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Health Promotion Forum of New Zealand Runanga Whakapiki Ake i te Hauora o Aotearoa
Maori, Maori health promotion

Health Promotion Forum is privileged to have had a brief catch-up with Adrian Te Patu.

Adrian is a past board member of our organisation and is currently co-vice president of the Public Health Association of New Zealand. Last year he became a member of the World Federation of Public Health Associations and has just begun leading the Federation’s indigenous working group. Here are a few words from Adrian.

 

We know you’ve had a few roles over the years. Could you tell us about some of those?

I really enjoyed representing my communities as an elected member of our Community Board on the Christchurch City Council. Local government is having an ever-increasing role in our lives and it was an advantage for me coming from public health where thorny divisive issues like fluoridation are the norm. I was elected before the earthquakes and the response, recovery and community engagement principles were paramount. I particularly enjoyed having the confidence of Ngai Tahu in my role.

 

What are some highlights from your work over the years?

What I particularly enjoyed in the early 2000’s was being a member of the Think Tank of the Te Waipounamu Health Promotion Coalition. This South Island group was an active part of the Health Promotion Forum that organised hui, symposia, discussion platforms and networked across the island. Some significant leaders in health today were part of this and we were supported wonderfully by our coordinator Helen Rance.

 

Tell us about current projects you are working on

It’s a privilege to lead the newly established “Indigenous Working Group” of the governing council of the World Federation of Public Health Associations. This is a fantastic opportunity to promote the plight of some of the 370 million recognised indigenous peoples of the planet. This association is a recognised civil society by the World Health Organisation alongside significant organisations such as; International Red Cross, The Order of St John, Doctors Without Borders and others. Our working group is in the forming stage at present.

 

What do you see as the emerging ideas, issues and foci for/of health promotion and public health?

The importance and continuity of the HPF and the PHA. This requires us to be relevant and to adapt to the environment no matter what the political sway or appetite is. No government or coalition should determine the right of these organisations to exist. So we make it so….

 

Any other comments?

The awarding of the 23rd IUHPE World Conference on Health Promotion to the Health Promotion Forum of New Zealand in Rotorua 2019 is an amazing accomplishment and is part of a well planned and executed series of events. This is due to years of dedication under the stewardship of Sione Tu’itahi.

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Video, What is HP

Health Promotion Forum is proud to announce the launch of two short information videos to inform health promotion practice.

The first – What is health promotion? – provides an Aotearoa New Zealand perspective on health promotion; its scope, potential and the focus of its work.   The second – Health promotion competencies – explain the scope and potential uses for the competencies.

HPF’s Senior Health Promotion Strategist Karen Hicks was the mastermind behind the creation of these videos.  “This could be the start of greater understanding of the crucial work done by health promoters in Aotearoa New Zealand,” she said.  The purpose behind the videos was to make it easier for health promoters around the country to understand the scope and potential of their role – as well as to have a way of explaining it to other.   “I encourage all my wonderful colleagues out there to share these videos with their friends, family, colleagues and managers,” said Karen.

– See more at: http://www.hauora.co.nz/new-videos-shed-light-on-health-promotion-in-new-zealand.html#sthash.O2plPbZ6.dpuf

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Maori, What is HP

A new paper, published in UK publication Ethnicity and Health in June, indicates we have a way to go to address ongoing inequities for Māori and other indigenous groups.  It points out that, in the Aotearoa context, Te Tiriti o Waitangi “is a legislative, policy and professional imperative for the public health community.”

 

HPF Deputy Executive Director, Trevor Simpson has co-authored the paper, which finds that there is variable application of Te Tiriti o Waitangi and there is room for further development in many areas of the New Zealand public health service.  It points to Treaty Understanding of Hauora in Aotearoa-New Zealand (TUHA-NZ) as “landmark document” and an essential tool to operationalise the policies outlined in Te Tiriti.

 

The paper Realising the rhetoric: Refreshing public health providers’ efforts to honour Te Tiriti o Waitangi in Aotearoa, New Zealand investigates the ways public health units and non-governmental organisations meet their Te Tiriti o Waitangi obligations in terms of service delivery to Māori. Drawing on data from a nationwide survey of public health providers the article argues New Zealand public health providers can strengthen efforts to advance tino rangatiratanga (Māori control over things Māori) in every day practice.

 

Trevor worked alongside Heather Came (Senior Lecture, Auckland University of Technology), Tim McCreanor (Associate Professor Massey University) and Claire Doole, (Senior Lecturer, Auckland University of Technology), to bring this important paper to fruition.

 

The work was supported with a grant from the Faculty of Health and Environmental Sciences, Auckland University of Technology.

 

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What is HP

Mt Wellington (Auckland) based PHO Alliance Health Plus Trust (AH+) announced in July the establishment of the Alliance Community Initiatives Trust (ACIT).

This is a standalone charitable trust aiming to address the social determinants of health ‘one social determinant of wellbeing at a time for one person at a time in one NZ community at a time.’  It will focus initially on Mangere in South Auckland.

“Complex health and well-being problems require common denominator solutions that cut across multiple domains including social, economic, cultural and environmental,” says AH+ Chairman, Mr Uluomatootua (Ulu) Aiono.  “At both AH+ and ACIT we know gains are temporary unless we identify the common denominator and eliminate the root cause through critical thinking based grass roots interventions in the demand side. A critical prerequisite for this is collaboration amongst frontline service providers.”

ACIT aims to collect data to “identify common denominators and pin down the root cause.”

Commenting on the new initiative, HPF Deputy Executive Director Trevor Simpson said “It’s great to see primary health care organisations are looking into the determinants space, health equity and looking at bottom up, top down interventions. This is a health promotion approach.”

Trevor pointed out the existing data available to ACIT – and any other organisation working on addressing the social determinants of health.  This includes, for example, the deprivation index, disease distribution studies, reports from groups such as Child Poverty Action Group (CPAG) and the Health Education Health Promotion Policy Research Unit (HePPRU – Otago University)

“I’m sure ACIT is aware that the frameworks for implementing this project are already in place in the form of the Ottawa Charter and Te Tiriti o Waitangi.”

The strands of the Ottawa Charter provide for the ACIT’s work:

  • Building healthy public policy,
  • Strengthening community action,
  • Creating supportive environments,
  • Developing personal skills and
  • Reorienting health services.

