Case Studies, Community, Economics, Equality, Pacific
by Sione Tu’itahi, Executive Director, Health
Promotion Forum of New Zealand (HPF)
Auckland University of Technology (AUT),
August 19, 2015
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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.
Following her attendance at the Equity at the Centre Conference in Alice Springs (4-5 September 2014), HPF Senior Health Promotion Strategist Karen Hicks reports on some of the presentations made during the two day event.
“Austerity kills” – that was the claim of Sharon Friel, Professor of Health Equity at the Australian National University, Canberra in her presentation Power and People: a game plan for health equity in the 21st Century. “Health promotion is about freedom and empowerment; giving people a voice,” she said. “What is shaping our everyday living resources is power.” She characterised budget cuts as ‘structural violence’ that threaten equity and wellbeing.
“Injustices are everywhere and they affect peoples’ health. These injustices can and should be eliminated. ….. How we understand, frame, communicate and engage around matters to do with health equity guides the types of actions that are taken, or not, to improve the lives of all groups in society.”
“Health promotion is about freedom and empowerment; giving people a voice,” she said. “What is shaping our everyday living resources is power.” She characterised budget cuts as ‘structural violence’ that threaten equity and wellbeing.
Asked what health promoters can do in their everyday practice, Prof Friel said “We need to think about our work with an equity lens on every day; otherwise we are not addressing the social determinants of health.”
Prof Friel’s game plan for health promoters consisted of three steps:
1. Keep equity at the centre.
Rather than focusing on selective social determinants of health (such as housing or education) we need to keep equity as a whole at the centre of everything we do.
2. Frame your messages to fit your audience.
Realpolitik (based on power and on practical factors) rather than ideology is the way to go in the current Australian climate, for example.
Data is powerful. Evidence will support the value of health promotion and initiatives.
Social media is a powerful way to create a movement. It will succeed where traditional media often meet with resistance from the industry that fund them.
3. Release the power.
The strength of health promotion lies in its ability to work collaboratively with a range of people and disciplines. We can release the power of these networks by:
Recognising the skills and capacity of our workforce and empower them to make a difference.
Foster relationships with a wide range of complementary disciplines to create a team effort.
About Sharon Friel
Sharon Friel is Professor of Health Equity, incoming Director of Regulatory Institutions Network (RegNet) and Director of the Menzies Centre for Health Policy, The Australian National University, Canberra
She is is from the east end of Glasgow. After leaving Scotland in 1990, she pursued an academic career in public health following a brief stint making carpets in Germany and smelling beer in England. Sharon Friel is currently Professor of Health Equity at the National Centre for Epidemiology and Population Health and Director of the Menzies Centre for Health Policy at the Australian National University. Between 2005 and 2008 she was the head of the Scientific Secretariat, based at University College London, of the World Health Organisation’s global Commission on Social Determinants of Health. In 2010 she was awarded an Australian Research Council Future Fellowship to investigate the interface between health equity, social determinants and climate change (particularly through food systems and urbanisation), based at the National Centre for Epidemiology and Population Health, ANU. Before moving to Australia, she worked for many years in the Department of Health Promotion, National University of Ireland, Galway. She is co-founder of the Global Action for Health Equity Network (HealthGAEN), a global alliance concerned with research, training, policy and advocacy related to action in the social and environmental determinants of health equity, and chairs Asia Pacific-HeathGAEN.
Jo Lawrence-King
10 September 2014
Alice Springs, September 2014
In September HPF Senior Health Promotion Strategist Karen Hicks represented Aotearoa New Zealand at the Australian Health Promotion Association Conference Equity at the Centre: Action on Social Determinants of Health in Alice Springs. Highlights from the event included
- Sharon Friel’s plenary session on politics, power and people
- Karen’s own presentation on Indigenous health promotion and workforce development
- Martin Laverty’s discussion of the economics of social justice
- Kerry Taylor’s findings about the power of language as a determinant of health
In her presentation Politics, power and people: A game plan for health equity in the 21st century Prof Sharon Friel identified a game plan; actions that health promoters can undertake.
