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Equality, News
To provide a collective voice and expert support for effective policies and actions to reduce the harm from tobacco, alcohol and unhealthy foods, a new organisation has been established. Health Coalition Aotearoa (HCA) also aims to reduce inequities through a focus on the determinants of health. Launched in Wellington recently, Health Minister Dr David Clark commended the initiative, led by Professor Boyd Swinburn of the School of Population Health, University of Auckland. Dr Clark highlighted the need for more and better collaboration among health professionals, academics, NGOs and the Government to tackle health inequities in New Zealand. Professor Swinburn said at the launch that unhealthy diets, obesity, tobacco, and alcohol contribute about one third of the overall preventable health loss in New Zealand. Investment in population prevention of harm from tobacco, alcohol and unhealthy food is half a per cent of the national health budget and government prevention infrastructure was weak. “Implementing the World Health Organization’s (WHO) ‘Best Buys’ for preventing chronic disease would save lives and money,’ Professor Swinburn said. The Health Promotion Forum (HPF) is among more than 20 NGOs and institutions, and academic leaders that are foundation members of HCA. “We need collective leadership and a united front to address the many challenges that we face today,” said HPF Executive Director Sione Tu’itahi. Pictured at the launch of the coalition are from left: Professor Michael Baker, Otago University, Dr Lisa Te Morenga, Victoria Uni, Dr Ashley Bloomfield, Director-General, Ministry of Health, Professor Boyd Swinburn, University of Auckland, Hon Minister of Health Dr David Clark, Professor Sally Casswell, Massey University, Mike Kernaghan, CEO of Cancer Society.Equality, Maori
In October 2015 HPF’s Deputy Executive Director Trevor Simpson and Senior Health Strategist, Dr Viliami Puloka together presented to a multi-sectoral group in Kaitaia. “Towards Health Equity – putting the tools in the kete” discussed health and social inequities and suggested ways in which the group – from health and social services providers, WINZ and local authority representatives, police and education professionals – could work together to improve outcomes in their local community. A working group formed from the meeting with the group continuing discussions and working more cohesively to improve equity in the wider northern region.
Equity at the Centre Conference in Alice Springs (4-5 September 2014), HPF Senior Health Promotion Strategist Karen Hicks reports on some of the presentations made during the two day event.
“Austerity kills” – that was the claim of Sharon Friel, Professor of Health Equity at the Australian National University, Canberra in her presentation Power and People: a game plan for health equity in the 21st Century. “Health promotion is about freedom and empowerment; giving people a voice,” she said. “What is shaping our everyday living resources is power.” She characterised budget cuts as ‘structural violence’ that threaten equity and wellbeing.
“Injustices are everywhere and they affect peoples’ health. These injustices can and should be eliminated. ….. How we understand, frame, communicate and engage around matters to do with health equity guides the types of actions that are taken, or not, to improve the lives of all groups in society.”
“Health promotion is about freedom and empowerment; giving people a voice,” she said. “What is shaping our everyday living resources is power.” She characterised budget cuts as ‘structural violence’ that threaten equity and wellbeing.
Asked what health promoters can do in their everyday practice, Prof Friel said “We need to think about our work with an equity lens on every day; otherwise we are not addressing the social determinants of health.”
Prof Friel’s game plan for health promoters consisted of three steps:
1. Keep equity at the centre.
Rather than focusing on selective social determinants of health (such as housing or education) we need to keep equity as a whole at the centre of everything we do.
2. Frame your messages to fit your audience.
Realpolitik (based on power and on practical factors) rather than ideology is the way to go in the current Australian climate, for example.
Data is powerful. Evidence will support the value of health promotion and initiatives.
Social media is a powerful way to create a movement. It will succeed where traditional media often meet with resistance from the industry that fund them.
3. Release the power.
The strength of health promotion lies in its ability to work collaboratively with a range of people and disciplines. We can release the power of these networks by:
Recognising the skills and capacity of our workforce and empower them to make a difference.
Foster relationships with a wide range of complementary disciplines to create a team effort.
About Sharon Friel
Sharon Friel is Professor of Health Equity, incoming Director of Regulatory Institutions Network (RegNet) and Director of the Menzies Centre for Health Policy, The Australian National University, Canberra
She is is from the east end of Glasgow. After leaving Scotland in 1990, she pursued an academic career in public health following a brief stint making carpets in Germany and smelling beer in England. Sharon Friel is currently Professor of Health Equity at the National Centre for Epidemiology and Population Health and Director of the Menzies Centre for Health Policy at the Australian National University. Between 2005 and 2008 she was the head of the Scientific Secretariat, based at University College London, of the World Health Organisation’s global Commission on Social Determinants of Health. In 2010 she was awarded an Australian Research Council Future Fellowship to investigate the interface between health equity, social determinants and climate change (particularly through food systems and urbanisation), based at the National Centre for Epidemiology and Population Health, ANU. Before moving to Australia, she worked for many years in the Department of Health Promotion, National University of Ireland, Galway. She is co-founder of the Global Action for Health Equity Network (HealthGAEN), a global alliance concerned with research, training, policy and advocacy related to action in the social and environmental determinants of health equity, and chairs Asia Pacific-HeathGAEN.
Jo Lawrence-King
10 September 2014
Following her attendance at the 

- 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.
Equality, Maori, News, Racism
A feature article on an Australian TV website has highlighted the issue of the indigenous health gap; an issue that echoes the situation of Māori here in Aotearoa New Zealand. The article, by Bianca Nogrady, highlights the fact that indigenous Australians have a life expectancy ten years lower than non-indigenous Australians. She identifies social determinants of health such as income, access to affordable housing, stress and race as key factors in this gap. Crowded housing and ear infections