“Te Tiriti o Waitangi adds in a political, moral, ethical and rights based imperative to act”, adds Trevor.  “We look forward to working alongside another organisation coming on board with the concepts of health promotion.”

acit-logo

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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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January 2016:  Senior Health Promotion Strategist Karen Hicks contributed this post to the WHO’s This Week in Global Health

 

Health Promotion: An Effective Approach to Achieve the Sustainable Development Goals

~Written by: Karen Hicks, Senior Health Promotion Strategist & Lecturer, New Zealand (Contact: karen_ahicks@hotmail.com)

In September 2015 the United Nations adopted seventeen sustainable development goals (SDGs) (Figure 1) as part of the 2030 Agenda for Sustainable Development; which aims to end poverty, fight inequality, injustice, and tackle climate change. These SDGs are acknowledged as going beyond the previous Millennium Development Goals (MDGs) as they aim to address, ‘The root cause of poverty and a universal need for development that will work for all people’ (United Nations, 2015).

 

 

Figure 1. Sustainable Development Goals.

Source: http://wfto.com/sites/default/files/field/image/2015-07-21-SDGs.png

Each of the SDGs relate to health and wellbeing with aims, approaches and principles that are concomitant to the discipline of health promotion; a discipline that acknowledges the complexity of health and is based on the principles of human rights, equity and empowerment (Williams, 2011). Consequently, such principles imply that health promotion is an effective approach toward achieving the SDGs. This approach is supported by the global framework and described in “The Ottawa Charter for Health Promotion” (WHO, 1986) (Figure 2) which identifies five key action areas: building healthy public policy, creating supportive environments, strengthening community actions, developing personal skills and reorientating health services through advocacy, enabling mediation for effective practice.

 

Figure 2. The Ottawa Charter for Health Promotion Logo. Source:http://www.who.int/healthpromotion/conferences/previous/en/hpr_logo.jpg

 

An example of a collaborative initiative that illustrates health promotion as defined in the Ottawa Charter is the International Network of Health Promoting Hospitals & Health Services (HPH). The initiative collaborates to reorient health care towards an active promotion of health, aiming to improve for patients, staff, and communities. Further detail on the approach can be accessed on the HPH website (http://www.hphnet.org).

The principles and actions illustrated alongside the interdisciplinary approach of health promotion that empowers people and communities (Health Promotion Forum of New Zealand, 2014) and focuses on equity and the broader determinants of health (Davies 2013) is acknowledged by the World Health Organisation, “Health promotion programmes based on principles of engagement and empowerment offer real benefits. These include: creating better conditions for health, improving health literacy, supporting independent living and making the healthier choice the easier choice” (WHO 2013 p 16).  The value associated to the approach clarifies how health promotion can effectively contribute to achieving the seventeen SDGs where the SDGs can guide the delivery of effective health promotion to improve health, wellbeing and personal development throughout the global community.

 

References:

Clinical Health Promotion Centre. The International Network of Health Promoting Hospitals & Services.  http://www.hphnet.org/ Accessed 22/1/2016. Bispebjerg University Hospital Denmark.

Davies, J.K. 2013. Health Promotion: a Unique Discipline? Health Promotion Forum of New Zealand.

Health Promotion Forum of New Zealand. 2014.http://www.hauora.co.nz/defining-health-promotion.html#sthash.5sStc8VF.dpuf.

United Nations. 2015. http://www.un.org/sustainabledevelopment.

Williams, C. 2011. Health promotion, human rights and equity. Keeping up to date. Health Promotion Forum of New Zealand.

World Health Organisation. 1986. The Ottawa Charter for Health Promotion. WHO.

WHO (2013) Health 2020: a European policy framework and strategy for the 21st century Copenhagen, World Health Organisation

 

Read the blog at TWIGH

 

 

 

23 March 2016

 

Karen Hicks

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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, News, What is HP

A Master’s Degree dissertation by HPF’s Senior Health Promotion Strategist Karen Hicks has upheld the widely held view that  the 2012 New Zealand Health Promotion Competencies (HPC2012) are unique in the world, due to their central inclusion of indigenous Māori perspectives.  This central positioning of Māori results in a framework that is an effective capacity-development tool to improve Māori health and reduce inequities.

 

Findings from Karen’s qualitative research confirmed that the HPC2012 provides an example of best practice that is values-driven and inclusive. Karen’s analysis showed that the process’ cultural-sensitivity was made possible by the:

 

a)      weaving of Māori tikanga values throughout the development phase.

b)      inclusion of grassroots workers – the backbone of the health promotion workforce – in the development process for the competencies.

c)       provision of adequate time to meaningfully consult with Māori.

 

Karen used a two-fold methodology for her research, including the comparative analysis of secondary data from four international health promotion competency frameworks and analysis of primary data obtained from interviews with New Zealand health promotion public health leaders.

 

 

The HPC2012 is the second version of the competencies; the first having been published in 2000.   The rigorous review and wide consultation with Māori was a response to feedback that identified inadequate consultation with the indigenous people of Aotearoa New Zealand as a shortcoming of the first version.

The current competencies were recently recognised by the International Union of Health Promotion and Education (IUHPE) as equivalent to their own European Health Promotion Competencies.  See article.

 

 

 

16 March 2016

Jo Lawrence-King

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Competencies, What is HP

From 16 April, the Health Promotion Forum is excited to offer an online course, introducing the social determinants of health: a foundation stone for the understanding of health promotion.  This new mode of delivery will allow practitioners across Aotearoa New Zealand to continue their professional development in a convenient and inexpensive way.

Icons for education for all, distance education, training and tutorials

Icons for education for all, distance education, training and tutorials

“We are conscious that those working in remote locations do not always have the resource to travel to the main centres for training,” says HPF Executive Director Sione Tu’itahi.  “This approach supports flexible learning in your own home or workplace; 24 hours a day, 7 days a week.”

The course is a pilot of what is hoped to be a series of similar courses exploring and demystifying health promotion.  Social determinants of health are the underlying ‘causes of the causes’ of health and wellbeing.  They form a key foundation for the discipline and practice of health promotion.

With a level four education classification, the course is suitable for learners of all levels.  It is also relevant to a wide range of professionals, including those working in public and community health, social services, education and city and county councils.

The course will involve approximately six hours of study: this includes time to read background material and watch video clips, as well as fulfilling course work.  Registrations will remain open for just one month and participants will have 7 days from the date of their registration in which to complete it.

It is being offered in collaboration with CLAD Services, a New Zealand company that specialises in online solutions for training.  The course fees is $99.00, including GST.

 

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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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We asked three health promotion professionals three questions for the spring/summer 2015 issue of Hauora, focusing on health promotion in Aotearoa New Zealand and the Health Promotion Forum.

Here are their responses:

What do you see as some of the major issues regarding health promotion in Aotearoa New Zealand and the world today?

