencies, the HPF’s Health Promotion Strategists are providing the global body with detail around the correlation between the two competency documents.

Health Promotion Forum first produced the New Zealand Health Promotion Competencies in 2000 following two years of extensive consultation.  The current – 2012 – version of the Competencies was the result of continued discussions and feedback, which identified a need to strengthen the content and context related to Māori values and Te Tiriti o Waitangi.  These latest competencies identify the specific knowledge, skills, behaviours and attitudes for effective health promotion practices in the Aotearoa New Zealand context.

The decision to recognise the New Zealand competencies was made at a December 2015 meeting of the IUHPE Accreditation System meeting.

– See more at: http://www.hauora.co.nz/nz-health-promotion-competencies-recognised-by-global-body1.html#sthash.YquMnPTF.dpuf

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The International Union of Health Promotion and Education (IUHPE) has recently acknowledged the New Zealand Health Promotion Competencies as equivalent to its own European Competencies.  This is a promising step towards the ultimate aim of global competencies and accreditation; which would offer health promoters the potential to broaden employment opportunities and the exchange of knowledge and experience around the world.

HPF’s Executive Director Sione Tu’itahi was excited about this significant step and its potential implications for health promoters of Aotearoa.  “Imagine when New Zealand health promoters can travel anywhere in the world and transfer their competencies to work in any member country,” he said.

The IUHPE has its own European-wide competencies; developed out of itsCompHP project.  New Zealand was represented by past HPF Health Promotion Strategist Helen Rance on the Global Advisory Committee that developed these European competencies.  The IUHPE has also developed a European accreditation process to sit alongside the competencies.  It identifies performance criteria to meet the competencies. Within this process individual practitioners submit a portfolio of evidence rather like nursing; identifying their evidence in meeting each competency.  This submitted to their National Accreditation Organisation, which assesses the evidence successful accreditation means they can be called a European Health Promoter with the registration lasting three years. Academic institutions that deliver health promotion courses can also become accredited following a similar process.

Because the European and Aotearoa competencies were developed concurrently, the frameworks consist of the same nine competency domains.  The detail below each competency domain heading is different in the Aotearoa context, from that in the European domains as ours prioritise health promotion knowledge and practice that is specific to this country’s context.  In order to formalise the IUHPE recognition of the New Zealand Competencies, the HPF’s Health Promotion Strategists are providing the global body with detail around the correlation between the two competency documents.

Health Promotion Forum first produced the New Zealand Health Promotion Competencies in 2000 following two years of extensive consultation.  The current – 2012 – version of the Competencies was the result of continued discussions and feedback, which identified a need to strengthen the content and context related to Māori values and Te Tiriti o Waitangi.  These latest competencies identify the specific knowledge, skills, behaviours and attitudes for effective health promotion practices in the Aotearoa New Zealand context.

The decision to recognise the New Zealand competencies was made at a December 2015 meeting of the IUHPE Accreditation System meeting.

 

 

 

 

9 March 2016

Jo Lawrence-King

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Global, Pacific

The cluster of Zika virus outbreaks and the associated neurological disorders has caused global concern; particularly in tropical and sub-tropical areas.

HPF’s Dr Viliami Puloka offers a perspective for consideration by health promoters working to prevent disease and for the communities under threat.

Communities can be empowered with information on prevention of the spread of disease and on how to remain healthy in order to fight the virus, should they become infected, he says.

 

zika-mosquito

 

On 1 February 2016 the World Health Organisation declared a Public Health Emergency of International Concern (PHEIC) regarding the high incidence of abnormally small brains and other neurological disorders in babies born to mothers infected with the Zika virus.

Much discussion and concern has resulted from the WHO’s decision.

Health promotion will play a key role in minimising the effects of Zika on Pacific peoples.  Being well, being informed and taking precautions to reduce exposure to the disease-carrying mosquito will all contribute to communities’ resistance to the virus and its associated issues, says Health Promotion Forum’s Senior Health Promotion Strategist Dr Viliami Puloka.

Here in the Pacific region the rainy season – when mosquitoes are most prevalent – has just begun.  We have recently had new cases of the Zika virus declared in Samoa and Tonga.   One case of Guillain-Barré was identified in Waikato and linked to the Zika virus.  The patient was a man who had recently arrived from Tonga, however, and it was considered to represent no risk of an outbreak here.  This is because the virus is spread via a mosquito that is not found in New Zealand’s colder climate.  Meanwhile the virus has been present in French Polynesia for some time.  There, at least 40 cases of Guillain-Barré syndrome have been associated with the virus.

Zika was first identified in Brazil in May 2015.  Since then babies born to mothers infected with the virus have been found to have a higher incidence of neurological disorders, the main one of which has been abnormally small brains – or microencephaly.  While it has not been proven that the disorders are a direct result of the virus, this is strongly suspected.  In recent days another possible association has been suggested: the use of an antilarval chemical included in the drinking water of the affected residents in Brazil.

Health authorities in New Zealand and the Pacific are putting in place protection measures and public policies to prevent the spread of Zika virus, however Dr Puloka, who is responsible for the HPF’s Pacific portfolio, points out that communities have an equally vital role to play.  Minimising and modifying potential breeding sites is one way in which communities can act to prevent the spread of the Zika, he says. Residents are advised to empty, clean or cover containers that can hold water.  This includes receptacles like buckets, flower pots or tyres.  According to Dr Puloka it is also common practice to have a layer of oil on the top of the water in a septic tank.  This prevents the reproduction of the mosquitoes, whose pupae need oxygen from above the water to survive.