- 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.
Social Science & Medicine Journal has concluded that income inequality does indeed have a negative effect on population health and wellbeing; and that narrowing this gap will improve it. The paper suggests ways in which governments need to act to address this growing problem.
“It comes as no surprise to us that this is the conclusion of this paper,” says HPF’s Executive Director Sione Tu’itahi. “What surprises us is that there was ever any doubt. This will be a strong addition to our body of evidence. We implore governments in Aotearoa New Zealand and around the world to address inequality as the key to improving the health and wellbeing of their people.”
The paper’s authors cite world leaders, including the US President, the UK Prime Minister, the Pope and leaders at the International Monetary Fund, the United Nations, World Bank and the World Economic Forum; all of whom have described income inequality as one of the most important problems of our time. Several of these leaders have also emphasised its social costs. “Inequality is increasing in most regions of the world, rapidly in most rich countries over the past three decades,” they say.
“The evidence that large income differences have damaging health and social consequences is already far stronger than the evidence supporting policy initiatives in many other areas of social and economic policy, and the message is beginning to reach politicians,” say the authors. “The reason why politicians do not do more is almost certainly a reflection of the undemocratic power of money in politics and the media. Narrowing the gap will require not only redistributive tax policies but also a reduction in income differences before tax. “
The paper, by Professors Kate Pickett and Richard Wilkinson (pictured above), was drawn from a ‘very large’ literature review, including those papers that have previously thrown doubt over the causal link between income inequality and population health. The outcome was a strong body of evidence to support the link, while those few papers that drew different conclusions were found to have been based on studies using inappropriate measures.
Photo: Guardian.co.uk
Story: Jo Lawrence-King
April 2015
A paper published this year in 
literature review, commissioned by the former Health Funding Authority in December 2000, examined the most relevant literature on strategies that improve Māori and Pacific peoples’ access to primary health care services. It may help inform PHOs when planning services to improve access.
This Equality, News, Pacific

“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 |
Equality, News, Pacific
“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 |

Equity at the Centre Conference in Alice Springs (4-5 September 2014), HPF Senior Health Promotion Strategist Karen Hicks reports on some of the presentations made during the two day event.
Read an overview of the highlights from Karen.
Following her attendance at the The economics of social jutice – cost benefit analysis to achieve social determinants action
The main thrust of Martin Laverty’s presentation was that equity is an economic asset for a country and should be valued as such.Politics, Power and People
“Austerity kills” – that was the claim of Sharon Friel, Professor of Health Equity at the Australian National University, Canberra in her presentationPower and People: a game plan for health equity in the 21st Century.
Abstract for Martin Laverty’s presentation
The 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.
Biography
Martin 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-KingEquality, Family and child, News
Child Poverty Action Group’s Associate Professor Susan St John has decried the Working for Families scheme and called for the correction of “the moral bankruptcy of a social security tax-funded payment for children that deliberately excludes the poorest children….” This follows the discovery of a data error at Statistics New Zealand, which led to an underestimate of the number of families living below the poverty line. The new figures released from the Ministry of Social Development (MSD) on 27 February reveal a worse household income situation than previously thought for Aotearoa New Zealand.
Equality, News
Child Poverty Action Group’s Associate Professor Susan St John has decried the Working for Families scheme and called for the correction of “the moral bankruptcy of a social security tax-funded payment for children that deliberately excludes the poorest children….” This follows the discovery of a data error at Statistics New Zealand, which led to an underestimate of the number of families living below the poverty line. The new figures released from the Ministry of Social Development (MSD) on 27 February reveal a worse household income situation than previously thought for Aotearoa New Zealand. It is clear, from the revised statistics, that the Global Financial Crisis had a greater impact in 2009 on the incomes of lower-income households than originally thought. The 2011/12 figure for children living below the poverty line has been revised to 150,000 from the original 125,000. The number of children estimated to be living below the very low income line during this period has been revised to 285,000 from 265,000. “This is a huge indictment of the failure of government policies to protect the poorest children in a recession.” Her blog on the subject goes on to quote the Court of Appeal’s finding in 2013 that the Work Tax Credit policy discriminated “with harmful effect” against 230,000 of New Zealand’s poorest children.”
Equality, Maori, Pacific
Bruce Jesson Lecture 2013“Assertive, if not aggressive approach” called for by the Right Hon Sir Edmund Thomas

- Values directed by economic order
- Exploitation
- Equality
- Governmental intervention
- Unemployment
- Taxation
- Trade unions
- Social justice
full press release here.
Pacific health researchers called for a greater focus and action around Pacific children in their early years to break the cycle of poverty before this sad legacy is passed on to the next generation. Read the
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
review is that avoidable health inequalities are unfair and putting them right is a matter of social justice. “…health inequalities are not inevitable and can be significantly reduced.”
According to Michael Marmot’s report “social justice is a matter of life and death. It affects the way people live, their consequent chances of illness and their risk of premature death.”
The central tenet of this English
position statement uses the term equity in preference to equality because it better recognises that people differ in their capacity for health and their ability to attain or maintain health. Consequently, equitable outcomes in health may require different (i.e. unequal) inputs to achieve the same result. This is the concept of vertical equity (unequal, or preferential, treatment for unequals) in contrast to horizontal equity (equal treatment for equals).”
“This
Te Tiriti o Waitangi has been identified as the founding document of Aotearoa and the key to health promotion in this country.