Zoe Aroha Martin-Hawke identifies two interconnected issues facing health promotion in Aotearoa; the wide-ranging use and understanding of the term ‘health promotion’ and a decrease in the use of the term in workplace titles.

“The use and understanding of the term ‘health promotion’ is wide-ranging, with some perceptions overlapping and others quite separate.  The challenge is to find a balance between autonomy of each perspective and enabling collaborative working in the areas that intersect.  The emergence of competitive funding contracts, with a set health promotion agenda, makes this particularly difficult.

“Secondly a decrease in the use of the term ‘health promotion’ in job titles, work departments and job descriptions sees fewer people identifying as health promoters.  This may be related to the lack of consensus on the definition of health promotion and/or on  funding directives.  Such a lack of clarity may restrict the ability of people to practice the health promotion model they believe in.  As a result, Zoe is concerned that the discipline is losing its value, respect and presence in Aotearoa.”

“Health promotion consists of so many dimensions that are strongly connected with Māori thinking it would be sad to see it disappear in the formal sense,” says Zoe.  “Furthermore people have invested time and money into the study of health promotion and are passionately connected to the discipline.  To not be able to practice what they have been students of for many years seems unethical. “

 

Much of Wiki Shepherd Sinclair’s 11 year career in health has focused on Health Promotion.  She believes that the challenges facing the Health Promotion space in Aotearoa New Zealand – and the world – today include lack of collaboration and communication, poor cultural awareness, lack of community engagement and an experienced, but unqualified workforce.

According to Dr Mihi Ratima – and as outlined in the recent book she edited with Associate Professor Louise Signal (Promoting Health in Aotearoa New Zealand) – major issues facing health promotion include the challenge of neoliberalism, the positioning of health promotion on the periphery, and the difficulty in maintaining the health equity focus.

As noted in the book, the health of the planet – and all of us who live on it – is under dire threat from factors such as climate change, obesity and new infectious disease. Progressive health promotion is an approach that can counterbalance threats to health with practice, policy and advocacy for health, well-being and equity. “There is an urgent need for further government investment in this approach”, she says.

Perhaps our greatest challenge, according to Mihi, is in achieving health equity. “We are good at the rhetoric around reducing inequities, but are things really changing? If not, why don’t we have a sense of urgency about it? What does the evidence say about some of the issues we know are important from a public health perspective, like income inequality? What is going on with those wider determinants? We know we can be effective, as evidenced by narrowing of gaps in life expectancy between ethnic groups over time.  But we also know that many of our interventions continue to have a majority population focus, leaving out some groups, and inadvertently increasing inequities. We must normalise a commitment to health equity in everything we do in health promotion, use the excellent health equity tools we have at our disposal, and ensure that no one is left out. The lived realities and voices of those who are different from us need to be part of the solutions.”

 

What do you see as the role of the Health Promotion Forum in population health today? 

Zoe Aroha Martin-Hawke:“To lead workforce development to ensure that there is a shared understanding, respect and pathway for health promotion champions throughout the country.”

To keep the sector up to date on health promotion internationally and nationally.

To keep information flowing into the NZ context to secure a strong health promotion lens and voice to keep us connected and focused on the areas we need to collaborate on. Progressing indigenous perspectives on health, health equity and everyone’s right to health are key messages and activities that the health promotion forum are leading and can continue to lead in the quest for equitable population health. Health promotion leadership is needed and the health promotion forum can build that leadership through its membership.

Wiki Shepherd-Sinclair suggested the following;

  • Supporting organisations to gain a better understanding of what health promotion in Aotearoa is and what this looks like in practice
  • Supporting organisations to have a shared understanding and common language of health promotion
  • To have a lead advocacy role in health promotion and public health
  • To promote Healthy public policy
  • Encouraging organisations to grow their networks and/or partnerships
  • To help organisations build awareness and skills to implement the Health Promotion Competencies
  •  Providing a set of practical tools and training around the HP competencies

According to Mihi Ratima “Health promotion is an established approach to addressing public health problems in New Zealand. A key role of the Health Promotion Forum is in supporting the workforce and organisations to develop shared understandings of effective health promotion approaches.  This leads to greater health equity and improved outcomes for individuals, whanau and communities: what works and how to apply health promotion through policy, practice and advocacy”.

Mihi also believes the Health Promotion Forum has a role to play in supporting the development and growth of the body of theory and evidence for effective health promotion.

 

What would you say to an organisation considering membership of the health promotion forum?

Zoe Aroha Martin-Hawke : “For clarity, consistency, ongoing workforce development and the ability to connect with like-minded health promotion workers from across the country, to keep up to date with international health promotion movements the Health Promotion Forum is exemplary.”

“HPF is one of those rare examples of how to truly work from a reducing inequalities framework.”

“As a member of the Health Promotion Forum you can trust that their statements around “prioritising activities that will benefit people communities who are least disadvantage” are not just words.  They take a systems approach to tackling these issues by starting with their own organisation – where it should start.

“Their team consists of a strong Pacific and Māori team at all levels from the Board, to the Executive Director, to Deputy Executive Director to accountant.  All members of the team understand and are dedicated to viewing the reduction on inequalities in a broad socio-economic context, where promotion, prevention and protection are at the forefront.”

 

Wiki Shepherd-Sinclair encourages organisations to consider membership of HPF as the health promotion leader in Aotearoa New Zealand.  “The connections with regional and international leaders are a real plus for organisations that also want to grow their networks and strengthen relationships. The sharing of health promotion expertise and best practice, to increase better outcomes for our communities and populations, is of huge importance,” she says.

 

“It is critical that we have shared understandings of effective approaches to health promotion and work collaboratively,” saysMihi Ratima. “The HPF provides a mechanism through which organisations are able to work together and leverage off one another for the benefit of the entire membership. Member organisations are able to form relationships with one another and access training and expertise that is not otherwise available to them. This network of provision provides an expanded sphere of influence whereby innovation in health promotion is able to be easily shared and its value maximised through uptake within the network.”

 

 

 

 

Jo Lawrence-King

7 October 2015

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First New Zealand Health Promotion book

Promoting Health in Aotearoa New Zealand

Promoting Health in Aotearoa New Zealand was conceptualised as a text that equally integrates Māori and Pākehā analysis; consistent with an approach that emphasises the Treaty of Waitangi partnership and indigenous rights. The editors have endeavoured to achieve this through collaboration between Māori and Pākehā editors, advisors and contributors. Contributors to the book include: Professor Sir Mason Durie, Professor John Raeburn, Associate Professor Papaarangi Reid, HPF’s Executive Director Sione Tu’itahi, Associate Professor Cindy Kiro, and HPF’s previous Executive Director Dr Alison Blaiklock.