1. Keep equity at the centre.
Rather than focusing on selective social determinants of health (such as housing or education) we need to keep equity as a whole at the centre of everything we do.
2. Frame your messages to fit your audience.
Realpolitik (based on power and on practical factors) rather than ideology is the way to go in the current Australian climate, for example.
Data is powerful. Evidence will support the value of health promotion and initiatives.
Social media is a powerful way to create a movement. It will succeed where traditional media often meet with resistance from the industry that fund them.
3. Release the power.
The strength of health promotion lies in its ability to work collaboratively with a range of people and disciplines. We can release the power of these networks by:
Recognising the skills and capacity of our workforce and empower them to make a difference.
Foster relationships with a wide range of complementary disciplines to create a team effort.
Karen Hicks’ presentation discussed Indigenous health promotion competency and workforce development in Aotearoa, New Zealand. The New Zealand approach is being held up around the world as a model to assist and inform indigenous health promotion.
Focusing on the role an effective health promotion workforce has on in reducing health inequities, Karen introduced three inclusive and equitable capacity building tools:
- TUHANZ (a Treaty Understanding of Hauora in Aotearoa New Zealand),
- the health promotion competencies and the
- health promotion society
She pointed out that the development these tools are informed by indigenous health promotion in consultation with the health promotion workforce.
The main thrust of Martin Laverty’s discussion was that a healthy population is essential for a productive, healthy, growing economy.
In his presentation, The economics of social justice: cost benefit analysis to achieve social determinants action, Laverty asserted that equity is an asset and, which we should examine with an economic lens. We can do this by the way we communicate to governments: framing our arguments according to the left-right orientation of the Governments of the day.
To discuss the subject of equity with a Government positioned to the right it is important to discuss social determinants of health in the context of facilitating an effective economy. Those governments that want people to be responsible for their own health need first to invest in social capital and in social determinants of health such as housing and child development. This enables people to have the capacity and capability to be responsible for their own health.
If addressing a left wing government, on the other hand: we need to frame social determinants of health in relation to fairness.
Martin Laverty is Chair of Social Determinants of Health Alliance
Kerry Taylor’s PhD research at from Flinders University, Alice Springs campus, suggested that language as a social determinant of health is putting indigenous people’s lives at risk.
There are over 200 languages spoken in Australia; most of which are not spoken by health workers. As a result health workers are unable to share a common language or deep dialogue with patients/communities.
The outcomes for services accessed by indigenous communities include:
- high staff turnover due to staff feeling ill equipped,
- poor access to healthcare
- language becoming a significant social determinant of health.
Jo Lawrence-King and Karen Hicks
24 November 2014
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
Nogrady cites an example, by Professor Dennis McDermott from Adelaide’s Flinders University, of housing and ear infections. Where a large number of people live at close quarters – as is more common among poorer indigenous people – children are more likely to suffer repeat ear infections as they are passed around the household.
“What happens is that non-Indigenous kids get it maybe once, they have a brush with it, and then it’s gone,” says Prof McDermott. “But with Indigenous kids in an overcrowded situation, it goes around and comes back, goes around and comes back, such that it’s a huge impact on hearing loss.”
This hearing loss has life-long effects. Children can’t hear in school, adults can’t hear on the job, it can impact on mental health, anger management, and wellbeing, McDermott says.
The impact is doubled with racism
According to Prof. McDermott racism has a clear and proven impact on people, as does connection to country – or the land from which people come.
“That psycho-spiritual connection to country, and doing these ceremonies, observing, burning the country when necessary…, is actually a positive contributor to health.”