He suspects that immunity to mosquito-borne diseases may offer hope to those Pacific island nations to have recently seen the arrival of the Zika virus.  “The mosquito that carries the Zika virus is the same one that carries dengue fever, chikungunya and yellow fever,” he says.  “People of the Pacific islands have been exposed to these mosquitoes for many years and have developed a level of resistance to those diseases.”  This contrasts starkly with the situation in Brazil, where the people had previously not been exposed to those mosquitoes or their diseases.

Other precautions – where practicable – include using insect repellent, wearing clothes (preferably light-coloured) that cover as much of the body as possible and using physical barriers such as screens, closed doors and windows.

During outbreaks, health authorities may also advise spraying of insecticides.

Dr Puloka’s advice to communities threatened by the Zika virus is that now, more than ever, it is important to be well, be informed and take the necessary precautions to minimise the risk of being bitten by the mosquito that carries the disease.

 

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Evidence, Global, News

A glowing review by Henry March was published this month in UK paper NewStatesman of Michael Marmot’s book The Health Gap: the Challenge of an Unequal World.  The review – and the book –  highlights Marmot’s long-held view that mortality statistics are a question of inequity.

 

 

“If everyone in England over the age of 30 had the same low mortality as people with university education, there would be 202,000 fewer deaths before the age of 75 each year . . . 2.6 million extra years of life saved each year.”  The reviewer quotes from Marmot’s book.

bn-lb211_bkrvma_jv_20151102152610

 

There has been much argument over the years, says Henry March, about how “health” should be defined. “One might scoff a little at the breadth of the World Health Organisation’s definition: “complete physical, mental and social well-being and not merely the absence of disease or infirmity”. But it is difficult to disagree with the underlying idea that good health is more than just the absence of disease.”

 

“We need to seek out the “cause of the causes”. Working-class people smoke more, have higher obesity rates, take less exercise and die younger as a result – but why? Those of a right-wing disposition might suggest that it is simply because they are feckless and have not exercised their free will to work hard and live healthy lives. But this, you realise as you read Marmot’s book, is the propaganda of the victors.”

 

Henry March is clearly convinced by this book; pronouncing it ‘splendid and necessary’.

Rrad the full review

 

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Global, What is HP

University professor and physician Trevor Hancock has urged society to rethink the role and effectiveness of health care as a determinant of our health.  According to his December 2014 article in Canadian newspaper Times Colonist  “…as a society we should be investing more in creating social conditions and environments that make people healthy, rather than in increasingly expensive high-tech care.”  This is very sound advice, according to HPF’s senior health promotion strategist Dr Viliami Puloka.

 

Traditionally, we have given hospitals, doctors and the health care system the responsibility to look after our health. “That relationship seemed to work well in the days where most of our health issues were largely acute infective processes that required urgent but short term medical interventions by doctors and nurses,” says Viliami. “However, the major health problems we face today are not acute infections from a single organism treatable with antibiotics, but chronic conditions with multiple risk factors that lie outside the remits of the existing health care system.”

 

Dr Hancock’s article highlights two main points that are very relevant to the situation in New Zealand. Firstly, the importance of shared responsibility for the management of people’s health; between the individuals themselves, the wider community and health care providers. This is particularly critical in the management of chronic conditions, such as diabetes and obesity, where the individual has to make healthy choices and behaviour modifications in order to be well. The role of health care providers here is to support and empower individuals to make these healthy choices. Secondly, the importance of enabling-environments where healthy choices are the easy choices. These enabling-environments must include socio-economic and political environments. Dr Hancock refers to these as the upstream – or health – determinants that are outside the reach of the individuals and the jurisdictions of the health system.

 

drowning

 

As in Canada, we here in New Zealand have identified these health problems and their solutions. The solutions include cost-effective ‘upstream’ strategies such as community health promotion.  However we have, to date, failed to address  the processes that prevent individuals from benefitting from these upstream approaches. “We have been busy rescuing half-drowned people downstream. It is time that we work with our leaders putting in place policies and legislations to prevent people from falling into the river in the first place.”

 

Author: Viliami Puloka

Editor:  Jo Lawrence-King

6 January 2015

 

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Global, Video, What is HP

Two videos from the Health Promotion Forum of New Zealand (HPF) are receiving widespread praise – and calls for more – across the population health community in Aotearoa and the world.

what-is-hp-video-screen-grab-1

Viewed by more than 750 people to date, What is Health Promotion? answers the vexed question for many about this much-misunderstood discipline, while Health Promotion Competencies introduces health promoters to a useful resource for developing their role.

Renowned Professor and author John Raeburn commented “Really good.  Very succinct and to the point,” and, on a poignant note, he added;  “Ah, if only we could achieve that!”

WHO’s Professor Margaret Barry – Head of World Health Organization Collaborating Centre for Health Promotion commented: “There are very nicely produced short videos, which provide a useful snapshot of what Health Promotion practice is about and the skills and competencies that health promoters apply. They will be of interest to all those studying and working in Health Promotion and related areas globally.”

University lecturers up and down Aotearoa, and from as far afield as Scotland, say they have added the videos to their teaching resources. 

HPF hopes to produce more videos in the future.  Keep up to date on our videos by liking us on facebook or by e-mailing Barb to subscribe to our biannual newsletter Hauora.

 

 

19 March 2015

Jo Lawrence-King

 

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Evidence, Global, News

scottish-thistle-from-freestock

 

Scottish MPs (MSPs) have called for a multi-agency approach to tackle inequalities.  This follows the publication of the Report on Health Inequalities after a two year inquiry, which identified the ongoing health gap between the rich and poor in Scotland.

The gap, they say, has endured; despite political will and investment in public health campaigns on smoking, nutrition and exercise.  In fact the inquiry identified that such campaigns had the potential to increase inequalities.  This is for two reasons:

  1. Such campaigns do not address the primary causes of inequalities such as poverty and deprivation and
  2. There is greater likelihood that the approaches would be taken up by the more literate and financially-able middle classes than those living in poverty.