Health promotion in Aotearoa New Zealand has elements that, in combination, make for a unique approach.  Ratima explains: “Key features are the unique contribution of Māori understandings and approaches; the application of a rights-based approach for example in relation to Treaty of Waitangi-based rights and indigenous rights; the strong equity focus; commitment to addressing determinants of health; an emphasis on strengthening community development and self-determination; and the use of local models, frameworks and tools.”

There is very little text available that looks at health promotion in New Zealand – particularly as it relates to Māori. In fact Promoting Health in Aotearoa New Zealand is rare internationally for its strong focus on indigenous health. Frequently we refer to overseas texts when teaching and supporting public health practice.  Often these are not relevant to Māori, other New Zealanders or the New Zealand context. This has been of concern to health promotion academics and practitioners for some years.

“This book has been written to address that gap,” says Mihi.  It explores ways in which Māori, and other, perspectives have been melded with Western ideas to produce distinctly New Zealand approaches. In doing so it addresses the need for locally written material for use in teaching and practice, and provides direction for all those wanting to solve complex public health problems.

The book highlights the “dire threat” to the health of the planet – and all of us who live on it – from factors such as climate change, obesity and new infectious diseases. It concludes that progressive health promotion is an approach that can counterbalance threats to health with practice, policy and advocacy for health, well-being and equity.

 

HPF’s Executive Director Sione Tu’itahi was invited to speak a the book launch.  He was also a contributor to the book.

“…The process by which the book was produced, both in contents and presentation, reflects a successful partnership that resonates with the letter and spirit of our nation’s founding document, Te Tiriti o Waitangi; an example worth emulating. It also places Matauranga Maori (Maori knowledge)  prominently, while it weaves together the knowledge of the West, the knowledge of the East, and Indigenous knowledge systems as a set of effective solutions for addressing  our health challenges.

Although the primary focus is on Aotearoa, the book brings in the experience and knowledge of Moana Nui a Kiwa and other regions, thus making the book a very valuable contribution to our collective effort at the global level to address planetary health.

The recent launching of Promoting Health in Aoteroa New Zealand is very timely because:

– there is an increasing awareness in all sectors, government, community, and the corporate sectors, that  to be effective in addressing our socio-economic, cultural, physical, ecological and spiritual wellbeing, we have to be health promotional and preventative in our integrated approaches

– there is also a marked increase in the number of courses and qualifications on health promotion and public health in universities, polytechs and wananga. This book is a ‘must have’ reading and resources for all learners and practioners

– additionally, there is an increasing awareness in other sectors, such as social development and education, of the connectedness of the set of challenges that we all try to address, and therefore, the increasing need to learn from other sectors such as health and some of their comprehensive and effective tools and approaches such as health promotion

I would like to congratulate the hard-working editors, Associate Professor Louise Signal, and Dr Mihi Ratima.  Your perseverance, dedication, endless patience, and professionalism, have paid off. Well done!”

 

 

 

 

 

 

Jo Lawrence-King

7 October 2015

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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.

“Austerity kills” – that was the claim of Sharon Friel, Professor of Health Equity at the Australian National University, Canberra in her presentation Power and People: a game plan for health equity in the 21st Century.  “Health promotion is about freedom and empowerment; giving people a voice,” she said.  “What is shaping our everyday living resources is power.”  She characterised budget cuts as ‘structural violence’ that threaten equity and wellbeing.  

“Injustices are everywhere and they affect peoples’ health. These injustices can and should be eliminated. …..  How we understand, frame, communicate and engage around matters to do with health equity guides the types of actions that are taken, or not, to improve the lives of all groups in society.”

“Health promotion is about freedom and empowerment; giving people a voice,” she said.  “What is shaping our everyday living resources is power.”  She characterised budget cuts as ‘structural violence’ that threaten equity and wellbeing.

Asked what health promoters can do in their everyday practice, Prof Friel said  “We need to think about our work with an equity lens on every day; otherwise we are not addressing the social determinants of health.”

Prof Friel’s game plan for health promoters consisted of three steps:

1. Keep equity at the centre.

Rather than focusing on selective social determinants of health (such as housing or education) we need to keep equity as a whole at the centre of everything we do.

2. Frame your messages to fit your audience.

Realpolitik (based on power and on practical factors) rather than ideology is the way to go in the current Australian climate, for example.

Data is powerful.  Evidence will support the value of health promotion and initiatives.

Social media is a powerful way to create a movement.  It will succeed where traditional media often meet with resistance from the industry that fund them.

3. Release the power.

The strength of health promotion lies in its ability to work collaboratively with a range of people and disciplines.  We can release the power of these networks by:

Recognising the skills and capacity of our workforce and empower them to make a difference.

Foster relationships with a wide range of complementary disciplines to create a team effort.

 

About Sharon Friel

Sharon Friel is Professor of Health Equity, incoming Director of Regulatory Institutions Network (RegNet) and Director of the Menzies Centre for Health Policy, The Australian National University, Canberra

She is is from the east end of Glasgow. After leaving Scotland in 1990, she pursued an academic career in public health following a brief stint making carpets in Germany and smelling beer in England. Sharon Friel is currently Professor of Health Equity at the National Centre for Epidemiology and Population Health and Director of the Menzies Centre for Health Policy at the Australian National University. Between 2005 and 2008 she was the head of the Scientific Secretariat, based at University College London, of the World Health Organisation’s global Commission on Social Determinants of Health. In 2010 she was awarded an Australian Research Council Future Fellowship to investigate the interface between health equity, social determinants and climate change (particularly through food systems and urbanisation), based at the National Centre for Epidemiology and Population Health, ANU. Before moving to Australia, she worked for many years in the Department of Health Promotion, National University of Ireland, Galway. She is co-founder of the Global Action for Health Equity Network (HealthGAEN), a global alliance concerned with research, training, policy and advocacy related to action in the social and environmental determinants of health equity, and chairs Asia Pacific-HeathGAEN.

 

 

 

 

Jo Lawrence-King

10 September 2014

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Alice Springs, September 2014

In September HPF Senior Health Promotion Strategist Karen Hicks represented Aotearoa New Zealand at the Australian Health Promotion Association Conference Equity at the Centre: Action on Social Determinants of Health in Alice Springs.   Highlights from the event included

  • Sharon Friel’s plenary session on politics, power and people
  • Karen’s own presentation on Indigenous health promotion and workforce development
  • Martin Laverty’s discussion of the economics of social justice
  • Kerry Taylor’s  findings about the power of language as a determinant of health

 

In her presentation Politics, power and people: A game plan for health equity in the 21st century Prof Sharon Friel identified a game plan; actions that health promoters can undertake.