In Australia there is hard evidence to support that those people living ‘on country’ and experiencing at least some elements of a traditional lifestyle are healthier. They tend to be more physically active, have a better diet, lower body-mass index, lower blood pressure, lower blood glucose levels, lower prevalence of diabetes and a lower risk of cardiovascular disease.
Despite the issue seeming insurmountable Prof. McDermott is optimistic. He compares the health gap to climate change, explaining that there is no vested interest in listening to the evidence and making a change. However, he says; “I think if we can only get that message through and build a critical mass of discourse in the community, then the politicians will fall in line.”
The original article appeard on www.abec.net.au. Read it here.
“Inequalities in health exist both within and between countries. They are both unnecessary and unjust. They also create a great cost to societies…” These are the opening words of the latest Eurohealth; the quarterly publication of the WHO-hosted European Observatory on Health Systems and Policies. Reporting on the 7th European Public Health Conference, this special edition for 2015 focuses on the issues discussed at the November 2014 event in Glasgow, Scotland. 
With the theme of the conference being “Mind the Gap: Reducing Inequalities in Health and Health Care”, EuroHealth articles look at:
- How Roma communities are responding to inequalities;
- The adaptation of health promotion and disease prevention interventions for migrant and ethnic minority populations;
- The Glasgow Declaration;
- Learning from each other – where health promotion meets infectious diseases;
- Public health monitoring and reporting;
- Changing your health behaviour – regulate or not;
- Developing the public health workforce;
- Building sustainable and resilient health care systems;
- Leaving a legacy in Glasgow;
- Conclusions; and Eurohealth Monitor.
The European Observatory on Health Systems and Policies is a partnership between the World Health Organization Regional Office for Europe, the Governments of Austria, Belgium, Finland, Ireland, Norway, Slovenia, Sweden, the United Kingdom and the Veneto Region of Italy, the European Commission, the World Bank, UNCAM (French National Union of Health Insurance Funds), London School of Economics and Political Science and the London School of Hygiene & Tropical Medicine.
Read more about inequalities and other significant health issues in Eurohealth Number 1, 2015 here.
A paper published this year in Social Science & Medicine Journal has concluded that income inequality does indeed have a negative effect on population health and wellbeing; and that narrowing this gap will improve it. The paper suggests ways in which governments need to act to address this growing problem.
“It comes as no surprise to us that this is the conclusion of this paper,” says HPF’s Executive Director Sione Tu’itahi. “What surprises us is that there was ever any doubt. This will be a strong addition to our body of evidence. We implore governments in Aotearoa New Zealand and around the world to address inequality as the key to improving the health and wellbeing of their people.”
The paper’s authors cite world leaders, including the US President, the UK Prime Minister, the Pope and leaders at the International Monetary Fund, the United Nations, World Bank and the World Economic Forum; all of whom have described income inequality as one of the most important problems of our time. Several of these leaders have also emphasised its social costs. “Inequality is increasing in most regions of the world, rapidly in most rich countries over the past three decades,” they say.
“The evidence that large income differences have damaging health and social consequences is already far stronger than the evidence supporting policy initiatives in many other areas of social and economic policy, and the message is beginning to reach politicians,” say the authors. “The reason why politicians do not do more is almost certainly a reflection of the undemocratic power of money in politics and the media. Narrowing the gap will require not only redistributive tax policies but also a reduction in income differences before tax. “
The paper, by Professors Kate Pickett and Richard Wilkinson (pictured above), was drawn from a ‘very large’ literature review, including those papers that have previously thrown doubt over the causal link between income inequality and population health. The outcome was a strong body of evidence to support the link, while those few papers that drew different conclusions were found to have been based on studies using inappropriate measures.
Photo: Guardian.co.uk
Story: Jo Lawrence-King
April 2015
This 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.