It concluded that effective narrowing of the gap will require a multi-agency, multi-initiatives approach.

The MSPs pointed out that the primary causes of health inequalities; social and economic problems; lie outside of the health sector.  The National Health Service (NHS) alone cannot these issues. They identified three approaches to tackle inequalities:

  • Measures through the taxation and benefits system;
  • Agencies collaborating to work effectively on related policies such as housing and education;
  • NHS to provide better access to primary health services for the poorest and most vulnerable.

While the life expectancy gap in New Zealand is not as great as that in Scotland, there remain significant differences between different sectors of the population, with Māori and Pacific people faring poorly in health outcomes.

“It is particularly important to address this inequity; not only as a moral issue but as a societal one: inequities are linked to poor health outcomes, reduced opportunity, poor economic growth, lack of social cohesion and increased health care costs.,” says HPF Senior Health Promotion Strategist Karen Hicks.  “HPF will watch the development of this initiative in Scotland with interest.”

 

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The Ottawa Charter for Health Promotion is a 1986 document produced by the World Health Organization. It was launched at the first international conference for health promotion that was held in Ottawa, Canada.  I lays the foundation for health promotion action.

The health promotion emblem provides a graphic interpretation of health promotion.  Explanation of the emblem

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The ‘Bangkok Charter for Health Promotion in a globalized world’ was agreed to by participants at the 6th Global Conference on Health Promotion held in Thailand from 7-11 August, 2005. It identifies major challenges, actions and commitments needed to address the determinants of health in a globalized world by reaching out to people, groups and organizations that are critical to the achievement of health. – See more at: http://www.hauora.co.nz/global-context.html#sthash.0YtkIBgQ.dpuf

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The Declaration of Alma-Ata was adopted at the International Conference on Primary Health Care, Almaty (formerly Alma-Ata), currently in Kazakhstan, 6-12 September 1978. It expressed the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world. It recognises the primary health care approach as the key to achieving the goal of “Health for All”.

0

The Alma-Ata Declaration is considered by many to be the founding framework for health promotion internationally.  It came from an International Conference on Primary Health Care, in Alma-Ata, USSR, 1978.
“The International Conference on Primary Health Care, meeting in Alma-Ata this twelfth day of September in the year Nineteen hundred and seventy-eight, expressing the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world ….. “

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World Health Report 2008 – Primary Health Care – Now More than Ever

“Globalization is putting the social cohesion of many countries under stress, and health systems, as key constituents of the architecture of contemporary societies, are clearly not performing as well as they could and as they should.
People are increasingly impatient with the inability of health services to deliver levels of national coverage that meet stated demands and changing needs, and with their failure to provide services in ways that correspond to their expectations. Few would disagree that health systems need to respond better – and faster – to the challenges of a changing world. PHC can do that.”  The 2008 WHO report Now More Than Ever outlines Primary Healthcare (PHC) reforms to mee the health challenges of today’s world.

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Global, News

The World Health Organization (WHO) identified a need for the development of public health leadership at a conference in November.   The global body called on governments, acadaemia, civil society and public health institutions to commit greater effort to developing the skills needed in the field; in order to protect public health values and to mitigate against public health threats.

 

departing-crowd-from-freestock

 

WHO also emphasised the need to strengthen the collective capacity for systems-thinking*, which focuses on population-based approaches as well as personal approaches to health and wellbeing improvement.

 

Over 1,400 public health practitioners, researchers and policy- makers from more than 65 countries participated in sessions  at the conference; covering topics such as the changing public health roles, gaps in health systems research and effective communication.

 

Dr Elke Jakubowski, programme manager of public health services at the WHO’s Division of Health Systems and Public Health,was speaking  at the 7th European Public Health Conference: Mind the Gap-reducing inequalities in health and health care in Glasgow, 19-22 November 2014.

 

Read the WHO article.

 

*Systems thinking involves interventions and engagement with key stakeholders and organisations across many sectors.  It is a framework for seeing interrelationships; understanding that everything is connected and that every action has an effect.  It is consistent with the social ecological model where health promoters appreciate the interconnectedness that exists through the relationships people have with and between family, friends, organizations, teams, communities, faith groups, etc. The social ecological model is a systems thinking model.

 

18 December 2014

Karen Hicks and Jo Lawrence-King

 

0

Following her attendance at the Equity at the Centre Conference in Alice Springs (4-5 September 2014), HPF Senior Health Promotion Strategist Karen Hicks reports on some of the presentations made during the two day event.

Read an overview of the highlights from Karen.

The economics of social jutice – cost benefit analysis to achieve social determinants action

The main thrust of Martin Laverty’s presentation was that equity is an economic asset for a country and should be valued as such.

Politics, Power and People

“Austerity kills” – that was the claim of Sharon Friel, Professor of Health Equity at the Australian National University, Canberra in her presentationPower and People: a game plan for health equity in the 21st Century.

0

Diet, Global, News

Consumers International (CI) and World Obesity Federation (WOF) are calling on the international community to develop a global convention to fight diet-related ill health, similar to the legal framework for tobacco control.

Unhealthy diets now rank above tobacco as a global cause of preventable non-communicable diseases (NCDs).

 

obesity-eating-from-stockxchng

 

The two international membership bodies will officially launch their Recommendations towards a Global Convention to protect and promote healthy diets at the World Health Assembly in Geneva.

The Recommendations call on governments to make a binding commitment to introduce a raft of policy measures designed to help consumers make healthier choices and improve nutrition security for everyone.