1. Keep equity at the centre.

Rather than focusing on selective social determinants of health (such as housing or education) we need to keep equity as a whole at the centre of everything we do.

2. Frame your messages to fit your audience.

Realpolitik (based on power and on practical factors) rather than ideology is the way to go in the current Australian climate, for example.

Data is powerful.  Evidence will support the value of health promotion and initiatives.

Social media is a powerful way to create a movement.  It will succeed where traditional media often meet with resistance from the industry that fund them.

3. Release the power.

The strength of health promotion lies in its ability to work collaboratively with a range of people and disciplines.  We can release the power of these networks by:

Recognising the skills and capacity of our workforce and empower them to make a difference.

Foster relationships with a wide range of complementary disciplines to create a team effort.

 

Karen Hicks’ presentation discussed Indigenous health promotion competency and workforce development in Aotearoa, New Zealand.  The New Zealand approach is being held up around the world as a model to assist and inform indigenous health promotion.

Focusing on the role an effective health promotion workforce has on in reducing health inequities, Karen introduced three inclusive and equitable capacity building tools:

  • TUHANZ (a Treaty Understanding of Hauora in Aotearoa New Zealand),
  • the health promotion competencies and the
  • health promotion society

She pointed out that the development these tools are informed by indigenous health promotion in consultation with the health promotion workforce.

The main thrust of Martin Laverty’s discussion was that a healthy population is essential for a productive, healthy, growing economy.

In his presentation, The economics of social justice: cost benefit analysis to achieve social determinants action, Laverty asserted that equity is an asset and, which we should examine with an economic lens.  We can do this by the way we communicate to governments: framing our arguments according to the left-right orientation of the Governments of the day.

To discuss the subject of equity with a Government positioned to the right it is important to discuss social determinants of health in the context of facilitating an effective economy.  Those governments that want people to be responsible for their own health need first to invest in social capital and in social determinants of health such as housing and child development.  This enables people to have the capacity and capability to be responsible for their own health.

If addressing a left wing government, on the other hand: we need to frame social determinants of health in relation to fairness.

Martin Laverty is Chair of Social Determinants of Health Alliance

 

Kerry Taylor’s PhD research at from Flinders University, Alice Springs campus, suggested that language as a social determinant of health is putting indigenous people’s lives at risk.

There are over 200 languages spoken in Australia; most of which are not spoken by health workers.  As a result health workers are unable to share a common language or deep dialogue with patients/communities.

The outcomes for services accessed by indigenous communities include:

  • high staff turnover due to staff feeling ill equipped,
  • poor access to healthcare
  • language becoming a significant social determinant of health.

 

 

 

Jo Lawrence-King and Karen Hicks

24 November 2014

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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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“Inequalities in health exist both within and between countries.  They are both unnecessary and unjust.  They also create a great cost to societies…”  These are the opening words of the latest Eurohealth; the quarterly publication of the WHO-hosted European Observatory on Health Systems and Policies.  Reporting on the 7th European Public Health Conference, this special edition for 2015 focuses on the issues discussed at the November 2014 event in Glasgow, Scotland. 

With the theme of the conference being “Mind the Gap: Reducing Inequalities in Health and Health Care”, EuroHealth articles look at:

  • How Roma communities are responding to inequalities;
  • The adaptation of health promotion and disease prevention interventions for migrant and ethnic minority populations;
  • The Glasgow Declaration;
  •  Learning from each other – where health promotion meets infectious diseases;
  • Public health monitoring and reporting;
  • Changing your health behaviour – regulate or not;
  • Developing the public health workforce;
  • Building sustainable and resilient health care systems;
  • Leaving a legacy in Glasgow;
  • Conclusions; and Eurohealth Monitor.

The European Observatory on Health Systems and Policies is a partnership between the World Health Organization Regional Office for Europe, the Governments of Austria, Belgium, Finland, Ireland, Norway, Slovenia, Sweden, the United Kingdom and the Veneto Region of Italy, the European Commission, the World Bank, UNCAM (French National Union of Health Insurance Funds), London School of Economics and Political Science and the London School of Hygiene & Tropical Medicine.

Read more about inequalities and other significant health issues in Eurohealth Number 1, 2015 here.

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A paper published this year in Social Science & Medicine Journal has concluded that income inequality does indeed have a negative effect on population health and wellbeing; and that narrowing this gap will improve it.   The paper suggests ways in which governments need to act to address this growing problem.

“It comes as no surprise to us that this is the conclusion of this paper,” says HPF’s Executive Director Sione Tu’itahi.  “What surprises us is that there was ever any doubt.   This will be a strong addition to our body of evidence.  We implore governments in Aotearoa New Zealand and around the world to address inequality as the key to improving the health and wellbeing of their people.”

The paper’s authors cite world leaders, including the US President, the UK Prime Minister, the Pope and leaders at the International Monetary Fund, the United Nations, World Bank and the World Economic Forum; all of whom have described income inequality as one of the most important problems of our time.   Several of these leaders have also emphasised its social costs.  “Inequality is increasing in most regions of the world, rapidly in most rich countries over the past three decades,” they say.

“The evidence that large income differences have damaging health and social consequences is already far stronger than the evidence supporting policy initiatives in many other areas of social and economic policy, and the message is beginning to reach politicians,”  say the authors.  “The reason why politicians do not do more is almost certainly a reflection of the undemocratic power of money in politics and the media. Narrowing the gap will require not only redistributive tax policies but also a reduction in income differences before tax. “

The paper, by Professors Kate Pickett and Richard Wilkinson (pictured above), was drawn from a ‘very large’ literature review, including those papers that have previously thrown doubt over the causal link between income inequality and population health.   The outcome was a strong body of evidence to support the link, while those few papers that drew different conclusions were found to have been based on studies using inappropriate measures.

 

Photo: Guardian.co.uk

Story: Jo Lawrence-King

April 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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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”.

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Effective co-ordination of primary care beyond treatment and prevention services to include comprehensive disease prevention and health promotion is central to the success of the Primary Health Care Strategy. To achieve effective health promotion in a PHO, public health and primary care practitioners will need to work together.
The purpose of this guide is to assist PHOs and DHBs develop, assess and deliver health promotion programmes aimed at improving the health status of the population and reducing health inequalities. A Guide to Developing Health Promotion Programmes

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A new occasional paper published this week argues that, in building the capacity of the HP workforce, models of good practice in education and training should be explored and utilised that truly reflect inherent HP values and principles. She proposes that self-directed and work-based learning are relevant and should be explored in more detail by trainers and educators across the globe.