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 |
An article in the 15 December Manawatu Standard, Inequalities stymie health gains for Polynesians, makes a poignant statement and raises important concerns on Māori and Pacific health. Highlighting statistical data gleaned from the New Zealand Health Survey results for 2013 and 2014, the report covered the wide gap in health outcomes between Māori and Pacific and other ethnic groups. A staggering array of both causes and conditions were listed, describing a situation in which certain social groups experience a greater burden of disease than their existing counterparts (see ‘Health promotion, human rights and equity’ on the Health Promotion Forum website).
Most of these outcomes can be attributed to social inequities; that is, those unfair, avoidable and unjust factors that impact negatively on the health of social groups. A closer look shows that these outcomes are systemic and relate to what Sir Michael Marmot has described as the social determinants of health (see HPF paper ‘Health and social inequalities; issues of justice and fairness’)
In the article, interviewee Chrissy Paul touches on a number of key points as to why these disparities may persist. As she accurately points out, these outcomes cannot simply be put down to ethnicity. It can also be shown that they cannot be classed as behavioural or cultural but rather structural i.e. how society is arranged. The entire breadth of a situation must be considered when questioning why any health outcome occurs. For example if Māori and Pacific people are experiencing higher rates of psychological duress then the reasons for this could emanate from a range of social, environmental, political and economic factors. Chrissy further provided an important clue by referencing the fact that negative health statistics are found in “[Deprivation] Decile 10 areas,” that is communities that experience higher levels of deprivation.
On this topic it is timely, for proponents of preventative health, that a nationwide discussion has focussed on poverty and the widening gap between the ‘haves’ and ‘have nots’. For example, Bryce Edwards, in his NZ Herald opinion piece on Monday 15th December suggests that ‘Inequality’ could be the word of the year in New Zealand politics. The correlations between poverty and health outcomes are now very well-known and understood. It is true that poverty exists across all ethnicities but it is hard to overlook the stark contrast between Māori and Pacifica peoples and other groups.
Children are a case in point. The Child Poverty Monitor: 2014 Technical Reportshows that 1 in 3 Māori and Pacifica children live in poverty as compared to 1 in 6 European children. It also states that three out of 5 of these children are likely to live this way for many years. The impact of this on health across the life continuum is obvious, not to mention extremely costly. For example rates of hospitalisations for children living in the most deprived areas (NZDep deciles 9–10) were nearly 3 times higher than for those in areas with the least deprivation (NZDep deciles 1–2). Further the majority of hospital admissions were due to infectious and respiratory diseases among children aged 0–14 years. During 2009–2013, 82% of these admissions were for asthma and wheeze, acute bronchiolitis, acute upper respiratory infections, gastroenteritis, viral infection of unspecified site, skin infections or pneumonia (bacterial, non-viral). In many cases these outcomes were completely preventable.
One simple solution is to reinstate a universal child benefit; to lift not only poor families, but all struggling whānau, above the bread line. Other answers can be found in the Office of the Children’s Commissioners report Choose kids: why investing in children benefits all New Zealanders.
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 and our communities. Keeping people well, it seems, is the much cheaper option.
16 December 2014
Trevor Simpson
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 |
An article in the 15 December Manawatu Standard, Inequalities stymie health gains for Polynesians, makes a poignant statement and raises important concerns on Māori and Pacific health. Highlighting statistical data gleaned from the New Zealand Health Survey results for 2013 and 2014, the report covered the wide gap in health outcomes between Māori and Pacific and other ethnic groups. A staggering array of both causes and conditions were listed, describing a situation in which certain social groups experience a greater burden of disease than their existing counterparts (see ‘Health promotion, human rights and equity’ on the Health Promotion Forumwebsite).