Measures include placing stricter controls on food marketing, improving the provision of nutrition information, requiring reformulation of unhealthy food products, raising standards for food provided in public institutions and using economic tools to influence consumption patterns.

Publication of the Recommendations comes on the 10th anniversary of the WHO Global Strategy on Diet and Physical Activity and Health, which recognised the impact of unhealthy diet and lifestyle.

Since then however, global deaths attributable to obesity and overweight have risen from 2.6 million in 2005 to 3.4 million in 2010, thus intensifying the pressure on governments to take stronger action to tackle the rising epidemic of obesity and consequent chronic disease.

Consumers International Director General, Amanda Long says: “The scale of the impact of unhealthy food on consumer health is comparable to the impact of cigarettes. The food and beverage industry has dragged its feet on meaningful change and governments have felt unable or unwilling to act.

“The only answer remaining for the global community is a framework convention and we urge governments to seriously consider our recommendations for achieving that. If they do not, we risk decades of obstruction from industry and a repeat of the catastrophic global health crisis caused by smoking.”

“If obesity was an infectious disease we would have seen billions of dollars being invested in bringing it under control,” said Dr Tim Lobstein, World Obesity Fediration Director of Policy.  “But because obesity is largely caused by the overconsumption of fatty and sugary foods, we have seen policy-makers unwilling to take on the corporate interests who promote these foods. Governments need to take collective action and a framework convention offers them the chance to do this.”

Here in New Zealand the Government has recently announced funding for the Healthy Families NZ scheme, aimed at reducing obesity and improving the health outcomes for more disadvantaged communities around the country.  Read our article from February 2014 on this initiative.

Obesity is a major risk factor for a wide range of non-communicable diseases. Figures show that in 2008, 36 million people died from non-communicable diseases, representing 63 per cent of the 57 million global deaths that year. In 2030, such diseases are projected to claim the lives of 52 million people.

 

Read the full recommendations from CI and WOF.

 

Press release from Consumers International

Photo: Byron Solomon – StockXchng.com

20 May 2014

 

0

Diet, Global, News

Consumers International (CI) and World Obesity Federation (WOF) are calling on the international community to develop a global convention to fight diet-related ill health, similar to the legal framework for tobacco control.

 

Unhealthy diets now rank above tobacco as a global cause of preventable non-communicable diseases (NCDs).

 

The two international membership bodies will officially launch their Recommendations towards a Global Convention to protect and promote healthy diets at the World Health Assembly in Geneva.

 

un-palais

 

The Recommendations call on governments to make a binding commitment to introduce a raft of policy measures designed to help consumers make healthier choices and improve nutrition security for everyone.

 

Measures include placing stricter controls on food marketing, improving the provision of nutrition information, requiring reformulation of unhealthy food products, raising standards for food provided in public institutions and using economic tools to influence consumption patterns.

 

Publication of the Recommendations comes on the 10th anniversary of the WHO Global Strategy on Diet and Physical Activity and Health, which recognised the impact of unhealthy diet and lifestyle.

 

Since then however, global deaths attributable to obesity and overweight have risen from 2.6 million in 2005 to 3.4 million in 2010, thus intensifying the pressure on governments to take stronger action to tackle the rising epidemic of obesity and consequent chronic disease.

 

Consumers International Director General, Amanda Long says: “The scale of the impact of unhealthy food on consumer health is comparable to the impact of cigarettes. The food and beverage industry has dragged its feet on meaningful change and governments have felt unable or unwilling to act.

 

“The only answer remaining for the global community is a framework convention and we urge governments to seriously consider our recommendations for achieving that. If they do not, we risk decades of obstruction from industry and a repeat of the catastrophic global health crisis caused by smoking.”

 

“If obesity was an infectious disease we would have seen billions of dollars being invested in bringing it under control,” said Dr Tim Lobstein, World Obesity Fediration Director of Policy.  “But because obesity is largely caused by the overconsumption of fatty and sugary foods, we have seen policy-makers unwilling to take on the corporate interests who promote these foods. Governments need to take collective action and a framework convention offers them the chance to do this.”

 

Here in New Zealand the Government has recently announced funding for the Healthy Families NZ scheme, aimed at reducing obesity and improving the health outcomes for more disadvantaged communities around the country.  Read our article from February 2014 on this initiative.

 

Obesity is a major risk factor for a wide range of non-communicable diseases. Figures show that in 2008, 36 million people died from non-communicable diseases, representing 63 per cent of the 57 million global deaths that year. In 2030, such diseases are projected to claim the lives of 52 million people.

 

Read the full recommendations from CI and WOF.

 

Press release from Consumers International

Photo: Byron Solomon – StockXchng.com

20 May 2014

0

Global, News, Policy

An in-depth paper published in The Lancet this February urges policy makers to recognise and address global political determinants of health inequity.  “Grave health inequity is morally unacceptable,” the authors say; it is a “global political responsibility” to ensure “transnational activity does not hinder people from attaining their full health potential.”

 

global-governance-for-health

 

The paper, produced by the Commission on Global Governance for Health challenges the ‘biological’ argument for health inequalities and places the main responsibility for them firmly at the feet of national governments around the world; calling on them to redress the imbalance of fairness and justice that currently exist.  “Despite large gains in health over the past few decades, the distribution of health risks worldwide remains extremely and unacceptably uneven,” say the paper’s authors.

“Health equity should be a cross-sectoral political concern, since the health sector cannot address these challenges alone”. The Commission recognises the crucial role of the health sector in addressing health inequalities it points out that the sectors efforts  “often come into conflict with powerful global actors in pursuit of other interests such as protection of national security, safeguarding of sovereignty, or economic goals.”