Caroline is a Research Fellow at the Centre for Health Research, University of Brighton, UK.

 

 

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News, What is HP

Sixteen people met in Auckland on Monday 9 June to ratify the founding constitution of the world’s first health promotion professional society. “This is a significant phase in what has been a wonderful journey,” said HPF’s Deputy Executive Director Trevor Simpson, who has been a driving force behind the Society for the past 4 years.  “It was a privilege to be given this portfolio.”

 

trevor-prof-soc-jun-2014

 

At the meeting the health promotion supporters agreed the founding constitution of the Society.  It will be an independent organisation with paid membership open to anyone who observes the ethos and values of health promotion, regardless of their academic or professional qualification.

 

The next step will be to lodge documentation with the Companies Office with a view to creating a registered Society, a formal legal body.

 

The concept of a professional organisation in Aotearoa was first mooted 18 years ago and has undergone close scrutiny and questioning over this time.  Trevor Simpson is confident that this robust discussion around its establishment will result in a thoughtfully planned, “nimble, stand-on-its-own-two-feet organisation”.

 

Providing an overview of the history of the Society’s formation, Trevor referred to the country’s heritage of leadership in change and human rights.  “New Zealanders have shown over and over that we are leaders in standing up for what we think we should have,” he said; citing Te Whiiti (Parihaka), Kate Sheppard (votes for women) and David Lange (nuclear-free NZ) as just some examples.

 

Present at the meeting were two members of the Professional Society Interim Committee.  Ann Shaw, of both the PHA and the Cancer Society has been involved in the initiative since its inception. Grant Hocking, from Action on Smoking and Health (ASH), joined the committee three years ago. Trevor acknowledged their contribution as well as that of past members including:

 

  • prof-soc-agenda-jun-2014
  • Dr Alison Blaiklock (past HPF Executive Director)
  • Cheryl Ford (of Cancer Society Christchurch)
  • Helen Rance (past Health Promotion Strategist at HPF)
  • Grant Berghan (Public Health Consultant)

Read more about the Professional Society – history and ethics.

 

For further information please contact Trevor Simpson.

 

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Pacific, Policy, What is HP

South West Pacific health promotion leaders have undertaken in March to develop a work plan that includes research, New Zealand representation at global health promotion meetings and to develop a health promotion work plan for the region.

 

swp-map

 

The decisions were taken at a March meeting of the South West Pacific regional committee of the International Union of Health Promotion and Education (IUHPE)

Health promotion work plan for the South West Pacific

The committee is to begin work on a plan for health promotion development for the South West Pacific region. Priority areas for the three-year plan include

  • workforce development
  • research,
  • indigenous health promotion and health issues.

Research

The meeting approved a submission from HPF to investigate some of the challenges that face the discipline of health promotion and its practitioners in the region. These include policy decisions that disadvantage certain sectors of the community, job-losses due to the recession and research on the effectiveness of health promotion.

Indigenous NZ health promotion advances

Two new members were welcomed onto the committee, further strengthening region’s indigenous health promotion work.  Dr Viliami Puloka, a health promotion team leader at the Secretariat for the Pacific Community (SPC), is based in Noumea, New Caledonia.  His appointment is the first from a small Pacific nation in ten years.

Trevor Simpson, Deputy Executive Director at HPF was also co-opted onto the committee, taking advantage of his work as a member of the Regional Indigenous Health Promotion Working Group of IUHPE.

Already in place is Dr Heather Gifford:chair of the SWP regional indigenous health promotion working group and co-chair of the IUHPE global working group for indigenous health promotion.

As a member of the global executive board of the IUHPE, Sione Tu’itahi was tasked with keeping indigenous health promotion on the agenda at all meetings. “This is great news for both Maori and Pacific health promotion,” he said. “Our progress and positive experience with Indigenous health promotion in New Zealand is leading the way at a global level”.

Sione Tu’itahi is executive director of the HPF, vice-president of the South West Pacific region of the IUHPE and a member of its global executive board.

The South West Pacific region of IUHPE includes New Zealand, Australia three countries in South East Asia and all other 22 Pacific small nations and territories. Its regional office is co-hosted by HPF and the Health Promotion and Research and Evaluation Unit of the School of Public Health, University of Otago.

 

30 April 2014

 

By Sione Tu-itahi

Editor: 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

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The interdisciplinary nature of health promotion places it at the cutting edge of health and wellbeing: offering creative and effective ways to promote wellbeing and protect groups, communities and populations from health challenges. It shares a common ground with several disciplines that focus on human and ecological wellbeing.  One such discipline is social development.

We have reached a point where the challenges facing social and economic wellbeing are global; requiring action at all levels from local and national to regional and worldwide.  We have seen the limitations of a narrow, discipline-focused approach. According to Sir Mason Durie:[1] “…the failure of groups working in isolation to make substantial gains requires new approaches that are not handicapped by sectorial limitations or simplistic conclusions that one body of knowledge or one professional group has all the answers.”

Health promotion and social development share many common principles

Although based in different sectors, the fields of social development and health promotion share some common underlying principles. This common ground provides a strong framework for closer collaboration between the different disciplines; yielding benefits, effectiveness and efficiency for all concerned.

Some of these common principles are:

  • The aim of advancing  the  holistic health and wellbeing of peoples and communities
  • A core set of underlying causes  or determinants that can make or break the health and social wellbeing of peoples and communities
  • The understanding that health and development must be achieved with approaches that are sustainable for both humans and the rest of the ecology
  • A belief in the inherent power and ability of peoples and communities to take control of these underlying causes, and, therefore, be the masters of their own futures[i]
  • Similar strategies, such as community development, whānau  and family capacity building, for addressing the needs of peoples and communities.

 

Whānau  Ora: a strong example of health promotion’s interdisciplinary approach

The Whānau Ora approach is a strong example of an initiative that acknowledges the shared principles; operating across the health, social development, education and justice sectors.  It is health promotion at the whānau  level.

While the terminology of Whānau  Ora is of Māori origin, the philosophy and practice can be found in many Pacific cultures. In many cases, the terms used are also linguistically related: Fanau Ola, for example, is a term used in Tongan and Samoan cultures to express the collective wellbeing of the extended family. Like its Māori equivalent, Fanau Ola in Pacific cultures refers to extended families and communities leading their own holistic development and being in control of their wellbeing and future. As more and more Māori  and Pacific providers take up a Whānau  Ora and Fanau Ola approach in working with communities, they realise that whānau  and families are empowered not only because the approach resonates with their Indigenous worldviews, values and practices, but also whānau  and families are taking control of their future and leading themselves, rather than relying on others and providers.