Most of these outcomes can be attributed to social inequities; that is, those unfair, avoidable and unjust factors that impact negatively on the health of social groups. A closer look shows that these outcomes are systemic and relate to what Sir Michael Marmot has described as the social determinants of health (see HPF paper ‘Health and social inequalities; issues of justice and fairness’)
In the article, interviewee Chrissy Paul touches on a number of key points as to why these disparities may persist. As she accurately points out, these outcomes cannot simply be put down to ethnicity. It can also be shown that they cannot be classed as behavioural or cultural but
rather structural i.e. how society is arranged. The entire breadth of a situation must be considered when questioning why any health outcome occurs. For example if Māori and Pacific people are experiencing higher rates of psychological duress then the reasons for this could emanate from a range of social, environmental, political and economic factors. Chrissy further provided an important clue by referencing the fact that negative health statistics are found in “[Deprivation] Decile 10 areas,” that is communities that experience higher levels of deprivation.
On this topic it is timely, for proponents of preventative health, that a nationwide discussion has focussed on poverty and the widening gap between the ‘haves’ and ‘have nots’. For example, Bryce Edwards, in his NZ Herald opinion piece on Monday 15th December suggests that ‘Inequality’ could be the word of the year in New Zealand politics. The correlations between poverty and health outcomes are now very well-known and understood. It is true that poverty exists across all ethnicities but it is hard to overlook the stark contrast between Māori and Pacifica peoples and other groups.
Children are a case in point. The Child Poverty Monitor: 2014 Technical Reportshows that 1 in 3 Māori and Pacifica children live in poverty as compared to 1 in 6 European children. It also states that three out of 5 of these children are likely to live this way for many years. The impact of this on health across the life continuum is obvious, not to mention extremely costly. For example rates of hospitalisations for children living in the most deprived areas (NZDep deciles 9–10) were nearly 3 times higher than for those in areas with the least deprivation (NZDep deciles 1–2). Further the majority of hospital admissions were due to infectious and respiratory diseases among children aged 0–14 years. During 2009–2013, 82% of these admissions were for asthma and wheeze, acute bronchiolitis, acute upper respiratory infections, gastroenteritis, viral infection of unspecified site, skin infections or pneumonia (bacterial, non-viral). In many cases these outcomes were completely preventable.
One simple solution is to reinstate a universal child benefit; to lift not only poor families, but all struggling whānau, above the bread line. Other answers can be found in the Office of the Children’s Commissioners report Choose kids: why investing in children benefits all New Zealanders.
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 and our communities. Keeping people well, it seems, is the much cheaper option.
16 December 2014
Trevor Simpson
Following her attendance at the Equity at the Centre Conference in Alice Springs (4-5 September 2014), HPF Senior Health Promotion Strategist Karen Hicks reports on some of the presentations made during the two day event.
Read an overview of the highlights from Karen.
The economics of social jutice – cost benefit analysis to achieve social determinants action
The main thrust of Martin Laverty’s presentation was that equity is an economic asset for a country and should be valued as such.
Politics, Power and People
“Austerity kills” – that was the claim of Sharon Friel, Professor of Health Equity at the Australian National University, Canberra in her presentationPower and People: a game plan for health equity in the 21st Century.
In the report from the Equity at the Centre Congress in Alice Springs (4-5 September 2014), HPF Senior Health Promotion Strategist Karen Hicks Martin Laverty’s presentation.
According to Martin Lavety, CEO of Catholic Health Australia; equity is an economic asset for a country and should be valued as such. His advice to those advocating equity with governments that focus on indivicual respoinsibility was to argue the case that investiment in social capital (e.g. housing, safe pregnancy, economic development) is necessary in order to make individual responsibility possible.
“If we want people to be productive and to have economic growth,” said Lavety, “we need a healthy population.” He pointed out that people are unable to take individual responsibility for their health if it is already compromised.
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-King
Equality, 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.
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, 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.”
4 March 2014
Jo Lawrence-King
Equality, Maori, Pacific
Bruce Jesson Lecture 2013
“Assertive, if not aggressive approach” called for by the Right Hon Sir Edmund Thomas
Retired Court Appeal Judge the Right Hon Sir Edmund Thomas (pictured right – from 3 News) called for an “assertive, if not aggressive approach” by communities and community groups; to reverse the extreme inequality that currently exists in Aotearoa New Zealand. He was speaking to a packed Maidment Theatre in Auckland, late October.