“This is a timely development for the discourse about our health and the wellbeing of our planet,” says HPF Executive Director Sione Tu’itahi. “What happens at the international level impacts directly on the local level, whether we like it or not: take global warming and trade, for example. Worldwide political determinants are rising fast but our governance and policy framework are still largely focused on local and national interests at the expense of our collective wellbeing. As a global family, we can no longer afford to focus on the room that we occupy when the whole house is battered by the storm.”

 

The political origins of health inequity: prospects for change

The Lancet, Volume 383, Issue 9917, Pages 630 – 667, 15 February 2014

Access the article online at The Lancet here (you will need to register, but it is free)

 

1 May 2014

By: Sione Tu’itahi

Edited: Jo Lawrence-King

 

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Highlights from the International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion

– “Best Investment for Health”

IUHPE President Michael Sparks took time out of his busy schedule to present the highlights of the conference for HPF. 

The 21st International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion in Pattaya Thailand was noted for its truly global focus.   More than 2,000 delegates, from over 80 countries attended the event this August.   The theme – ‘Best Investment for Health” – provided many opportunities to discuss and debate this crucial question, as well as to share good practice, network and socialise.

It was the first time the conference was held in a developing Asian nation.  This gave participants from the region an unprecedented opportunity to participate.  In turn, it afforded a greater understanding among all participants of the varying levels of investment in health promotion across countries and of the broad range of issues affecting the practice of health promotion across the different contexts.

Highlights of the 21st International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion:

  • Presentations on work done in the South West Pacific region with Māori and indigenous Australian populations; including a well-received presentation from HPF’s Deputy Executive Director, Trevor Simpson.
  • South West Pacific regional office of the IUHPE now hosted in New Zealand, with HPF’s Executive Director Sione Tu’itahi now Vice-President of the this regional arm.
  • An emerging issue around tobacco in Thailand during the conference provided an opportunity for delegates to throw their support behind moves to strengthen tobacco control there.
  • New awards were created for ‘most liked poster’ and ‘health promotion practice.
  • Wrap-up of the conference.

 

New Zealand contribution

Of particular interest was the work done by the IUHPE’s Indigenous Health Promotion Network. Work done in the South West Pacific region with Māori and Indigenous Australian populations is often viewed as cutting edge and sessions were well attended by conference participants from other countries.  Presentations from the region included a well-received one by HPF’s Deputy Executive Director Trevor Simpson.

Another development of particular interest to health promoters of Aotearoa New Zealand was the shifting of the leadership in the South West Pacific region of the IUHPE to this country.  The Health Promotion Forum of New Zealand Executive Director, Sione Tu’itahi, has been elected Vice-President of the South West Pacific Region of IUHPE, while Associate Professor Louise Signal, Director of the Health Promotion and Policy Research Unit (HePPRU) and Health, Wellbeing & Equity Impact Assessment Research Unit (HIA), Department of Public Health,  Otago University is its Regional  Director.  Until now these positions have been drawn from Australia for many year.

Delegates weighed in to support local battle to improve tobacco control in Thailand

During the conference there were also interesting developments in relation to local tobacco controls.   The tobacco Giant Philip Morris challenged in court the Thai Ministry of Public Health’s legislation to increase health warnings on cigarette packages to 85% of the outer surface.  The country’s lower court issued an injunction against the Public Health Ministry to suspend enforcement of the regulations.

Informed of these developments, conference delegates took action: developing a letter of support to the minister and petitioning the IUHPE General Assembly to write to the minister.  Delegates also participated in a local media event to publicise the global support for tobacco control clearly evident at the conference.

Following the conference The Ministry, encouraged by the support from the global health promotion community, has appealed against the injunction to the Supreme Court.  A ruling is expected late this year or early in 2014.

New awards created

Two new awards were created this year:  the “most liked” daily poster session and the “Health Promotion Practice” awards.  Recipients of the latter were three distinguished practitioners:

  • Dr. Gene R.Carter, the Executive Director and CEO of ASCD (formerly the Association for Supervision and Curriculum Development)
  • Prof.Prakit Vathesatogkit, Executive Secretary, The Action on Smoking and Health Foundation
  • Dr. Don Eliseo Lucero-Prisno III, Lecturer, University of Liverpool

 

 

 

 

 

 

 

Article by: Michael Sparks

Editor: Jo Lawrence-King

Published: November 2013

0

Commission on Global Governance for Health calls on national governments to address global political determinants

An in-depth paper published in The Lancet in February 2014 urges policy makers to recognise and address global political determinants of health inequity.  “Grave health inequity is morally unacceptable,” the authors say; it is a “global political responsibility” to ensure “transnational activity does not hinder people from attaining their full health potential.”

The paper, produced by the Commission on Global Governance for Health challenges the ‘biological’ argument for health inequalities and places the main responsibility for them firmly at the feet of national governments around the world; calling on them to redress the imbalance of fairness and justice that currently exist.  “Despite large gains in health over the past few decades, the distribution of health risks worldwide remains extremely and unacceptably uneven,” say the paper’s authors.

“Health equity should be a cross-sectoral political concern, since the health sector cannot address these challenges alone”. The Commission recognises the crucial role of the health sector in addressing health inequalities it points out that the sectors efforts  “often come into conflict with powerful global actors in pursuit of other interests such as protection of national security, safeguarding of sovereignty, or economic goals.”

“This is a timely development for the discourse about our health and the wellbeing of our planet,” says HPF Executive Director Sione Tu’itahi. “What happens at the international level impacts directly on the local level, whether we like it or not: take global warming and trade, for example. Worldwide political determinants are rising fast but our governance and policy framework are still largely focused on local and national interests at the expense of our collective wellbeing. As a global family, we can no longer afford to focus on the room that we occupy when the whole house is battered by the storm.”

