This Statement from Indigenous participants in the 23 rd IUHPE World Conference on Health Promotion (Rotorua, Aotearoa New Zealand) is a call on the health promotion community and the wider global community to make space for and privilege Indigenous peoples’ voices and Indigenous knowledges in promoting planetary health and sustainable development for the benefit of all. It should be read alongside the Rotorua Statement from all participants in this Conference.
Indigenous peoples are diverse and our worldviews, which have developed over millennia of human experience, are specific to peoples and place. However, there are fundamental commonalities in these worldviews that have provided the basis for Indigenous peoples’ movements that draw us together around our shared interests. Core features of Indigenous
worldviews are the interactive relationship between spiritual and material realms, intergenerational and collective orientations, that Mother Earth is a living being – a ‘person’ with whom we have special relationships that are a foundation for identity, and the interconnectedness and interdependence between all that exists, which locates humanity as part of Mother Earth’s ecosystems alongside our relations in the natural world.
Understanding our place in the natural world in relational ways leads us to consider how access to the natural environment shapes human health and wellbeing, the impacts of our activities on the environment, and our inalienable collective responsibilities of stewardship which will benefit future generations.
Within Indigenous worldviews our relationship with the natural world is characterised by reverence and values that include sustainability, guardianship and love. Planetary health is understood as the health and wellbeing of Mother Earth and of humanity as an inextricable part of natural ecosystems. It should also be noted that Indigenous languages are critical in articulating Indigenous worldviews as they
enable the most full and accurate expression of Indigenous conceptualisations, and should be protected.
The forces of colonisation, capitalism and globalisation have caused massive environmental degradation, climate change, loss of biodiversity and the devastation of Indigenous communities. Further, they have led to intellectual imperialism and the widespread subjugation and exclusion of Indigenous worldviews, bodies of knowledge and voices.
Prevailing Western and other worldviews promote individualism and anthropocentric perspectives that to human peril separate humanity from the natural world. This has encouraged human activity that accelerates the depletion of planetary resources, the destruction of ecosystems, pollution, climate change and increase in the risk of ecological collapse.
Environmental degradation impacts disproportionately on Indigenous peoples because of close relationships with the natural world and our already marginalised circumstances in nation states. The silencing of Indigenous voices and the subjugation of Indigenous bodies of knowledge has been detrimental to all, most evident in our global environmental crisis.
Indigenous health promotion (as opposed to the generic form of health promotion which has largely Western origins) emerged in response to Indigenous peoples’ needs to make space for our own ways of seeing the world and as a vehicle to realise our aspirations to sustain future generations who are healthy, proud and confident as Indigenous peoples. It is an Indigenous-led endeavour with origins that stretch back in time to customary systems to maintain health and wellbeing that emphasised social and ecological connections. At the same time, Indigenous health promotion is open to knowledge generated from within other worldviews where there is alignment. Indigenous health promotion can be understood as the process of increasing Indigenous peoples’ control over the determinants of health and strengthening our identities as Indigenous peoples.
Ecological collapse is the greatest threat to human health and survival globally. Health promotion (policy, research, education and practice) needs to change to effectively respond to the challenges of the Anthropocene and bring intergenerational health equity into its systems and frameworks. Engaging with indigenous worldviews and bodies of knowledge
provides opportunities to find solutions to this most pressing threat and ways forward to promote the health of Mother Earth and sustainable development.
We call on the health promotion community and the wider global community to make space for and privilege Indigenous peoples’ voices and Indigenous knowledge in taking action with us to promote the health of Mother Earth and sustainable development for the benefit of all.
This Statement represents the collective voice of the social movement members, researchers, practitioners and policymakers who participated in the 23rd IUHPE World Conference on Health Promotion, held in Rotorua, Aotearoa New Zealand in April 2019. It should be read alongside the Indigenous Peoples’ Statement for Planetary Health and Sustainable Development from this Conference.
The conference participants call on the global community to urgently act to promote planetary health and sustainable development for all, now and for the sake of future generations. Planetary health is the health of humanity and the natural systems of which we are part. 1 It builds on Indigenous peoples’ principles of holism and interconnectedness, strengthening public health and health promotion action on ecological and social determinants of health. It puts the wellbeing of people and the planet at the heart of decision-making, recognising that the economy, as a social construct, must be a supportive tool fit for this purpose in the 21 st century.
Waiora is an Indigenous concept of our host country, Aotearoa New Zealand, which expresses the interconnections between peoples’ health and the natural environment, and the imperative of sustainable development. 2 3 Waiora represents a call to work with Indigenous peoples to draw on Indigenous knowledge, and to share knowledge from our diverse cultural systems for the wellbeing of the planet and humanity. Sustainable development for all is a clear way to ensure environmental, social and health justice for the people of today and for future generations.
Urgent action is needed because mounting evidence tells us that the current
economic and social development paradigm of infinite growth and endless exploitation of limited natural resources is unjust and unsustainable, leading to inequities within and among countries and across generations.
In 2015, the UN General Assembly adopted the new development agenda
“Transforming our world: the 2030 agenda for sustainable development”. 4 The 17 Sustainable Development Goals (SDGs) integrate economic, social and environmental development around the themes of people, planet, prosperity, peace and partnership. In doing so, they provide an action plan for the global community.
They prioritise the fight against poverty and hunger while focusing on human rights for all, and the empowerment of women and girls as part of the push to achieve gender equality. The SDGs recognise that eradicating poverty and inequality, creating inclusive economic growth and preserving the planet are inextricably linked to each other and to population health. 5
Conference participants call for immediate action from the global community in four key areas.
- Ensure health equity throughout the life course, within and among countries, and within and across generations. This requires:
The development of all peoples as empowered lifelong learners and
engaged contributors to individual health and the health of families,
communities and the planet.
Action and accountability to address the wide and enduring inequities
experienced by Indigenous peoples, while ensuring the protection of
cultural identity and customary ways of life.
Tackling the structural factors that drive the inequitable distribution of power, money, and resources; improving daily living conditions especially of those most in need; and measuring and understanding the problem and assessing the impact of action as outlined by the Commission on Social Determinants of Health. 6 Prioritising intergenerational health equity in systems, frameworks and
decision-making, as a central tenet of a planetary approach to health
- Make all urban and other habitats inclusive, safe, resilient, sustainable and conducive to health and wellbeing for people and the planet. This requires: Renewing and strengthening our relationship with planetary ecosystems. Protection of the planet from degradation, including through sustainable production, management and consumption of natural resources so that the planet can support the needs of present and future generations. This requires taking, enabling and advocating for immediate action on climate change and the loss of biodiversity.
Action to reduce disparities in the quality and quantity of resources
available to communities as these disparities are at the root of inequities in health. Current threats will accentuate such disparities. These include threats to food and water supplies associated with climate change, depletion of both renewable and non-renewable resources, the degradation of the environment such as contamination of food chains and ecosystems, poor air quality and massive forced migrations.
Greater cross-sectoral action to protect and improve the health of
populations experiencing inequities, including those in the world’s fast- growing urban areas.
Fostering of peaceful, just and inclusive societies which are free from fear, racism, violation and other violence.
The realisation of the health co-benefits of sustainable ‘One Planet’ living.
Ensuring urban decision-makers apply a “health equity lens” to assess the
risks and opportunities posed by policies and programmes and measure
their effects. 7
- Design and implement effective and fair climate change adaptation strategies.
The development of new approaches to global, regional, national and local governance and stewardship that will equitably promote health and well- being and prevent and mitigate disastrous climate and environmental breakdown, particularly in Low and Middle-Income Countries.
Repositioning Indigenous and traditional knowledge systems to be on an equal footing with science and other knowledge systems to promote health and well-being and prevent and mitigate disastrous climate change and environmental breakdown.
Development of action-oriented policies and partnerships between health and other sectors to develop policies addressing health and climate.
- Build collaborative, effective, accountable and inclusive governance, systems and processes at all levels to promote participation, peace, justice, respect of human rights and intergenerational health equity. This requires:
Respect for and adherence to the inherent rights of Indigenous peoples as articulated in the UN Declaration on the Rights of Indigenous Peoples.
Effective global governance free from the domination of economic considerations and commercial interests.
The promotion of participatory democracy, coherent policy-making and regulation in the public interest and to restrict conflict of interest.
Participants at the 23rd IUHPE World Conference in Rotorua also confirm the critical role and relevant expertise of the health promotion community in promoting human health, planetary health and sustainable development, including implementing the SDGs. Participants urge the health promotion community to provide leadership across our one planet.