Our challenge now is to build on the interdisciplinary model of health promotion.

 

[1] Durie, M. (2011), Nga Tini Whetu Navigating Māori  Futures, Huia Publishers, Wellington, p. 65

 

 

April 2014

By Sione Tu’itahi

Edited by Jo Lawrence-King

 

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HPF video answers the question; What is health promotion?

Watch the 2 minute 30 second video, including contributions from IUHPE president Michael Sparks and HPF Deputy Executive Director Trevor Simpson.

Prof John Raeburn: Health Promotion advocate

Read this warm, humble and in-depth interview with Emeritus Prof John Raeburn, whose 40+ years in health promotion have helped shape the profession.

Defining health promotion

Health promotion is both a discipline and a process. It focuses on empowering people and communities to take control of their health and wellbeing. Ranging from action at a community level to developing policies, it is founded on the principle that health and wellbeing begins in the settings of everyday life. Read more

Video: What if?…. health promotion campaigns actually worked?

In this 50 minute video, Dr Ekant Veer from the University of Canterbury discusses the severe limitations of NZ’s heavy reliance on mass media as a way of sharing knowledge to attempt health promotion. He explores the other factors needed to create successful health promotion initiatives, such as:

  • social norms
  • past experience
  • perceived consequences
  • environment
  • personal ability

The need for health promotion as a distinct approach

The World Health Organisation (WHO) asserts that factors such as where we live, our environment, genetics, education and relationships have a greater influence on our health and wellbeing than the commonly considered factors such as access to health care services [vi].

Although the causal pathway between the two is long, evidence to support this correlation is growing. Health promotion includes work to build that evidence and identify ways to build population health by improving the determinants.

Health promotion is at the cutting edge of hauora

The interdisciplinary nature of health promotion places it at the cutting edge of health and wellbeing: offering creative and effective ways to promote wellbeing and protect groups, communities and populations from health challenges. Read more

Health promotion: a distinct discipline

In his 2013 paper, Prof. John Kenneth Davies concludes health promotion has a unique and specialised role within a wider multidisciplinary approach to maintaining and improving health.

Video: The close link between human rights and health promotion

“States and others have legally binding obligations to engage in health promotion,” says Paul Hunt at the 20th Conference of the International Union of Health Promotion and Education. Health promotion is part of the government’s role in upholding a person’s right to the hightest attainable standard of health. Also see HPF’s The Right to Health – Proceedings of the Health and Human Rights Workshops, 2012.

Video: Understanding Health Promotion (Canada)

Ass’t Prof Suzanne Jackson discusses health promotion under the frameworks of the Ottawa and Bangkok charters. (8 mins)

Keeping Up to Date paper: Health promotion and spirituality: making the implicit explicit

Richard Egan explores the place of spirituality in health promotion in the 34th of HPF’s Keeping Up to Date peer-reviewed papers.  “In New Zealand, partly due to the contributions and aspirations of Māori, spiritual concerns are understood as an essential component of health.”  Egan’s paper argues that, due to growing evidence and a principled approach, attending to spirituality in health promotion is an ethical imperative, critical to our reflective practice and necessary for comprehensive planning, action and evaluation.

Richard is a Research and Teaching Fellow at the Cancer Society Social and Behavioural Research Unit, Te Hunga Rangahau Arae Mate Pukupuku, Department of Preventive and Social Medicine, University of Otago, Dunedin.

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The Health Promotion Forum has been striving to encapsulate the discipline of health promotion in a few words.  This is a challenge that has vexed the profession since it first emerged several decades ago.   It is widely acknowledged that we need a clear definition of health promotion to effectively communicate its purpose and value to others.

Below is our definition, which we invite health promoters around the country – and the world – to adopt.

Health promotion is both a discipline and a process.  It focuses on empowering people and communities to take control of their health and wellbeing.  Ranging from action at a community level to developing policies, it is founded on the principle that health and wellbeing begins in the settings of everyday life.

Health Promotion Forum of New Zealand
Runanga Whakapiki Ake i te Hauora o Aotearoa
April 2014

 

At HPF the discussions around defining health promotion have covered  a wide range of topics.  Our conclusions – on some of these topics – have been:

  1. There are three perspectives on health promotion relevant to the Aotearoa New Zealand setting.
  2. Health promotion is a unique discipline and is distinct from public health and health education.
  3. Health promotion is one of the disciplines that together work towards optimising population health.

Three equally important perspectives on health promotion

In Aotearoa New Zealand, health promotion is primarily based on two foundation documents: Te Tiriti o Waitangi and the Ottawa Charter, a global framework of the World Health Organisation[i].

There are at least three major perspectives of health promotion in New Zealand – Western, Māori, and Pasifika. While they have many things in common, each has its own unique elements and distinct source, history and strengths.

  1. From a Western perspective, health promotion is a public health discipline. It is the process of enabling peoples and communities to take greater control of their health[ii].
  2. From a Māori view point, health promotion is the enabling of Māori to take greater control of the determinants of their health and therefore their future[iii].
  3. From a Pasifika perspective, health promotion is the empowering of Pasifika peoples to control their wellbeing and their future[iv].

All three are ever-evolving systems of knowledge.  All require equal respect and acknowledgement in our collective learning and enrichment: as fellow human beings with equal rights and responsibilities.

HPF acknowledges that all three perspectives have merits and strengths to contribute.  We respect the need to provide space for the respective autonomy of each.  At the same time, where our perspectives overlap, we encourage collaborative effort and partnership for the collective wellbeing of society at all levels.

Health promotion is a unique discipline – distinct from public health and health education

“Health promotion is a discipline with its own ideology and ordered field of study.”  That is the conclusion of John Kenneth Davies, Professor of International Health Promotion (HPF) at the University of Brighton, England, in a paper commissioned by the Health Promotion Forum, November 2013.

Some people see health promotion as a strategy for achieving public health.  Others see it as a form of health education: encouraging behavioural change. Davies disagrees with both beliefs.  He asserts that health promotion’ uniqueness is founded in its work to tackle the determinants of health (the ‘causes of the causes’), and that it is distinct from public health by virtue of its more holistic approach.

“Health promotion has a unique and specialised role within a wider multidisciplinary approach to maintaining and improving health,” says Prof Davies in his paper Health Promotion: A Unique Discipline? He quotes Wills and Douglas (2008) as saying it is “a moral and political project and is fundamentally values-based.”

The discussion on health promotion and population health

In an attempt to tease out the distinction between population health and health promotion, HPF Senior Health Promotion Strategist Karen Hicks posed a question to a professional group on LinkedIn.  Over 60 contributions from 15 members gave rise to a sometimes heated discussion on the topic.