HPF Health Strategist Dr Ieti Lima was in the audience and reports on some of Sir Edmund’s key points to support his argument.
Call for “sufficient force”
In his powerful, engaging and, at times, challenging lecture, Sir Edmund proposed a focussed campaign to promote substantive human rights. He further called for “sufficient force” to ensure people claim the minimal social, economic and cultural standards to which they have a right. Sir Edmund asserted that, if the governing bodies or the courts cannot generate the required assertive approach to support people’s rights, the community must initiate the action needed. “Discussion and debate will not suffice,” he said. “This legacy is now too entrenched to be so readily reversed.”
Neo-liberalism at the heart of the problem
Sir Edmund was unequivocal in linking the “extreme – even obscene – inequality” that exists in Aotearoa New Zealand to the “traumatic neo-liberal transformation” that has been pursued here.
According to the retired judge, the top ten per cent of New Zealand’s population today owns half of the country’s wealth, while the bottom 50 per cent owns just five per cent of the wealth.
He pointed to Maori health statistics as appalling, and declared that he finds “the neglect of a people socially and culturally offensive.”
So how has this gross inequality been tolerated in a country that once prided itself on its egalitarian culture and sense of social justice? Sir Edmund’s explanation was blunt; it has been fostered and sustained by the rich and powerful, to perpetuate their own wealth and privilege. Sir Edmund argued that the term ‘equality’ is today more often than not defined in terms of equality of opportunity. By suggesting that all people have the same opportunity, the term obscures the true extent of inequality within the community. If this definition remains, it simply provides the opportunity for those in an advantaged position to further advance their superiority and privilege.
“This perspective of equality in turn impairs social mobility,” he said. “The disadvantaged are stuck with being disadvantaged. … It becomes a vicious circle”.
Neo-liberalism – according to Sir Edmund – is a theory that insists human well-being can best be advanced by ensuring strong property rights, free enterprise, free market and free trade. He identified eight features of the neo-liberal legacy:
- Values directed by economic order
- Exploitation
- Equality
- Governmental intervention
- Unemployment
- Taxation
- Trade unions
- Social justice
Assertive action by community groups
Sir Edmund challenged his audience to consider who will speak for “losers” in a capitalistic society? How can they be guaranteed their basic economic, social and cultural human rights? He proposed that a first step in any campaign to achieve a more equal and just society is to identify and challenge the damaging features of neoliberalism. Ultimately the aim is to arrest and reverse them.
In the absence of legal options to redress the inequalities, Sir Edmund called on a focussed campaign by community groups. “They [must] possess sufficient force for people to claim that the minimum social, economic and cultural standards they reflect are theirs as of right”.
Sir Edmund was the speaker at the annual Bruce Jesson 2013 at the Maidment Theatre, University of Auckland. He is a retired Court of Appeal Judge and former acting judge of the Supreme Court. His lecture was made to a mainly academic audience.
Author: Dr Ieti Lima
Editor: Jo Lawrence-King
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 full press release here.
The release, on Monday 9 December, of the first annual monitor of child poverty shows that one in four children* in Aotearoa New Zealand live in income poverty. One in six live without basic essentials like fresh fruit and vegetables, a warm house, decent shoes and visits to the doctor.
It has long been known that child poverty creates life-long health issues.
According to Iain Hines, Executive Director of the J R McKenzie Trust child poverty today is twice that of the 1980s. “If New Zealand’s road toll was twice that of the ‘80s ther would be outrage and immediate action taken to reduce it. We need the same momentum and action on child poverty.”
Children’s Commissioner Dr Russell Wills says the project is about giving New Zealanders the full picture on child poverty and to get New Zealanders talking about it. “Child poverty hurts all of us. It harms the individual child and it has substantial long-term costs to society. If we want to be a thriving, progressive and successful country – we’re not going to get there with 25 percent of our kids in poverty,” he says.