- Whitmee S, Haines A, Beyrer C, et al. Safeguarding human health in the Anthropocene epoch:
report of The Rockefeller Foundation–Lancet Commission on planetary health. The Lancet
- Durie M. An Indigenous Model of Health Promotion. 18th World Conference on Health Promotion
and Health Education. Melbourne, 2004.
- Durie M. An Indigenous model of health promotion. Health Promotion Journal of Australia
- UN General Assembly. Transforming our world: the 2030 Agenda for Sustainable Development.
New York: United Nations 2015
- World Health Organization. Health in 2015: from MDGs, millennium development goals to SDGs,
sustainable development goals. Geneva: World Health Organization, 2015
- Marmot M, Friel S, Bell R, et al. Closing the gap in a generation: health equity through action on
the social determinants of health. The Lancet 2008;372(9650):1661-69.
- World Health Organization. Health as the pulse of the new urban agenda: United Nations
conference on housing and sustainable urban development, Quito, October 2016. Geneva:
World Health Organization, 2016.
The Mayor of Rotorua has agreed to explore further the idea of Rotorua becoming a healthy city.
Steve Chadwick told delegates at the closing of the 23 rd International Union of Health Promotion and Education’s conference that she was looking forward to seeing what was involved in the process of becoming a healthy city.
Ms Chadwick was handed the Shanghai Consensus on Healthy Cities by Dr Faten ben Abdelaziz, the coordinator of Health Promotion with the World Health Organisation. (WHO).
Ms Chadwick said as a signatory to the United Nations Global Compact – Cities Programme, which is a worldwide initiative aimed at creating sustainable societies, Rotorua was keen to see what the journey to becoming a healthy city would entail.
She thanked the conference for the Rotorua – Waiora: Promoting planetary health and sustainable development and Indigenous legacy documents.
“We’re looking forward to seeing what is in the legacy statements,” she said.
Executive Director of the Health Promotion Forum (HPF), co-host of the conference, Sione Tu’itahi thanked the mayor for her support and for welcoming delegates to the city.
HPF’s Dr Viliami Puloka thanked everyone on behalf of participants who came from all over the Pacific and presented a mural which was painted by young artists from the Solomons and New Caledonia to the people of Rotorua.
The artists who painted the mural just outside the Energy Events Centre are under the Pacific Community’s (SPC) WAKE UP! Project aimed at encouraging young Pacific Islanders to get involved in efforts to control non-communicable diseases.
“Our hearts are filled with aroha as we present this artwork to the people of
Rotorua,” said Dr Puloka.
IUHPE2019 Rotorua put Māori culture on the world stage.
Māori culture was woven through the 23 rd International Union for Health Promotion and Education World Health Promotion conference with a powhiri by Te Arawa for overseas guests and delegates setting the tone.
The theme of ‘Waiora: Promoting Planetary Health and Sustainable
Development for All’ reflected the indigenous focus of the conference, which was attended by more than 1000 delegates from around the world and New Zealand. It was the largest conference Rotorua has ever staged.
For the first time at a world conference, Te Reo Māori was an official language and at an IUHPE conference it was the first time an indigenous legacy statement was released.
An indigenous lounge was set up in the exhibition area of the event, which was co-hosted by the Health Promotion Forum of NZ (HPF), where delegates could watch women from Hapai te Hauora weaving and speak to kaumatua.
Tūhoe leader Tamati Kruger’s speech was met with awe by delegates who
agreed it was powerful and inspiring. “The more we learn, the taller we get. Learning must never have the objective of knowledge. It must lead to action,” he told delegates.
Mr Kruger said it was good for our wellbeing to know who we are. It is not a protest, not a war against anyone but it was a “fight for our rangatiratanga, for our survival … that is our world today.
“Virtues are the habits that all of us need, so we may find the truths in our
culture and in our life,” he said.
“Tūhoe is Mauri ora … Tūhoe are looking for regular experiences of wehi, ihi, wana, in order to build themselves and fix themselves. Wana is a Māori term that generally depicts the thrill, joy and excitement of life and people need that to become decent and healthy people.
“Tūhoe declared Te Urewera, their land is a living being, their mother and can’t be owned. Their truth is based on their identity as Tūhoe. Being Tūhoe is their antidote to despair.”
Mr Kruger explained how Tūhoe was redesigning more appropriate spaces and buildings, criminal justice and crime prevention processes, energy and
recycling procedures and health services.
“Mauri Ora does not have an end date,” he said. He also emphasised the importance of climate change in Te Urewera. “Nature does not need people, people need nature. We don’t own the land. We live with it.
Dame Ann Salmond, Professor in Māori Studies and Anthropology at Auckland University addressed ‘Whaiora: The search for wellbeing”.
Dame Ann shared about the Christchurch shootings and said although there
was a need to acknowledge the racism and hatred that has always been with us, we can be hopeful about the emerging commitment to address these.
“New Zealanders pride themselves on tolerance but there has been much soul- searching in the wake of the Christchurch massacre. It was extraordinary to see New Zealanders reach for Māori values.
“We need to foster aroha and manaakitanga and kotahitanga,” she said.
Dame Ann said effective, accountable and inclusive governance sounded
mechanistic. “We need to look for new ways based on aroha and learn from Māori and Pacific traditions.
“The relations between and among people and other life forms are currently out of balance generating violence. Reciprocity has broken down.
“We need to strive for a state of ora: a balance between the wellbeing of the land, the wind, the sky, the ocean and all forms of life. Human wellbeing is just one element within this network of life,” she said. “If I am the river and the river is me. If the river is dying, I’m dying. It’s not poetry it’s reality, it’s public health. This is a relational theory of how reality works. We cannot separate our people from the environment.
“People are just one element in networks of kinship among all forms of life- health of people, land and oceans are but one.”
Sir Mason Durie who spoke at the launch of the conference emphasised how vital it was that indigenous approaches to planetary health and the health of people were acknowledged.
He talked about Te Pae Mahutonga, also known as the Southern Cross
together with the Matariki or Pleiades constellations to emphasise this.
Both star systems feature prominently across the Pacific as both navigational tools and as frameworks for the health of people and the environment.
He also shared his knowledge of indigenous health promotion and its intimate relationship to the natural world, the cosmos and people.
Sir Mason also reflected on the last two major health conferences held in
Rotorua, the first in 1907 when Māori Sanitary inspectors met for their first general conference. The conference took a health promotion approach.
The second was in 1937 when the Women’s Health League Te Ropu o te Ora, Tunohopu met.
It is vital to improve planetary health and achieve sustainable development for all says the Associate Minister for Health, Jenny Salesa.
Mrs Salesa made the comment while opening the 23 rd International Union for Health Promotion and Education (IUHPE) World Health Promotion Conference in Rotorua last night. (April 7).
The conference which has the theme of ‘Waiora: Promoting Planetary Health and Sustainable Development for All’ reflects the indigenous focus and important feature of the event.
Mrs Salesa commended the Health Promotion Forum of New Zealand, which is co-hosting the conference, and IUHPE for putting the conference’s extensive programme together.
“We are at a unique point in history. We have a higher life expectancy, lower child mortality, lower maternal mortality and considerable advances in science and technology. Despite this, we are facing significant challenges to the health of global population and natural systems on which we depend.
“While common to all people and nations, these challenges impact some populations disproportionately. It is imperative that we strive to improve
planetary health and achieve sustainable development for all.”
Mrs Salesa said the Government will demonstrate its commitment to improving wellbeing and living standards for all New Zealanders when it releases the world’s first Wellbeing Budget this year by a Government.
“This approach lifts our gaze from health to wellbeing and reframes our understanding of the determinants of both health and wellbeing. Specific priorities include transitioning to a low-emissions economy, lifting incomes of those at the highest risk of experiencing poverty, for example, our Māori and Pacific communities, supporting innovation in the digital age, improving child and youth wellbeing, and addressing mental health needs, particularly for those under 24 years old.”
Mrs Salesa said the conference provided a valuable opportunity for New
Zealand to learn from the collective expertise and wisdom of the international delegates.
Sione Tu’itahi, the Executive Director for the Health Promotion Forum said HPF and its partners wished Mr Tu’itahi said while climate change was the most significant issue in the world today, the Pacific region was one of the regions where it was most pronounced.
“In the words of one of our Pacific leaders, ‘it is climate crisis for us in the
Pacific.” He pointed out that while New Zealand wished to learn from the world, it also hoped to contribute its experience, especially in indigenous health promotion.