While some people hold a clear view about the distinction between health promotion and population health, for many there is still much confusion.  The majority of people who took part in Karen’s LinkedIn discussion see health promotion as a way of moving towards improved population health.  However there were differing views on how this is achieved.  Some see health promotion as individually focused behavioural change.  Others see it as a strategic approach to health inequities and the underlying social determinants of health.

Karen suggests that, perhaps a way to see health promotion is as one of the disciplines – along with public health and social development – that, together, work towards improving overall population health?

Further she suggests we might see health promotion as a continuum:  health promotion practitioners work at the community level, implementing programmes to improve hauora, while health promotion strategists work at the national and global policy level; aiming to improve the social determinants of health and address health inequities.

We look forward to continuing discussions around this complex question.

[i] World Health Organization. 1986.  Ottawa Charter, Geneva

 

[ii] World Health Organization 1986. Ottawa Charter, Geneva

 

[iii] Mihi Ratima, M. 2010.  Māori health promotion – a comprehensive

definition and strategic considerations, Health Promotion Forum, Auckland

 

[iv] Tu’itahi, S. & Lima, I. 2014. Pacific health promotion, a chapter soon to be published in textbook of health promotion, Otago University Press.

 

 

 

April 2014

By Jo Lawrence-King, Karen Hicks and Sione Tu’itahi

Edited by Jo Lawrence-King

 

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News, What is HP

student

 

UNITEC has this year launched a new Bachelor of Health and Social Development with a major in health promotion.  Offered at its Waitakere campus, the course will begin in February or July, and can be full-time (for three years) or part-time.

Offering a pathway into a wide variety of health and social development roles, the curriculum identifies ways in which to empower communities to take control of their own wellbeing.  Students develop an understanding of the strategic organisation of health promotion and the use of evidence based research.

Lian Wu – who previously worked at the University of Auckland Medical and Health Sciences School – will be the Major Leader for the course.

The Health Promotion Forum of New Zealand (HPF) offers a range of training courses, including the Certificate of Achievement in Introducing Health Promotion.

For further information: call 0800 10 95 10 or email study@unitec.ac.nz

 

Karen Hicks

31 March 2014
Photo courtesy of Elvis Santana: Stock.Xchng

 

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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

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Economics, Evidence, News, What is HP

who_logo_c300

 

A new policy summary, issued by the WHO (World Health Organisation) on 4 November, reveals substantial evidence to support the economic case for health promotion and prevention of non-communicable diseases.

The document summarises data from a major international study by the European Observatory on Health Systems and Policies, OECD and WHO/Europe.   The findings demonstrate the effectiveness of a wide range of actions, addressing some of the main risk factors to health including:

  • tobacco and alcohol consumption
  • impacts of diet and patterns of physical activity
  • children’s exposure to environmental harm
  • the protection of mental health
  • road safety.

While some of these interventions generate direct cost savings, many will require increased investment but generate additional health (and other) benefits.

The study will be published in 2014 as a book “Health Promotion, Disease Prevention: The Economic Case”.  It forms the basis for one of the evidence pillars for WHO’s Health 2020 strategy.

 

Published: 5 December 2013

Jo Lawrence-King

 

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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

world-happiness-report-image-small-for-web

 

“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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What is HP

In March 2013 an online survey was emailed to the Health Promotion Forum’s database, networks and reference groups to gain baseline data on the current knowledge of and implementation of the Nga Kaiakatanga Hauora mo Aotearoa Health Promotion Competencies for Aotearoa New Zealand 2012 amongst the health promotion workforce.

 

105 responses were collated from a variety of organisations and individuals.

 

The collated responses will inform the development of work to support the implementation of the competencies amongst the workforce.

Easy to read, colourful survey report can be found here.

 

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Pacific, What is HP

A new paper, published today, makes a further contribution to the development of Pacific leadership in health, education and other sectors.

Providing insight into the Tongan concepts of matapoto (intelligence and shrewdness) and lotopoto (wisdom and ethics), the paper explores the underlying values of these terms and how they are reflected in the values of many Pacific nations.

 

170px-george_tupou_i_c-_1880s

 

When used conjointly, the two terms indicate multi-dimensional intelligence, wisdom and consciousness.  This paper illustrates the dynamic coherence between training the mind and educating the heart and highlights the importance of values as an integral part of knowledge and learning.

Matapoto pea Lotopoto – Exploring intelligence and wisdom from a Tongan perspective for enhancing Pacific leadership in health, education and other sector – is by HPF’s Executive Director, Sione Tu’itahi.  It is published as part of the HPF’s Occasional Papers series.

Visit our Pacific health promotion pages.

 

 

Pictured: King George Tupou I

 

Published: 5 May 2013

By: Jo Lawrence-King

 

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Economics, Evidence, What is HP

“The Health Promotion Forum originally asked us to develop a full cost-benefit analysis (CBA) of measures to prevent smoking and obesity in young adults in New Zealand, as two examples of public health programmes. We lacked the funding or resources to do this.

 

This report is to pave the way for such a cost-benefit analysis. We argue that health promotion has for too long been stymied by a perception that they lack the data and indeed the funds to do a perfect cost benefit analysis.

 

This is a scoping study which seeks to illustrate that building a case for health promotion need not be excessively costly, nor does it need to wait for the perfect data. We illustrate the ideas using obesity and smoking as exemplars. We would however caution the use of the results.”  Savings from Prevention

 

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Maori, What is HP

The purpose of this paper is to provide a definition of Māori health promotion and to discuss Māori health promotion strategic issues to inform practice.

 
Māori health promotion is the process of enabling Māori to increase control over the determinants of health and strengthen their identity as Māori, and thereby improve their health and position in society (Ratima 2001). While this brief definition gives an indication of what Māori health promotion is about, by itself it does not convey completely the meaning and uniqueness of Māori health promotion. To more fully understand Māori health promotion, it is useful to refer to two models for Māori health promotion – Te Pae Mahutonga (Durie 2000) and Kia Uruuru Mai a Hauora (Ratima 2001). Together, these models describe both the breadth of Māori health promotion and its defining characteristics. The characteristics include the underlying concept of health, purpose, values, principles, pre-requisites, processes, strategies, key tasks, and markers.

 
A full definition of Māori health promotion is necessary to guide practice and enable common understandings as a basis for clear communication and advocacy for Māori health promotion. – See more at: http://www.hauora.co.nz/m%C4%81ori-health-promotion-comprehensive-deiniiton-and-strategic-considerations.html#sthash.LEDe55tb.dpuf

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