The political origins of health inequity: prospects for change  

The Lancet, Volume 383, Issue 9917, Pages 630 – 667, 15 February 2014

Access the article online at The Lancet here (you will need to register, but it is free)

 

 

 

 

 

February 2014

Jo Lawrence-King

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The World Health Organisation (WHO) has published five new policy guides for addressing health inequity.  The guides have been produced by New Zealand Doctor Belinda Loring, a past Fellow of Health Promotion Forum with a strong interest in health equity and action on the social determinants of health.  While she was still in New Zealand Dr Loring worked on health equity and public health at local, regional and national government levels, with a strong focus on Māori health inequities.

 

The equity action spectrum: taking a comprehensive approach

Alcohol and inequities

Injuries and inequities

Obesity and inequities

Tobacco and inequities

 

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Family and child, Global, Maori, What is HP

tariana-turia

 

A speech to parliament on Wednesday 28 January 2014 by Minister Tariana Turia has highlighted the groundswell of support for Whanau Ora as a model for health and wellbeing applicable to all New Zealanders.  Health Promotion Forum (HPF) Executive Director Sione Tu’itahi believes that the model goes even further; with relevance to people around the world.

 

Whanau Ora [……] has been openly embraced by New Zealanders of all cultures and creeds,” said Ms Turia in her speech “[It is] about empowering and enabling families to set their own priorities, to focus on outcomes.”  According to Ms Turia 160 providers are now using the Whanau Ora tool, with approximately 33,000 New Zealanders benefitting from the approach.  Ms Turia is not alone in seeing the value of community health promotion, with Minister of Health Hon Tony Ryall reportedly considering funding for such a programme.

 

Ms Turia is not alone in seeing the value of community health promotion, with Minister of Health Hon Tony Ryall reportedly considering funding for such a programme. – See more at: http://www.hauora.co.nz/whanau-ora-a-model-for-people-around-the-world.html#sthash.eWk0Ul5D.dpuf
Ms Turia is not alone in seeing the value of community health promotion, with Minister of Health Hon Tony Ryall reportedly considering funding for such a programme. – See more at: http://www.hauora.co.nz/whanau-ora-a-model-for-people-around-the-world.html#sthash.eWk0Ul5D.dpuf

 

 

Tu’itahi welcomed Ms Turia’s speech and Mr Ryall’s interest in community health programmes.  “We are rapidly moving from a model of hauora (health and wellbeing) by and for Māori to one that is widely recognised as being of value to all peoples of Aotearoa New Zealand,” he said.  “I predict that it won’t stop there: this will become a model followed by peoples across the globe.”

 

Aotearoa New Zealand – and HPF –  are highly regarded internationally.  In particular our approaches to indigenous health promotion were well-received at last year’s International Union of Health Promotion and Education (IUHPE) conference. Key elements of these approaches include a focus on the holistic view of health and wellbeing, increased control by communities over interventions and incorporating indigenous world views into health promotion planning. All of these aspects are reflected in the Whanau Ora approach.

 

Whanau Ora is founded on the principle of self-determination.  Unlike the conventional models of health care, the Whanau Ora approach empowers whanau and communities to have control over their own wellbeing.  Instead of focussing on illness and its treatment, Whanau Ora helps participants identify those elements that determine hauora and to prioritise strategies to improve outcomes.

 

“This is not an exclusively indigenous issue,” says Tu’itahi.  “There is a broad movement towards self-determination – in health and many other issues.  People around the world are taking an increasing interest in being well, rather than treating illness; on looking at the big picture of what affects our ability to fulfil our potential and doing something to address those determinants of our health.”   He believes that the Whanau Ora model will be one that is taken up and adapted for people around the world.  “Once again New Zealand will be a pioneer,” he said.  “Perhaps what we do need to recognise is that we owe Māori a debt of gratitude for a model that has the potential to revolutionise the hauora of people around the world.”

 

Visit the Government’s web-page about Whanau Ora.

 

Jo Lawrence-King

0

Global, Maori, Smoking

sione-may-16-2012

 

HPF – and New Zealand – is making a significant contribution to world health agendas.  Its most recent input was to the scientific programme of the 16th World Congress on Tobacco or Health. As a member of the board of the International Union for Health Promotion and Education (IUHPE), HPF’s Executive Director Sione Tu’itahi ensured the needs of indigenous peoples and ethnic minorities were included in the recommendations invited from the global organisation.

“This is a big step for New Zealand, the HPF and for Maori and all other indigenous peoples,” says Sione.  Smaller countries and ethnic minorities are often overlooked and vulnerable to the driving force of large companies and countries.  “Having a voice at this level is a wonderful opportunity to advocate for the rights of these less-represented peoples.”

Recommendations about the conference from the IUHPE included:

Discussions about the post-2015 development agenda to ensure health, including non-communicable diseases and social determinants are given the appropriate attention.

Discussion around support for politicians in the battle with tobacco industry on initiatives such as plain packaging.

Seeing outputs and outcomes of the WHO Europe NCD ministerial event focussing primarily on tobacco.

  • Focussing on ‘how to do’ as much as ‘what to do’
  • Including the health needs of indigenous peoples and ethnic minorities in all strategies.

Sione is the first indigenous person from the Pacific region to hold an official post with the IUHPE.  He is a member of the global board in his role as Vice-President of IUHPE, South West Pacific Region, which covers New Zealand, Australia, all small Pacific island nations and some countries in Asia.