“For centuries we have explored and applied the knowledge of the west, and east. It is timely with where we are now as a world community, to learn also from indigenous knowledge systems.”
IUHPE President and co-chair Graham Robertson said the conference programme provided a platform for the IUHPE’s Global Working Groups and members to showcase their work, as it does for guest speakers and many other contributors.
“It also allows the IUHPE to hear of latest developments and ideas that can inform future plans and advocacy work,” he said.
The conference will continue until Thursday, April 11.
For further information please contact:
Health Promotion Forum of NZ
firstname.lastname@example.org (021) 8964343
A general legacy document and an inaugural indigenous legacy document are being drafted for the conference.
The general statement will capture the essence of the conference and represent the voice of researchers, practitioners, social movement members and policymakers who participated in the conference.
HPF’s Dr Viliami Puloka who is coordinating the drafting the general statement says It will call on the global community to: Ensure health equity throughout the life course; make all urban and other habitat inclusive, safe, resilient and sustainable; Design and implement effective and fair climate change adaptation strategies and build effective accountable governance that promotes peace, justice and respect for all creation promoting planetary health.
HPF’s Executive Director Trevor Simpson who is part of the team drafting the indigenous statement says the contributors to this work are looking to draft the document from a specific position of indigenous thought and worldviews.
“Although complementary to the general statement there is an excitement that the Indigenous Statement will, for the first time provide a unique perspective that is neither western nor eastern but rather representative of the way Indigenous people feel about the planet and its co-relationship to health and wellbeing.”
Although confident that the statement will be adopted by the global health promotion community Mr Simpson acknowledges that there is recognition of the challenges faced, particularly given the diversity of indigenous people and their lived experience.
“It will be a very useful starting point, I think. We are trying to articulate indigenous views in an increasingly difficult political situation for many groups. When we consider the plight of the direct impact of climate degradation on indigenous communities, clearly it is incumbent on all of us to bring these things to the fore,” he adds.
HPF congratulates Dr Prudence Stone on her appointment as Chief Executive of the Public Health Association (PHA).
Dr Stone (Pictured left with Lee Tuki) who was previously the Executive Director of the Smokefree Coalition said public health was a key pillar of a functional, healthy society.
“There’s so much that can be achieved by taking a public health approach to issues. It is essential that the PHA is an effective watchdog and informant, so the right decisions get made,” said Dr Stone.
“There’s so much that can be achieved by taking a public health approach to issues. It is essential that the PHA is an effective watchdog and informant, so the right decisions get made.
“A lot of the time public health can be up against huge multinationals working in industries such as tobacco, sugar and alcohol. It’s crucial the PHA works to combat the persuasive influence big industry can have by ensuring we promote evidence-based policies. We must be constantly vigilant.”
Dr Stone added that one of her first priorities would be to get to know her
membership and their priorities.
HPF’s Executive Director, Sione Tu’itahi said: “Dr Stone will bring her experience in the public health sector to her leadership role and we look forward to working with her.”
PHA president Lee Tuki said public health needed to be put at the centre of all policy-making if we wanted people in New Zealand to be healthy.
“Dr Stone has the skills, knowledge and connections to get the public health voice clearly heard.
“Dr Stone is committed to making Aotearoa a better place to live for current and future generations of New Zealanders. She’s shown throughout her career that she is a great listener, is able to build consensus, and never gives up. She will be a relentless campaigner for public health in Aotearoa New Zealand.”
Passionate about health promotion: the Health Promotion Forum
10 years on and growing(Adapted from an article in the Health Promotion Forum newsletter, Issue 40, April 1997, updated February 2009.) In 1986, the five strands of the Ottawa Charter became the international guiding principles of health promotion practice. In New Zealand these, combined with Te Tiriti of Waitangi, became the foundations on which health promotion practice was to develop. In 1983 Professor Lawrence Green, regarded as one of the leading lights in health promotion, was brought to New Zealand by the Medical Research Council (MRC) to speak at a series of workshops on the planning and evaluation of health education and health promotion. Health promotion as a profession was evolving around the world from a more traditional health education practice. Professor Green’s visit highlighted a need for an independent forum to co-ordinate regional and voluntary opinion on health education and health promotion and to liaise with government organisations in the establishment of national goals. Over the next few years the MRC supported the development of such a forum through the establishment of an ad-hoc steering committee. It included the Departments of Health and Education, Auckland and Otago universities, the Mental Health Foundation, the National Heart Foundation, the Cancer Society, Maori Women’s Welfare League (MWWL), the Accident Compensation Corporation and the Alcoholic Liquor Advisory Council (ALAC). Funding from several of these organisations, as well as grants from the McKenzie and Sutherland Self Help Trusts, provided the financial support which established the Health Promotion Forum secretariat and allowed the appointment of its first research and executive officer in 1986. The Forum’s first home was at the University of Auckland’s Department of Community Health. An interview with former directors Cheryl Hamilton, Candace Bagnall and Kim Conway, provides a historical journey through the Forum’s development. Each of these women share a background of involvement in social change movements and a strong commitment to social justice and community participation. These principles along with the energy and vision of each director helped to create the dynamic organisation the Forum is today. Larry Peters, from Waikato University’s Department of Community Psychology was the Forum’s first director. Larry began to establish a national database of health promotion research and programmes and involved the Forum in co-ordinating a national nutrition symposium before returning to his native Canada after one year. By the time of Larry’s departure, the Forum was ready to develop a broader community base. Kim Conway, who had been working with ALAC, then at the cutting edge of health promotion and community action initiatives, and who had been in the alcohol field for a number of years, was recruited for this purpose on a part-time basis. Kim’s first task was a needs assessment with the health promotion community. This brought a call for information on issues and training, as well as advocacy on behalf of the health promotion field. In response, a directory of health promotion organisations was created and info sheets, which led to the development of the newsletter, were published. An initial series of training workshops was also set up. Kim established the Forum’s legal structure and its inaugural general meeting as an incorporated society was held in November 1988. A national body, the Forum is administered by an Auckland based secretariat. Its governing body is a council of representatives from elected member organisations. Founding members, wanting to ensure a bi-cultural perspective for the organisation, reflected this in the constitution. Kim recalled that in 1988 “a lot of organisations were just finding their feet with treaty issues” and commitment to Te Tiriti o Waitangi was still too controversial for one organisation which withdrew its support. All three past directors acknowledged the Forum’s first chairperson, the late Dr Erihapeti Rehu-Murchie (MWWL), for her commitment to partnership and her wise leadership and nurturing of the Forum during those formative years. By 1990, health promotion as a discipline had grown and so had the Forum. While Kim remained with the organisation part-time she handed over to full-time director, Candace Bagnall. Candace brought a strong social advocacy and policy background as well as education resource production skills to the Forum. She had recently returned to New Zealand from working as a programme and policy advisor in the Premier’s department in Victoria, Australia. She had also spent some years living in Northland at a critical time of what is now called the Maori cultural renaissance. Through her involvement in HART (Halt All Racist Tours) she was part of a small group which hosted the hikoi of 1994 through Tai Tokerau to Waitangi. Candace applied her passion and experience in these areas to the continued bicultural development of the Forum, the production of a national newsletter and launched the Forum’s bi-annual conferences. The Forum’s membership doubled as Candace further strengthened the health promotion networks. “The establishment of the database and health promotion directory named those who were interested in health promotion. It allowed them to feel part of a new and emerging health promotion profession.” Candace’s success in building relationships with key stakeholders also contributed greatly to consolidating the Forum’s position and increasing its profile and credibility. This included gaining the support of the Auckland Area Health Board and the late Dr John McLeod to set up the Forum at the health promotion community resource centre in Newmarket. In March 1992 the Forum shifted to the present site at 27 Gillies Avenue Newmarket. In 1991, Cheryl Hamilton, a women’s health activist enjoying a break from being a parliamentary electorate secretary, came on board to organise Health Workforce Development Fund training workshops. While this one-off series met some of the identified training need, the workforce was also asking for a qualification from a practical course for workers on the ground. Kim developed the course curriculum for a Certificate in Health Promotion for the Central Institute of Technology and, with Cheryl, tutored the first intake in 1992. The development of a rapidly expanding health promotion practice was affected considerably by the changing political environment of the early 1990s. The health reforms signalled a new era for the Forum and its members. The organisation’s focus became on the concept of health promotion rather than the specific issues of much of the workforce. In the new political climate the advocacy role became more of a challenge and the Forum, at times, walked a difficult political tightrope. Contracting and the purchaser provider split were also key components of this new era and the Forum developed contracts with the newly established Public Health Commission for workforce development at the national level and with North Health for regional services. Candace acknowledged the importance of the shift towards the workforce development work “that Kim and then Cheryl took such a strong lead in. In the end I think it became the main reason for the Forum’s continued existence.” In 1995 Cheryl exchanged her training role for that of director when Candace moved on to North Health to establish the structure for joint purchasing of national contracts for the four Regional Health Authorities. Cheryl remained in this role until early 2003 and during her years major initiatives at the Forum included the development TUHA-NZ: Towards an Understanding of Hauora in Aotearoa-New Zealand and Nga Kaitakatanga Hauora mo Aotearoa: Health Promotion Competencies for Aotearoa-new Zealand; three national health promotion Conferences were held biennially, and the course MIT/HPF Certificate of Achievement in Introducing Health Promotion was established.