The Child Poverty Monitor is a joint project by the Children’s Commissioner, J R McKenzie Trust and Otago University’s NZ Child and Youth Epidemiology Service (NZCYES). For the next five years it will publish four measures of child poverty: income poverty, material hardship, severe poverty and persistent poverty. The initiative aims to raise awareness of the problem and monitor New Zealand’s progress in reducing each of these measures.
The Monitor is supported by an extensive technical report.
More information on child poverty and health can be found in our Children and Young People section.
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
Equality, News
An article published in Christchurch’s The Press newspaper proposes the way we engage the broader public in the inequality debate is to make the issue relevant to them. “The answer is to persuade people that they are affected,” says the article’s author Philip Matthews. He suggests that the living wage debate is a good start to addressing the issue.
Matthews argues inequality is “not just immoral but has a social cost.” Closing the gap doesn’t have to be a Left versus Right issue, he says.
The living wage seems to be capturing the imagination of the public more than the broader and less tangible subject of inequality. Matthews theorises that, like child poverty, the living wage is a more easily grasped concept and therefore may be more easy to address.
Read the full article here.
Article published: 30 October 2013
Equality, Family and child, Maori
Inquiry into the determinants of wellbeing for tamariki Māori.
A report, issued in December 2013 by the Māori Affairs Committee, concludes that poverty is a major barrier to the wellbeing of tamariki Māori. The authors call on all New Zealanders to support the work being done to improve the wellbeing of our tamariki, and New Zealand as a whole. They encourage a collaborative approach between agencies and organisations to support the Whānau Ora – and similar – approach to working with Māori whānau. They unambiguously reject a silo mentality.
The central tenet of this English review is that avoidable health inequalities are unfair and putting them right is a matter of social justice. “…health inequalities are not inevitable and can be significantly reduced.”
According to Michael Marmot’s report “social justice is a matter of life and death. It affects the way people live, their consequent chances of illness and their risk of premature death.”
“This 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).”
Te Tiriti o Waitangi has been identified as the founding document of Aotearoa and the key to health promotion in this country.
Indigenous health gap – social determinants key
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.
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. – See more at: http://www.hauora.co.nz/indigenous-health-gap-social-determinants-key.html#sthash.KN5CTT39.dpuf
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. – See more at: http://www.hauora.co.nz/indigenous-health-gap-social-determinants-key.html#sthash.KN5CTT39.dpuf
‘Inequalities stymie health gains for Polynesians’ – Manawatu Standard
An article in the 15 December Manawatu Standard makes a poignant statement and raises important concerns on Māori and Pacific health. HPF Deputy Executive Director, Trevor Simpson comments.
Equity at the Centre – highlights
Following her attendance at the Equity at the Centre Conference in Alice Springs (4-5 September 2014), HPF Senior Health Promotion Strategist Karen Hicks reports on some of the presentations made during the two day event.
Read an overview of the highlights from Karen.
The economics of social jutice – cost benefit analysis to achieve social determinants action
The main thrust of Martin Laverty’s presentation was that equity is an economic asset for a country and should be valued as such.
Politics, Power and People
“Austerity kills” – that was the claim of Sharon Friel, Professor of Health Equity at the Australian National University, Canberra in her presentationPower and People: a game plan for health equity in the 21st Century.
Health promotion, human rights and equity
“The differences in health and wellbeing across the social hierarchy, and between ethnic groups, are not innate or natural, and the circumstances causing these unfair differences can be changed. The work of health promotion aims to bring about these changes, by advocating for fair social policies, programmes, and economic arrangements.” Carmel Williams’ 2011paper explores the crucial role of human rights in health promotion.
This is number 35 in the HPF’ Keeping Up to Date series of peer-reviewed papers.