IUHPE is a global umbrella organisation for health promotion professionals and organisations of the world.  Its headquarters are in Paris.  For the next three years (2013-2016) its South West Pacific Region office will be co-hosted by the Health Promotion Forum and the Health Promotion and Research and Evaluation Unit (HePPRU) of Otago University’s School of Public Health. HePPRU’s Director, Associate Professor Louise Signal, is also the Director of IUHPE for the South West Pacific Region.

Sione recently attended a meeting of the IUHPE’s Global Executive Board in Paris.  Read more about the trip here.

The HPF is a national umbrella organisation for health promotion organisations and teams in New Zealand.

0

Global, Policy

iuhpe-executives-inc-st

 

Health Promotion Forum (HPF) Executive Director Sione Tu’itahi is calling on health promoters at all levels to join forces and make a difference to hauora here and around the world.  “They say think globally, act locally, but these days we must think and act on all levels,” says Sione .

 

Sione returned last Friday from Paris, France, where he attended a two-day meeting of the GlobalExecutive Board of the International Union for Health Promotion and Education (IUHPE).  At the meeting the Board put together a work plan to contribute to solving global health challenges and ensuring the long-term sustainability of the IUHPE.  One of the key resolutions was to redouble efforts to unify and energise the health promotion movement and Sione hit the ground running when he arrived back in Aotearoa New Zealand.

 

“The world is but one global village and challenges impacting on the international level influence the national and local levels as well,” said Sione.  “Take the economic recession or global warming, for instance. Both challenges affect everyone at every level, whether you are in Paris, Auckland, or Ha’ano, [Sione’s home Island in Tonga].  “We must work together or we will all be affected by these common challenges, many of which are human-made and, therefore, can be resolved.”

 

Sione is the first Indigenous person from the Pacific region to hold an official post with the IUHPE.  He is a member of the global board in his role as Vice-President of IUHPE, South West Pacific Region, which covers New Zealand, Australia, all small Pacific island nations and some countries in Asia.

 

IUHPE is a global umbrella organisation for health promotion professionals and organisations of the world.  Its headquarters are in Paris.  For the next three years (2013-2016) its South West Pacific Region office is co-hosted by the Health Promotion Forum and the Health Promotion and Research and Evaluation Unit (HePPRU) of Otago University’s School of Public Health. HePPRU’s Director, Associate Professor Louise Signal, is also the Director of IUHPE for the South West Pacific Region.

 

The HPF is a national umbrella organisation for health promotion organisations and teams in New Zealand. While its primary focus is on the national level, HPF has both a global reach and a local impact.

 

Sione issued a personal invitation to health promoters around the country: “If you wish to be part of the solution on all levels, join a global movement and a national organisation.”

 

Join IUHPE and HPF by contacting Emma at HPF emma@hauora.co.nz.”

Read about the benefits of HPF membership.

 

Pictured above are (from left):

IUHPE President, Professor Michael Sparks, of the Australian National University, Ms Marie-Claude Lamarre, Executive Director of IUHPE, and Sione Tu’itahi, HPF Executive Director and Regional Vice-President of IUHPE, at the meeting held at the Paris Global Centre of Columbia University.

 

Story published: 13 December 2013

By: Sione Tu’itahi

Edited:  Jo Lawrence-King

 

0

Global, Policy

30 October 2013: The World Health Organisation (WHO) has released a review, which  “answers policy-makers’ demands for practical guidance on social policies that work to reduce inequities in health”.  The review identifies 12 “best buy” priorities for policy; particularly child poverty and unemployment in young people.

“For the first time we have an unprecedented evidence-based set of practical policy recommendations about what all countries can do to address the so-called “upstream” causes of health inequities, specifically targeted to their income level,” says Zsuzsanna Jakab, WHO Regional Director for Europe

 

european-child-climbing

 

The Review of Social Determinants and the Health Divide in the WHO European Region is the result of two years of research by a cross-disciplinary consortium of Europe’s leading experts, chaired by Professor Sir Michael Marmot, a leading world expert in health equity.

Professor Marmot visited Australia and New Zealand in April 2011 to attend a meeting hosted by the Asia Pacific hub of Global Action for Health Equity Network (AP-HealthGAEN)  (reported in the Autumn/Winter issue of Hauora 2011).  Here the Asia-Pacific applications of the global work in health equity were discussed.  In her Hauora article on the subject Dr Belinda Loring pointed out that over 60% of the world’s population lives in the Asia Pacific region.  “Life expectancy across the region varies by over 20 years,” she commented. “The scale of health inequities and the intensification of influences on health in this region demand specific attention and assessment through an Asia Pacific lens.” Dr Loring is Senior Policy Officer at HealthGAEN and an HPF Fellow

The Global Action for Health Equity Network (HealthGAEN) is an informal alliance for health equity through action on the social and environmental determinants of health.  It was established to build on the momentum, expertise and partnerships generated through the WHO Commission on Social Determinants of Health (CSDH).  The Asia-Pacific hub of HealthGAEN (AP-HealthGAEN) was established in 2009 to build a network for support and joint action on addressing health inequity across the region.  The Health Promotion Forum of New Zealand (HPF) is an active member of AP-HealthGAEN.

The CDSH, chaired by Professor Sir Michael Marmot, was established in 2005.  It was the start of a global movement for health equity.  It focused on action on the social determinants of health; generating worldwide interest among governments, civil society, academics and non- government organisations.

Read an executive summary of the review.

Read the European press release How to avert a public health emergency.

Read the UK briefing paper Public Health Time Bomb Waiting to Explode.

 

 

Item published 1 November 2013

 

0

Global, Maori, News, What is HP

Health promotion programmes in Aotearoa New Zealand were held up as models of best practice in August at the annual conference of the world’s most highly respected health promotion organisation.   Senior Health Promotion Strategists from the Health Promotion Forum (HPF) are participating at the conference of the International Union of Health Promotion and Education (IUHPE) in Pattaya, Thailand, August 25-29 2013.