Coming of age, 20092003 signalled a period of intensive change for the Forum. For a period after Cheryl left and the Forum was managed by a series of acting directors including Keith Preston, Diana MacDonald and Dallas Honey. Teina Kake took over the reins in 2003. A number of key staff left to further their careers in specialist areas, reflecting a conundrum for the Forum – interest in workforce development and education is often stronger in specific work streams to the detriment of broad based health promotion and generic training. Dr Alison Blaiklock’s arrival as Executive Director late in 2004 signalled a new era for the Forum. She is a public health physician who has worked in health promotion since 1994. Her special interests are the health of children and young people, the determinants of health, and health and human rights. Alison along with others attended the 6th World Conference (conducted by the World health Organisation) where The Bangkok Charter for Health Promotion in a Globalized World (11 August 2005) was agreed on. This Charter articulated new global approaches to health promotion and pointed new directions for the Forum. Also in 2005 the Forum signalled a shift in strategic direction with the launch of a new tohu (logo) and slogan ‘Hauora – Everyone’s Right’. The new focus on human rights approaches to health promotion and the need to address inequities prioritises resources around groups with least advantage such as Māori, Pacific, refugees and migrants. The report, Closing the Gaps, from the World Health Organisation Commission on Social Determinants of Health released in 2008 sanctions these approaches and gives direction to health promotion for the foreseeable future. Many changes such as the amended Constitution in 2008 and strengthened infrastructure position the Forum to serve the future workforce. Alison now leads a small team of health promoters with expertise in strategy and workforce development, support staff, contractors and consultants. Initiatives include, the expansion of the MIT Certificate of Achievement in Introducing Health Promotion, the support for MIT establishing an undergraduate qualification The Diploma in Health Promotion (Level 6, 120 credits), participation in other tertiary education developments, and the establishment of five reference groups – Māori, Pacific, primary health, academic and South Island – from the senior workforce throughout Aotearoa. A change of newsletter name to Hauora, launch of a new website in 2008 and an e bulletin Rongo Korero o Hauora reflect works in progress as the Forum seeks to keep pace with rapidly changing and expanding electronic communications. Within the Forum strong Māori, strengthening Pacific participation and the growing voice of Asian communities in both governance and service delivery reflect commitment to Te Tiriti o Waitangi, determinants of health and human rights based approaches to health promotion.
During the annual symposium in July 2009 the Forum celebrated 21 years.
Forum Council chairs from inception to 2010Dr Erihapeti Rehu-Murchie (MWWL) June Mariu (MWWL) Druis Barret (MWWL) Sandra Kirby (ALAC) Andrea McLeod (Otago DHB, Public Health South) Te Herekiekie Herewini (AIDs Foundation) Janferie Bryce-Chapman (Age Concern) Gary Brown (Hapai Te Hauora Tapui) Donna Leatherby incumbent – See more at: http://www.hauora.co.nz/history.html#sthash.EaEskPyW.dpuf
- made bars and restaurants Smokefree,
- banned tobacco’s promotional retail display,
- reduce allowances of duty-free tobacco
- raised tobacco’s excise tax,
- currently; introducing standardised packaging of tobacco and banning smoking in cars carrying children.
- Central Auckland (the CBD)
- South Auckland (Manurewa)
- West Central Auckland (Blockhouse Bay)
- Northland (Kaikohe)
- Building healthy public policy,
- Strengthening community action,
- Creating supportive environments,
- Developing personal skills and
- Reorienting health services.
Action to reduce New Zealand’s alarming childhood obesity rate needs to focus on the physical and social environments we live in, says the New Zealand College of Public Health Medicine.
A third of all Kiwi children are now overweight or obese, which the College says “must be urgently addressed to improve their current and future health”.
“Interventions at an individual level alone are unlikely to be successful in the long term,” says the president-elect of the College, Dr Felicity Dumble.
“We need to adapt our environment and change our social norms so that it’s easier for our children to establish and maintain a healthy weight.”
The College recently released a policy statement addressing childhood obesity; the policy recognised the issue as a significant public health challenge.
Dr Dumble says the College recognises the government’s commitment to addressing childhood obesity, but says New Zealand’s childhood obesity plan should be reviewed and amended as a matter of urgency, to fully reflect the World Health Organization’s (WHO) report titled Ending Childhood Obesity.
“If all of our nation’s children are to be healthy there must be a higher priority placed on addressing the issues causing childhood obesity,” she says.
The WHO Report was released earlier this year, stating no single intervention can halt the “rise of the growing obesity epidemic”.
It says that preventing and treating obesity requires a government-wide approach, in which policies across all sectors take health into account, avoid harmful impacts and thus improve population health and health equity.
In line with the WHO report, Dr Dumble says the College strongly supports three strategic objectives to help reduce childhood obesity in New Zealand;
• Tackle the obesogenic environment and norms
• Reduce the risk of obesity by addressing critical elements in the life course
• Treat children who are obese to improve their current and future health.
- Ms Osnat Lubrani, UN Resident Coordinator and UNDP Resident Representative, UNDP Pacific Office,
- Dr Viliami Puloka, HPF Pacific Leader and Otago University Research Fellow,
- Rt Hon Helen Clark, UNDP Administrator and former Prime Minister of New Zealand,
- Ms Leanne Eruera, HPF Business Manager and 2019 Conference Project Manager,
- Mr Sione Tu’itahi, HPF Executive Director and IUHPE Vice-President.
Gardening and Health: Let your garden be your health and your health be your gardenDr. Viliami PULOKA, Senior Health Promotion Strategist, New Zealand Health Promotion Forum Abstract When Hippocrates, the father of medicine some 2,500 years ago said “Let food be thy medicine and medicine be thy food”, I can assure you he was not talking about fast food like Cheese burgers, Fizzy drinks and French fries. He was talking about fresh produce from people’s home gardens. Being the top physician of his time and a leading scientist in the field of medicine, he knew the importance of good healthy food in providing proper fuel for healthy living. Consumption of foods that are highly processed but empty of proper nutrients is one of the key drivers of the obesity and diabetes pandemic the world is facing today, including Wallis and Futuna. The Wallis & Futuna Chronic Diseases Risk Factor Study in 2009 showed a 17% prevalence of diabetes, and an 87% prevalence of overweight and obesity among the study population. Eating fresh food, locally grown in home gardens is a very good way to prevent and control chronic diseases including diabetes and obesity. The health benefits of growing your own food are well documented. You are in control and decide what to grow. You are not dependent on food produced by someone you do not know, whose interest is your money not your health. Growing your own garden provides opportunities for physical activity which goes hand in hand with good nutrition giving you good health. One can also enjoy fresh air and sunshine, which is good medicine for the whole person. Wallis and Futuna are very fortunate to have such fertile soil, and many people still grow food in their own gardens. The challenge is the ever-increasing amount of readily available imported processed food that competes with traditional local cuisines. I like to suggest that the way forward to good health through home gardening is to ‘return to nature’ and re-claim the socio-cultural and economic value of home gardening and… “Let your garden be your Health and your Health be your garden”. “If I had the same life expectancy as a Tongan man, I’d only have one year and three months left to live.” Statistics show that life expectancy for men in Tonga is 65 years, mainly due to the rise in NCDs. A child born in the Pacific today is more likely to die before their grandparents and parents, largely due to the Obesogenic environments. It does not matter whether we are in Samoa, Tonga Vanuatu or Wallis and Futuna our story is one and the same. A healthy baby is born, fully immunized, is well cared for and loved. We invest in their education and they get good qualification, good job and they may earn good money. The food environment however makes it very easy for us to eat ourselves to death. Young Pacific persons develop diabetes as early as age 30 and many develops complications by age 40 requiring amputation at 50 followed by kidney failure at 55 paving the way for “early preventable death” the plight of Pacifica today. What a loss! Financial/economic investments as well as social and cultural loss that have direct impacts on families and the country as a whole. The presentation discusses NCD issues as related to how we look after our health as “a garden for our food security, health is for our everyday living.” Health isn’t everything, but without health, nothing else matters. Your health is the only resource we have to do life and to contribute to life. Doctors and nurses have known for many years now that health deteriorates when people don’t eat healthy food. Everyone knows that as a fact but knowledge is not enough to make us do what we know we should be doing. In the Pacific, NCDs cause up to 40% of sickness and up to 70% of deaths. Over 20% of countries’ budgets are allocated to NCD control in hospitals. Much more resources is needed for prevention and to address the many social cultural determinants outside the hospitals. Some 2500 years ago, Hippocrates said, “Let food be thy medicine and medicine be thy food”. The NCD issue is directly related to what we eat or do not eat. It is therefore important to look at the food we eat with the same respect we give to any medicine we take for any illness. From the food we eat our body have fuel or energy to carry out daily activities. To be healthy, the energy gain from food we eat should be proportional to the energy required for daily activity. This is the problem in the Pacific, we eat and gain way too much energy but spent too little doing minimal physical activity. We drives to the supermarket, buy processed energy rich food instead of working in our gardens. People in the Pacific don’t walk to the hospital, because when they do decide to go, they are too sick to walk. A 2009 study in Wallis and Futuna revealed high rates of factors causing NCDs. Not enough fruit and vegetables consumed, inadequate physical activity, high rate of high blood pressure and high rates of obesity. Specifically regarding obesity in Wallis and Futuna, the risk factors are visible as early as age 18. In the 18-24 age group, 51% of men and37 % of women are already obese. Many people are obese very early in life. In Wallis and Futuna, diabetes prevalence was three times higher in 2009 than 1986. High blood pressure was twice as prevalent and obesity remained high. If the various NCD risk factors in Wallis and Futuna and are compared with American Samoa (the Pacific NCD champions), the figures for both territories are quite similar. With regard to food security, the issue is access to and the availability and use of food. In Wallis and Futuna, these issues do not really apply, as food is available. The problem is related to the choices local people make in terms of food. We eat what we do not grow, we grow what we do not eat. Geoff Lawton said that all these issues can be solved by gardening. Gardening can really feed both body and mind. When people garden, they know exactly what they are growing, unlike shop items produced in unknown places by unknown people whose interest is more in our wallets than our good health. So it is best to grow our own food. Gardening should be medically prescribed. Uvea is a garden with a few houses dotted around it. Most homes have gardens and gardening has many benefits:
- Stress relief – A study in the Netherlands indicated that gardening is better at relieving stress than other relaxing leisure activities.
- Brain health – A study that followed people in their 60s and 70s for up to 16 years found that those who gardened regularly had a 36% lower risk of dementia than non-gardeners
- Nutrition – Studies have shown that gardeners eat more fruits and vegetables than other people. The freshest food you can eat is the food you grow,
- Healing – Interacting with nature also helps our bodies heal. A landmark study by Roger S. ULRICH, published in the April 27, 1984, issue of Science magazine, found strong evidence that nature helps heal.
- Immunity – In 2007, University of Colorado neuroscientist Christopher LOWRY, then working at Bristol University in England, made a startling discovery. He found that certain strains of harmless soil-borne Mycobacterium vaccae sharply stimulated the human immune system. It’s quite likely that exposure to soil bacteria plays an important role in developing a strong immune system .[m1] [VP2]
Health Promotion: An Effective Approach to Achieve the Sustainable Development Goals
~Written by: Karen Hicks, Senior Health Promotion Strategist & Lecturer, New Zealand (Contact: email@example.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
- Greater awareness of alchohol and tobbacco-related harms.
- A high level of community ownership
- Policies developed by local sports clubs
- Effective working relationships among the stakeholders
campaigns for smokefree carsNorthland Health Provider Te Hiku Hauora is leading a campaign to encourage Government to legislate against smoking in cars carrying children under 18 years of age. Cathy Cherrington, manager of Te Hiku Hauora’s health promotion team in Kaitaia presented a 2000 signature petition to co-leader of the Maori party Marama Fox earlier this month. The petition calls on Government to protect children agains passive smoking in cars. New rules in Britain now ban smoking in vehicles with children on board. The petition calls for a similar ban here and will be presented to Parliament by Ms Fox. Marama Fox – an ex-smoker and anti smoking campaigner – was delighted to accept the petition. She said she will accept support for her battle to eliminate smoking in New Zealand by 2025 from wherever it comes.
- 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
First New Zealand Health Promotion bookPromoting 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
- 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
- TUHANZ (a Treaty Understanding of Hauora in Aotearoa New Zealand),
- the health promotion competencies and the
- health promotion society
- high staff turnover due to staff feeling ill equipped,
- poor access to healthcare
- language becoming a significant social determinant of health.
- It is the first health promotion textbook that is based on our Aoteaora New Zealand experience and realities. It is therefore of marked relevance to our context and applies directly to our joint effort to address the determinants of health and inequities.
- 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.
- The book gives prominence to Matauranga Maori, while weaving together the knowledge of the west, the knowledge of the east, and indigenous knowledge systems. It holds them up as a set of effective solutions for addressing our health challenges.
- While the primary focus is on Aotearoa, the book brings in the experience and knowledge of Moana Nui a Kiwa and other regions, thus making it a very valuable contribution to our collective effort at the global level to address planetary health.
- There is a growing awareness in all sectors; government, community, and corporate; that, to be effective in addressing our socio-economic, cultural, physical, ecological and spiritual wellbeing, we must take an integrated health promotional and preventative approach.
- There has also been a marked increase recently in the number of courses and qualifications on health promotion and public health in universities, polytechnics and wananga. This book is a ‘must have’ reading and resources for all learners.
- Finally, awareness is of the connectedness of the challenges is grown in other sectors, such as social development and education. They see the increasing need to learn from other sectors, such as health, with some of their effective approaches such as health promotion.
- 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.
- Such campaigns do not address the primary causes of inequalities such as poverty and deprivation and
- There is greater likelihood that the approaches would be taken up by the more literate and financially-able middle classes than those living in poverty.
- Measures through the taxation and benefits system;
- Agencies collaborating to work effectively on related policies such as housing and education;
- NHS to provide better access to primary health services for the poorest and most vulnerable.
|“Making inroads into the elimination of child poverty may just be the remedy we all need for the ever increasing costs to the health system. Keeping people well, it seems, is the much cheaper option.”
Trevor Simpson, Deputy Executive Director,
Health Promotion Forum – Runanga Whakapiki Ake i te Hauora o Aotearoa
“Making inroads into the elimination of child poverty may just be the remedy we all need for the ever increasing costs to the health system. Keeping people well, it seems, is the much cheaper option.”
Trevor Simpson, Deputy Executive Director,
Health Promotion Forum – Runanga Whakapiki Ake i te Hauora o Aotearoa
- Smoking (46.2% of males and 16.3% of females aged 15-64 years)
- Alcohol consumption (22.2% of males and 4.8% of females aged 15-64 years)
- Low fruit and vegetable intake (approximately 92.8% of Tongans aged 15-64 reported they eat less than the require five servings of fruit and vegetables a day)
- Low physical activity (54.8% of females and 32.4% of males aged 15-64)
- Obesity (76.3% of females and 60.7% of males aged 25-64)
- High blood sugar (16.4% of Tongans aged 25-64 had elevated blood glucose levels)
- High blood cholesterol (66.1% of men and 34.2% of women aged 25-64 had blood cholesterol levels of more than 5.00 mmol/L)
- health equity
- child poverty and child health
- climate change
- nutrition and physical activity
Abstract for Martin Laverty’s presentationThe 2008 World Health Organisation’s Commission on Social Determinants of Health Closing the Gap report provided a road map for governments to improve population wide health outcomes. The WHO’s work received little attention in Australia when Closing the Gap was released, and its recommendations were ignored by the then Federal Government. In 2011, 40 social determinant advocates contributed to the book Determining the Future: A fair go and health for all. The book outlined actions Australia could take to implement the WHO’s recommendations and argued a Senate Inquiry should inform Australia’s next steps. Associated with the book’s publication was the emergence of the Social Determinants of Health Alliance (SDOHA), which is today leading national advocacy for action on social determinants. In mid-2012, a tri-partisan Senate Inquiry with backing of the Liberal Party, Labor Party, and Greens recommended the Australian Government adopt the 2008 WHO Closing the Gap report and commit to addressing the social determinants of health relevant to the Australian context. The Senate said government should adopt administrative practices that ensure consideration of the social determinants of health in all relevant policy development activities, particularly education, employment, housing, family, and social security policy. The Senate further said the National Health and Medical Research Council (NHMRC) should give greater emphasis in grant making to social determinants research. It concluded its recommendations by saying annual progress reports to Federal Parliament should be a key requirement of addressing the social determinants of health. With tri-partisan support for these Senate recommendations on social determinants, this presentation will state the social and economic case for adoption of the WHO social determinants framework, outline success to date in working to instil social determinants within government decision making, and also propose the next stages of an advocacy campaign to see the Senate recommendations implemented nationally.