2013-08-iuhpe-logo-500x500

 

Trevor Simpson – Deputy Executive Director at the HPF – presented a plenary session to showcase a health promotion module developed by Maori and in close collaboration with the Maori service users for whom it was being designed.  “This is a point of difference from many other health promotion approaches to indigenous peoples,” says Trevor.  Very often health promotion resources and practices are developed centrally, with little or no involvement of – or representation from – the people for whom they are being developed.  “We have found our approach to be highly successful in inspiring and empowering people to make beneficial changes to their health.”

 

The HPF’s Senior Health Promotion Strategist Karen Hicks presented her abstract “A Contribution to the Global Dialogue”.  In her presentation she will discuss how health promotion competencies, the advent of a professional society and a code of ethics together give health promotion professionals the tools they need to make effective improvements in health.

 

New Zealand is strongly represented in health promotion globally.  The HPF’s Executive Director, Sione Tu’itahi, is Vice-President of the South West Pacific Region of IUHPE, while Associate Professor Louise Signal, Director of the Health Promotion and Policy Research unit (HePPRU) and Health, Wellbeing & Equity Impact Assessment Research Unit (HIA), Department of Public Health,  Otago University is its Regional  Director. Together the HPF and HePPRU co-host the IUHPE’s South West Pacific Regional Office.

 

 

 

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Global, What is HP

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“New Zealanders are the 13th happiest in the world.” That’s the finding of the recently published World Happiness Report 2013.

A post this month on Otago University’s Public Health Expert blog highlights some of the relevant findings of the report, which looked at the happiness of 156 countries.

Of particular note to health promotion professionals is the finding in the report that public spending needs to focus more on prevention than on care.  It acknowledged the need for better evidence to support this shift.

Also highlighted in the Otago University’s blog is the emphasis on mental health as the “single most important determinant of individual happiness.”

Read the full report here.  Or read the Public Health Expert blog here.

 

Entered: 24 September 2013

 

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Milestones in Health Promotion. Published by World Health Organisation (WHO) in 2009, this is a collection of global statements in one booklet. Or you can access individual statements below:

Adelaide Statement on Health in all Policies -Report from the International Meeting on Health in All Policies, Adelaide 2010. The purpose of this report was to engage leaders and policy-makers at all levels of government – local, regional, national and international. It emphasizes that government objectives are best achieved when all sectors include health and well-being as a key component of policy development. This is because the causes of health and well-being lie outside the health sector and are socially and economically formed. Although many sectors already contribute to better health, significant gaps still exist.

WHO Global Conferences on Health Promotion

The Eighth Global Conference on Health Promotion: Health in all Policies. Helsinki, Finland 10-14 June 2013. Two items were produced from this conference: the Helsinki Statement and a Framework for Country action. Thestatement asserts that “health inequities between and within countries are politically, socially and economically unacceptable, as well as unfair and avoidable. Policies made in all sectors can have a profound effect on population health and health equity.” It called on governments to fulfil their obligations to their peoples’ health and wellbeing. Both the Statement and the Framework for Country Action can be found here.

The Seventh Global Conference on Health Promotion, Nairobi, Kenya 26-30 October 2009, produced a Call to Action, whichidentified key strategies and commitments urgently required for closing the implementation gap in health and development through health promotion.

The sixth Global Conference on Health Promotion – Thailand; 7-11 August 2005 – produced theBangkok Charter (above)

The Fifth Global Conference on Health Promotion: Bridging the Equity Gap, Mexico City, June 5th, 2000. Signed by Ministers of Health, the brief 8-pointMexico Ministerial Statement for the Promotion of Health: From Ideas to Action acknowledges the duty and responsibility of governments to the promotion of health and social development.

The Fourth International Conference on Health Promotion: New Players for a New Era- Leading Health Promotion into the 21st Century, meeting in Jakarta from 21 to 25 July 1997, came at a critical moment in the development of international strategies for health. It was the first to be held in a developing country and the first to involve the private sector in supporting health promotion. The Jakarta Declaration on Leading Health Promotion into the 21st Century identified the directions and strategies needed to address the challenges of promoting health in the 21st century.

The Third International Conference on Health Promotion, Sundsvall, Sweden 9-15 June 1991: Supportive Environments for Health. This conference called upon people in all parts of the world to actively engage in making environments more supportive to health. Examining today’s health and environmental issues together, the Conference points out that millions of people are living in extreme poverty and deprivation in an increasingly degraded environment that threatens their health, making the goal of Health For All by the Year 2000 extremely hard to achieve. The way forward lies in making the environment – the physical environment, the social and economic environment, and the political environment – supportive to health rather than damaging to it. The Sundsvall Statement on Supportive Environments for Healthis a call to action, directed towards policy-makers and decision-makers in all relevant sectors and at all levels.

The Second International Conference on Health Promotion in Adelaide, South Australia, 5-9 April 1988, continued in the direction set at Alma-Ata and Ottawa, and built on their momentum. Two hundred and twenty participants from forty-two countries shared experiences in formulating and implementing healthy public policy. The resulting Adelaide Recommendations on Healthy Public Policyreflect the consensus achieved at the Conference.

The first International Conference for Health Promotion in Ottawa, Canada 21 November 1986 produced the Ottawa charter (above)

The WHO has links to all its past conferences on health promotion.

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The central tenet of this English review is that avoidable health inequalities are unfair and putting them right is a matter of social justice.  “…health inequalities are not inevitable and can be significantly reduced.”

According to Michael Marmot’s report “social justice is a matter of life and death. It affects the way people live, their consequent chances of illness and their risk of premature death.”

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