BiographyMartin Laverty is the CEO of Catholic Health Australia, a network comprising ten percent of the nation’s not-for-profit hospital and aged care beds. He is also the inaugural Chair of the Social Determinants of Health Alliance and co-editor of the 2011 book Determining the Future: A Fair Go & Health for All, a book that contributed to a Senate Inquiry being established on social determinants of health. He is a member of the National Disability Insurance Scheme board, a member of the NSW Public Service Commission board, and a member of the Federal Government’s Aged Care Sector Committee. He is the Board Chair of the NSW Heart Foundation, and a member of the National Heart Foundation Board. He is also a member of the National Health Performance Authority Advisory Committee for Private Hospitals, and a member of the Australian Catholic University Faculty of Health Sciences advisory board. Martin is a lawyer by training, and is near to completing a PhD in governance of not-for-profit health services. 25 September 2014 Jo Lawrence-King
- 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)
- workforce development
- indigenous health promotion and health issues.
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:
New Zealand contributionOf 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 ThailandDuring 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 createdTwo 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
- 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.
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 advocateRead 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 promotionHealth 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
- personal ability
The need for health promotion as a distinct approachThe 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 hauoraThe 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 disciplineIn 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 explicitRichard 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.
|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
- There are three perspectives on health promotion relevant to the Aotearoa New Zealand setting.
- Health promotion is a unique discipline and is distinct from public health and health education.
- Health promotion is one of the disciplines that together work towards optimising population health.
- 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].
- 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].
- From a Pasifika perspective, health promotion is the empowering of Pasifika peoples to control their wellbeing and their future[iv].
Children’s Commissioner: “Prioritise child poverty in 2014 elections”Children’s Commissioner Dr Russell Wills has called for child poverty to be a key issue in the elections of 2014. In an opinion piece in the NZ Herald, he has suggested that the public will need to make some ‘tough decisions’ to put child poverty high on the agenda. “We will need to send clear messages to decision makers about our priorities,” he said. Dr Wills suggested that it is voters and influential organisations who must throw their support behind his call, in order to influence all parties to prioritise this issue. “…no government will go further than the public mood will allow,” he said “… as the debates around election year start to heat up, what will your contribution be? Will you leave the tough choices to the politicians, or will you stand up in your own organisations and ask: what can we do to prioritise children in this election year?” HPF Executive Director Sione Tu’itahi welcomed Dr Wills’ article. “Child poverty is the root cause of so much ill-health in Aotearoa New Zealand,” he said. “An investment in this tragic situation would go a long way to improve the wellbeing of a large sector of our society.” Dr Wills’ article directed his challenge at older people, motorists and health managers; asking them to call for greater prioritisation of child poverty. Acommentary in the same paper provides responses from the Automobile Association, Grey Power, Social Development Minister Paula Bennett and Labour children’s spokesperson Jacinda Ahern; the latter of whom offered assurances that Labour would prioritise child poverty. HPF has reported on the the Child Poverty Monitor, released on 9 December 2013, which revealed that a quarter of New Zealand children currently live in poverty. Visit our Children and Young People page to read more on this topic. Pictured: Dr Russell Wills with a young patient (photo: www.BayBuzz.co.nz) Jo Lawrence-King
Key findings of the Child Poverty Monitor 2013:Income poverty: 265,000 children (one in four)*. This looks at the amount of money families have to pay bills and purchase everyday essentials. This is defined as having less than 60% of median household income, after housing costs are removed. Material hardship: 180,000 children (17%). This means regularly going without things most New Zealanders consider essential – like fruit and vegetables, shoes that fit, their own bed and a warm house. Severe poverty: 10% of children. This means they are going without the things they need and their low family income means they don’t have any opportunity of changing this. These are the children experiencing material hardship and who are in families in income poverty. Persistent poverty: 3 out of 5 children in poverty are in poverty for long periods. These children are likely to live in poverty for many years of their childhoods. Persistent poverty is defined as having lived in income poverty over a seven year period. Visit our Children and Young People section to read more, including reports from the Children’s Commissioner and a report from the Public Health Advisory committee. * Following the discovery of a data error at Statistics New Zealand and Treasury, these figures have now been revised: Income poverty is now recognised as affecting 285,000 children. Read more about this error. Published: 10 December 2013 Jo Lawrence-King
- 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.
Your questions answeredWe have prepared answers to some of the most commonly asked questions about the Health Promotion Competencies.
Health Promotion competencies: Cancer Society self assessment template and guidelinesThe Cancer Society has worked with HPF to produce a personal development plan for health promoters. They may be helpful to inform personal development reviews or appraisals; identifying an individual’s competencies and providing ideas for further development. Feel free to download the template here.
Health promotion competencies: personal development review
Toi Te Ora in the Bay of Plenty DHB have given permission to HPF to share their personal development review blank template. This includes desired competencies for reference in a Health Promoter/Health Improvement Advisor’s personal development review.
Please feel free to contact Sharon Muru at Toi Te Ora if you would like to discuss how this template might be applied in your work setting.
Health Promotion Competencies survey reveals benefits to usersUsers of the Health Promotion Competencies say that their role is clearer after referring to the document. They speak of greater clarity in job descriptions and performance development and say it helps them plan, implement and evaluate their health promotion activities. These are just some of the findings of HPF’s survey in May 2013; examining how useful the document is and how its usefulness might be maximised. Read a summary of the findings here.
Generic competencies for public health in Aotearoa New ZealandThe Generic Competencies for Public Health provide a baseline set of competencies that is common to all public health roles across all public health sectors and disciplines. The Health Promotion Competencies sit on this base line. See the PHA website for the Generic Competencies (PDF) andkey documents about their development and implementation. For more information please contact HPF’s Senior Health Promotion Strategist Karen Hicks.
Developing a competent global health promotion workforce: pedagogy and practice – HPF occasional paper“… with the UN Political Declaration on Non-Communicable Diseases in place as well as global momentum to utilise the Health in All policies approach (IUHPE, 2014), now is a crucial time for the HP community to unite, to share resources and to build upon advances made within our evolving discipline over the last 40 years,” says Caroline Hall, Research Fellow at the University of Brighton in her July 2014 paper for HPF. “Fundamental to this process is accessing and harnessing opportunities to utilise inter-sectoral approaches and to build upon evidenced-based practices as a way of increasing capacity within the HP workforce. This should be combined with continued efforts to ensure the quality of these processes and practices, including increasing and recognising professional competence through recognised training and education pathways and which include ongoing workplace assessment.” Read other occasional papers here
Exploring the Whanau Ora Policy for Pacific health PromotionWorkshop held in Porirua March 15 2011. The presenter was Sione Tu’itahi of HPF. Sione presented Fānau Ola: A Pasifika Perspective on Whānau Ora; below are his text and power point presentations. Fānau Ola power point presentation in pdf format Fānau Ola A Pacific Perspective on Whanau Ora (text version to come)
More than 50% of health promoters use M-Health: intern surveyA survey, by HPF intern Ancy Paul, has revealed that more than half the health promotion workforce use M-health – a health information programme for smart devices.
Savings from Preventing Lifetime Smoking and Obesity in Young Adults: A Scoping StudyRhema Vaithianathan Department of Economics University of Auckland, April 2013 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. Savings from Prevention
Health Evidence Health promotion effectiveness: intuition with evidenceThis ‘Keeping Up to Date’ aims to increase awareness of the reasons to use evidence in practice, to stimulate debate about evidence, and to encourage the health promotion workforce to contribute to the evidence base by designing, delivering, and evaluating rigorous programmes. Nicki Jackson. Nicki is a lecturer at AUT University and has extensive experience in the field of evidence-based practice. Her work has provided her with the opportunity to work alongside international public health professionals to move forward the debate in using evidence in health promotion practice and develop the capacity of the health promotion workforce in using evidence. Keeping Up to Date – 22 edition
Health EvidenceHealth Evidence is a Canadian service and research organization located at McMaster University, Hamilton, aimed at assisting public health decision makers in their use of research evidence. Health Evidence offers a suite of services to support the development of knowledge, skill and culture for evidence-informed decision making. Launched in 2005, a key resource, thehttp://www.health-evidence.ca/ registry of systematic reviews, provides free, user-friendly access to a searchable database of public health relevant, quality-appraised reviews. Tailored capacity assessments for evidence-informed decision making, workshops and presentations on evidence-informed decision making ‘how to’, and Knowledge Broker services to mentor individuals/teams/organizations are available to support incorporation of evidence into practice.
The Cochrane LibraryThe Cochrane Library is available free to all Nzers at:http://www.thecochranelibrary.com/ Accessing the library this way will help ensure the continued MoH funding for the subscription to continue.
The Campbell CollaborationThe Campbell Collaboration aims to help people make well-informed decisions by preparing, maintaining and disseminating systematic reviews in education, crime and justice, and social welfare. The Campbell Collaboration is an international research network that produces systematic reviews of the effects of social interventions. Campbell is based on voluntary cooperation among researchers of a variety of backgrounds. Campbell’s strategic and policy making body is the Steering Group. Visit their website and library.
Evidence Based Health PromotionThe movement to develop ‘evidence based practice’ which first began in the field of medicine has spread to all parts of the health sector and other public sector activity. It is now widely accepted that activities to improve health should be supported by sound evidence. What is evidence? •At the most basic level, evidence involves ‘the available body of facts or information indicating whether a belief or proposition is true or valid’. •Evidence based public health and policy is an exercise in constructing realities and interventions within particular contexts. For policy-decision makers, evidence may be defined as ‘anything that establishes a fact or gives reason for believing something’. Visit the NSW Government Health websitefor more information and links to other useful sites.
Evidence of intervention effectiveness & cost-effectivenessResearch evidence, where available and of good quality, is an important component of decision making. We aim to make this type of evidence more accessible to decision makers by providing short summaries of relevant existing research that also consider the possible application of the research to policy and practice. The types of summaries that will become available in the short term are known as rapid reviews and evidence summaries. Results of relevant cost-effectiveness, cost-utility or cost-benefit analyses are also included. The Victorian Government Health web page also includes Overview | Rapid Reviews | Evidence Summaries | Evidence-based resources | Other evidence syntheses | Cost-effectiveness
The Question of Evidence in Health PromotionHealth promoters require credible evidence to identify relevant determinants of health, choose activiities to promote health, and then evaluate the effectivenss of these chosen activities. This issue of evidence in health promotion is a complex one that requires critical examination of what is meant by health promotion, the focus of health promotion activities, and the ideological isssues and prinicples that inform health promotion practice. It is argued that health promoters should be explicit about the prinicples and values behind their health promotion activities, and consider how ideology, values and data interact to produce evidence. Dennis Raphael, Health Promotion International Vol 5,No 4.
The Evidence of Health Promotion EffectivenessA Report for the European Commission by the International Union for Health Promotion and Education Assessing 20 years Evidence of the Health, Social, Economic and Political Impacts of Health Promotion,and Recommendations for Action. In order to contribute to the debate on Europe’s developing public health policy, the International Union for Health Promotion and Education (IUHPE) decided to undertake an ambitious and innovative project which would assess and collect the evidence of 20 years of health promotion effectiveness. Shaping Public Health in a New Europe
Evidence Supporting Population Health Promotion InitiativesPopulation health promotion is about creating the conditions that support the best possible health for everyone. Promoting health is a shared responsibility that requires the co-ordinated action of many sectors working together to improve well-being. The following document provides evidence from the literature supporting the need for health promotion. The document evidence is included in the areas of health promotion, healthy child development, heart health, home care, nutrition, physical activity/recreation, tobacco control and the workplace. Selected Literature Review Population Health Branch, Saskatchewan Health
A Maori overview of programme evaluation The evaluation hikoi:This book aims to:
- Provide the reader with an overview of the issues surrounding public health programme evaluation by and for Maori
- Give examples of the range of approaches that might be useful
- Highlight areas that evaluators may need to consider.
The Partnership Analysis Tool For Partners in Health Promotion
A resource for establishing, developing and maintaining productive partnerships. Produced by John McLeod on behalf of Vic Health, it assists organisations to develop a clearer understanding of the range of purposes of collaborations, reflect on established partnerships and look at ways to move forward. The Partnership Analysis Tool
Collaborative StrategiesWe expect the site will be useful to partnership members, researchers, policy makers, and funders interested in using collaborative approaches to improve community health and well-being. Center for the Advancement of Collaborative Strategies in Health
Integrated Health PromotionHealth Promotion, Primary and Community Health Victorian Department of Human Services, Australia have developed Integrated health promotion: A practice guide for service providers and Measuring health promotion impacts: A guide to impact evaluation in integrated health promotion, resource kit.
PublicationsThe Ministry of Health has an extensive collection of publications about child health in New Zealand These include the 1998 Child HealthStrategy. Child health publications
Influences in Childhood on the Development of Cardiovascular Disease and Type 2 Diabetes in Adulthood: An Occasional Paper (2005)This paper examines the medical literature on the childhood determinants which correlate to adulthood diabetes and cardiovascular disease in an effort to inform policy decisions and program implementation in the health sector. It also provides important information for health practitioners who are striving reduce the chronic disease trends for adults in NZ. Influences in Childhood
Health Eating Healthy Action: Strategic Framework (2003)This strategy calls for a more integrated and multi-sectoral approach to addressing nutrition, physical activity and obesity, and highlights the importance of both individual behaviour and our environment. Strategic Framework
Children and Young People: Indicators of Wellbeing in New Zealand 2008This the second indicator report published by MSD highlighting indicators of social well-being of children and young people, how these have changed and the status of health for different child and youth groups in the current population. MSD has utilized the findings from this report to advise the UNCROC report to be submitted to the United Nations. Summary of findings Full Report
Raising Children in New Zealand: The Influence of Parental Income on Children’s OutcomesThis report examines the impact parental income has on many child outcomes including health and well-being. By focusing on the correlation between net family income and child outcomes this report contributes in advising public policy on income support. Influence of Parental Income
The Social Report 2010: Indicators of Social Well-being in New ZealandThis site provides in-depth information on the social health and well-being status of New Zealand society, through the use of indicators to monitor trends over time and to make global comparisons. The site also contains the full 2008 Social report and areas dedicated to the different indicators. The Social Report 2010
Where Health Begins‘New Zealand’s child health outcomes compare poorly internationally. In a 2009 report from the Organisation for Economic Co-operation and Development (OECD 2009), Doing Better for Children, New Zealand ranked 29th out of 30 countries for child health and safety. In fact, some of New Zealand’s disease patterns among children are closer to those of developing countries’ (PHAC, 2010). What can advocates, clinicians, policy-makers and researchers do to strengthen the promotion of child health in New Zealand? This was the topic of a workshop of key stakeholders hosted by the Health Promotion and Policy Research Unit, University of Otago, Wellington. 28 October 2010 Power point presentation
WHO Global Conferences on Health PromotionThe Eighth Global Conference on Health Promotion: Health in all Policies. Helsinki, Finland 10-14 June 2013. Two items were produced from this conference: the Helsinki Statement and a Framework for Country action. Thestatement asserts that “health inequities between and within countries are politically, socially and economically unacceptable, as well as unfair and avoidable. Policies made in all sectors can have a profound effect on population health and health equity.” It called on governments to fulfil their obligations to their peoples’ health and wellbeing. Both the Statement and the Framework for Country Action can be found here. The Seventh Global Conference on Health Promotion, Nairobi, Kenya 26-30 October 2009, produced a Call to Action, whichidentified key strategies and commitments urgently required for closing the implementation gap in health and development through health promotion. The sixth Global Conference on Health Promotion – Thailand; 7-11 August 2005 – produced theBangkok Charter (above) The Fifth Global Conference on Health Promotion: Bridging the Equity Gap, Mexico City, June 5th, 2000. Signed by Ministers of Health, the brief 8-pointMexico Ministerial Statement for the Promotion of Health: From Ideas to Action acknowledges the duty and responsibility of governments to the promotion of health and social development. The Fourth International Conference on Health Promotion: New Players for a New Era- Leading Health Promotion into the 21st Century, meeting in Jakarta from 21 to 25 July 1997, came at a critical moment in the development of international strategies for health. It was the first to be held in a developing country and the first to involve the private sector in supporting health promotion. The Jakarta Declaration on Leading Health Promotion into the 21st Century identified the directions and strategies needed to address the challenges of promoting health in the 21st century. The Third International Conference on Health Promotion, Sundsvall, Sweden 9-15 June 1991: Supportive Environments for Health. This conference called upon people in all parts of the world to actively engage in making environments more supportive to health. Examining today’s health and environmental issues together, the Conference points out that millions of people are living in extreme poverty and deprivation in an increasingly degraded environment that threatens their health, making the goal of Health For All by the Year 2000 extremely hard to achieve. The way forward lies in making the environment – the physical environment, the social and economic environment, and the political environment – supportive to health rather than damaging to it. The Sundsvall Statement on Supportive Environments for Healthis a call to action, directed towards policy-makers and decision-makers in all relevant sectors and at all levels. The Second International Conference on Health Promotion in Adelaide, South Australia, 5-9 April 1988, continued in the direction set at Alma-Ata and Ottawa, and built on their momentum. Two hundred and twenty participants from forty-two countries shared experiences in formulating and implementing healthy public policy. The resulting Adelaide Recommendations on Healthy Public Policyreflect the consensus achieved at the Conference. The first International Conference for Health Promotion in Ottawa, Canada 21 November 1986 produced the Ottawa charter (above) The WHO has links to all its past conferences on health promotion.
‘Inequalities stymie health gains for Polynesians’ – Manawatu StandardAn article in the 15 December 2014 Manawatu Standard makes a poignant statement and raises important concerns on Māori and Pacific health. HPF Deputy Executive Director, Trevor Simpson comments.
The Auckland Supercity and Future Health EquityReport on the Symposium held at the School of Population Health, University of Auckland, 12 July 2011 The recent changes to Auckland’s governance to integrate local and regional authorities into a single Auckland Council, combined with new provisions to produce an Auckland Spatial Plan, marks an unparalleled opportunity to commit to a shared agenda to improve the wellbeing of all Aucklanders. This is a unique chance to ensure that fairness and wellbeing underpins the way Auckland develops over the next 30 years. Improvements to wellbeing or equity will not occur by accident nor good intentions alone. Specific strategies are needed now, drawing upon multiple sources of evidence and shared knowledge if the Auckland Plan is to improve wellbeing for all. A full-day symposium “The Auckland Supercity and Future Health Equity” was convened to discuss these issues and to consider how health equity could feature in the Auckland Plan. This report provides an overview of the presentations (with links), discussion and summation. Auckland Supercity Marmot Report
Fact and action sheets on health inequitiesThese fact and action sheets were prepared in the lead up to a visit by Sir Michael Marmot in July 2011, hosted by the New Zealand Medical Association. The purposes of these sheets are several:
- To attempt a brief stocktake on health inequities in New Zealand, both on what the current state of play is and what the future policy priorities might be.
- To provide background material for participants of the Auckland and Wellington Symposia.
- To provide material for the media in the lead up to, and during, Sir Marmot’s visit. Fact sheets
Health Promotion, Human Rights and EquityIn this issue of ‘Keeping Up To Date’ we look at the important and practical role of health and human rights in the health promotion armoury to redress these inequities, and not just by resorting to judicial processes. All people working in health promotion are working for the right to health! See HPF Publications Keeping Up to Date Autumn/Winter no. 35 – Carmel Williams
Reducing New Zealand’s health inequities requires urgent actionNew Zealand Medical Association Health Equity Position Statement, March 2011 “It is now well recognised that a society’s health status is closely linked to various social determinants. Minimising the impact these social determinants have on health is now a focus of concern for many high income nations including New Zealand. Apart from the obvious societal gains from a more healthy and equitable nation, there is the potential for addressing the ever increasing cost of healthcare.” Read the Health Equity Position Statement
Fair Society, Healthy Lives The Marmot ReviewFebruary 11th marks the first anniversary of the publication of the Marmot Review. In February 2010, the Marmot Review Team published Fair Society, Healthy Lives. This was the culmination of a year long independent review into health inequalities in England which Professor Sir Michael Marmot was asked to chair by the Secretary of State for Health. The review proposes the most effective evidence-based strategies for reducing health inequalities in England from 2010. Since publication we have seen, and worked to support, many developments based on the approach advocated by the review…read more. New Inequalities Data,News Coverage, Implementation Download the Executive Summary (4.8 MB) The Full Report (25MB) can be found on the Marmot Review Website
Social determinants approaches to public health from concept to practiceEditors – Erik Blas, Johannes Sommerfeld and Anand Sivasankara Kurup About this ebook The thirteen case studies contained in this publication were commissioned by the research node of the Knowledge Network on Priority Public Health Conditions (PPHC-KN), a WHO-based interdepartmental working group associated with the WHO Commission on Social Determinants of Health. The case studies describe a wealth of experiences with implementing public health programmes that intend to address social determinants and to have a great impact on health equity. This publication complements the previous publication by the Department of Ethics, Equity, Trade and Human Rights entitled Equity, social determinants and public health programmes, which analysed social determinants and health equity issues in 13 public health programmes, and identified possible entry points for interventions to address those social determinants and inequities at the levels of socioeconomic context, exposure, vulnerability, health outcomes and health consequences.Down load this ebook
The Economic, Social and Environmental Determinants of Human Development and Health EquityThree internationally renowned speakers discuss how environmental, political,economic and cultural characteristics of societies shape conditions in which people live, work and age. Inequities in these factors play a major role in producing health inequities in Australia,across the Asia Pacific region and globally. If set up well, economic development, trade, working conditions, urbanisation and health care for example could simultaneously improve development, social inclusion and health, but if done badly these factors can all increase health inequities. Podcast Professor Sir Michael Marmot in conversation with ANU academics Presented by Asia Pacific HealthGAEN and ANU College of Medicine, Biology & the Environment
Health starts where we live, learn, work and playA new way to talk about the determinants of health and a great way of talking about public health! It is a report on how to talk about the determinants of health to people who haven’t thought about it before. It makes sense to people and with people across a range of personal beliefs. – “Health starts where we live, learn, work and play” which is also a great way of talking about public health! The report is based on research with Americans but its ideas are also useful for New Zealand health promoters. Download it here
World Conference on Social Determinants of Health
2011 World Conference on the Social Determinants of Health
WHO held a conference in Rio de Janeiro, Brazil, to get support from governments on actions to improve health equity and the social determinants of health.
A report written for the Conference by the Asia-Pacific Global Action on Health Equity (HealthGAEN) includes many stories of actions being taken in Asia and the Pacific (including New Zealand) to improve health equity.
Sharon Friel, the Chair of Asia-Pacific HealthGAEN, blogged about the conference saying it showed the best and worst of global health politics
Fran Baum who is an Australian public health leader, co-chair of the People’s Health Movement, and was one of the Commissioners for the WHO Commission on Social Determinants of Health, blogged for the British Medical Journal before, during and at the end of the meeting.There were many expert speakers and frank discussions. The governments attending the conference, after considerable negotiations between their representatives, agreed to the Rio Declaration on Social Determinants of Health. The Rio Declaration, while useful, does not recognise the effects on health of unfair trade practices and climate change. When Professor David Saunders pointed this out to the Conference, he received a standing ovation from the floor. Civil society organisations produced an alternative declaration. Visit thePeoples Health Movement website to read the Alternative Declaration. You can read WHO’s summary of the meeting and find many useful resources about social determinants and the Conference here. 24 June, 2011 – A new WHO publication entitled “Social determinants approaches to public health: from concept to practice” takes the discussion on avoidable and unfair inequities in health to a practical level. The book follows the publication in early 2010 of “Equity, social determinants and public health programmes”, which analysed social determinants from the perspective of a range of priority public health conditions, exploring possible entry points for addressing health inequities at the levels of socioeconomic context, exposure, vulnerability, health-care outcome and social consequences. from Concept to Practice