A wide-ranging UN climate report released yesterday (March 10) shows that climate change is having a major effect on all aspects of the environment as well as on the health and wellbeing of the global population.
The report, The WMO Statement on the State of the Global Climate in 2019, which is led by the UN weather agency (World Meteorological Organization), contains data from an extensive network of partners.
It documents physical signs of climate change – such as increasing land and ocean heat, accelerating sea level rise and melting ice – and the knock-on effects on socio-economic development, human health, migration and displacement, food security, and land and marine ecosystems.
Writing in the foreword to the report, UN chief António Guterres warned that the world is currently “way off track meeting either the 1.5°C or 2°C targets that the Paris Agreement calls for”, referring to the commitment made by the international community in 2015, to keep global average temperatures well below 2°C above pre-industrial levels.
Australian wildfires spark global CO2 increase
Several heat records have been broken in recent years and decades: the report confirms that 2019 was the second warmest year on record, and 2010-2019 was the warmest decade on record. Since the 1980s, each successive decade has been warmer than any preceding decade since 1850.
Ongoing warming in Antarctica saw large-scale ice melt and the fracturing of a glacier, with repercussions for sea level rise, and carbon dioxide emissions spiked following the devastating Australian bushfires, which spread smoke and pollutants around the world.
The warmest year so far was 2016, but that could be topped soon, said WMO Secretary-General Petteri Taalas. “Given that greenhouse gas levels continue to increase, the warming will continue. A recent decadal forecast indicates that a new annual global temperature record is likely in the next five years. It is a matter of time.”
The widespread impacts of ocean warming
Greenhouse gas emissions continued to grow in 2019, leading to increased ocean heat, and such phenomena as rising sea levels, the altering of ocean currents, melting floating ice shelves, and dramatic changes in marine ecosystems.
The ocean has seen increased acidification and deoxygenation, with negative impacts on marine life, and the wellbeing of people who depend on ocean ecosystems. At the poles, sea ice continues to decline, and glaciers shrunk yet again, for the 32nd consecutive year.
Unprecedented floods and droughts
In 2019, extreme weather events, some of which were unprecedented in scale, took place in many parts of the world. The monsoon season saw rainfall above the long-term average in India, Nepal, Bangladesh and Myanmar, and flooding led to the loss of some 2200 lives in the region.
Parts of South America were hit by floods in January, whilst Iran was badly affected in late March and early April. In the US, total economic losses from flooding were estimated at around $20 billion. Other regions suffered a severe lack of water. Australia has its driest year on record, and Southern Africa, Central America and parts of South America received abnormally low rains.
Last year also saw an above-average number of tropical cyclones, with 72 in the northern hemisphere, and 27 in the southern hemisphere.
The human cost
The changing climate is exerting a toll on the health of the global population: the reports shows that in 2019, record high temperatures led to more than 100 deaths in Japan, and 1462 deaths in France. Dengue virus increased in 2019, due to higher temperatures, which have been making it easier for mosquitos to transmit the disease over several decades.
Following years of steady decline, hunger is again on the rise, driven by a changing climate and extreme weather events.
Worldwide, some 6.7 million people were displaced from their homes due to natural hazards – in particular storms and floods, such as the many devastating cyclones, and flooding in Iran, the Philippines and Ethiopia. The report forecasts an internal displacement figure of around 22 million people throughout the whole of 2019, up from 17.2 million in 2018.
COP26: time to aim high
In an interview with UN News, Mr Taalas said there is a growing understanding across society, from the finance sector to young people, that climate change is the number one problem mankind is facing today, “so there are plenty of good signs that we have started moving in the right direction”.
“Last year emissions dropped in developed countries, despite the growing economy, so we have been to show that you can detach economic growth from emission growth. The bad news is that, in the rest of the world, emissions grew last year. So, if we want to solve this problem, we have to have all the countries on board”.
Speaking at the launch of the report on Tuesday at UN Headquarters in New York Mr Guterreson said “we have to aim high” at the 2020 UN Climate Change Conference (COP26), which will be held in the Scottish City in November.
The UN chief called on all countries to demonstrate that emission cuts of 45 per cent from 2010 levels are possible this decade, and that net-zero emissions will be achieved by the middle of the century.
Four priorities for COP26 were outlined by Mr Guterres: more ambitious national climate plans that will keep global warming to 1.5 degrees above pre-industrial levels; strategies to reach net zero emissions by 2050; a comprehensive programme of support for climate adaptation and resilience; and financing for a sustainable, green economy.
International health promotion leader Dr Trevor Hancock has helped put health on the agenda of thousands of cities and towns around the world.
Dr Hancock was a plenary speaker at the 23rd International Union for Health Promotion and Education (IUHPE) World Health Promotion Conference in Rotorua from April 7 – 11, 2019. Although recently retired from his position as a Professor and Senior Scholar at the School of Public Health and Social Policy at the University of Victoria he’s as busy as ever as he shares with us from his home in Canada about keeping the Healthy Cities Movement “moving”, plans for broadening, deepening and connecting the “Conversations for a One Planet Region” and about some spin-off projects in the works.
Hauora:Trevor you are one of the founders of the (now global) Healthy Cities and Communities movement? Can you please tell us what prompted you to launch this movement, what its aims are and what has been achieved so far?
Dr Trevor Hancock speaking at the global health promotion conference in Rotorua last April.
TH: Well, I didn’t exactly launch the movement, but I did help pioneer it. I trained in medicine in the late 1960s/early 1970s in London and then spent four years in family practice in Canada. The last two years were in a community health centre in Toronto, where we served a somewhat under-privileged community. It was clear to me that many of the health problems my patients experienced were economic, social and environmental problems, not really medical problems, which cemented my interest in public health, so I did a Masters at the U of Toronto, graduating in 1980.
You can’t do public health without
becoming keenly aware of the roots of modern-day public health in the struggle
to address the terrible living and working conditions in the towns of the
industrialising world in the 19th century, and to the stories of
John Snow, Edwin Chadwick and other leaders. One of those leaders I found
particularly inspiring was Sir Benjamin Ward Richardson, a self-professed
‘disciple’ of Chadwick. In 1875 he gave an inspirational address to the Social
Science Association on “Hygeia: A City of Health”, which is still well worth
reading.
So when I started work as the
Health Planner for the City of Toronto in the Department of Public Health’s new
Health Advocacy Unit in 1980 , I had this work in mind. One of my tasks was to
create a mission statement for the Department, and we adopted the following:
Our mission is to help to make the City of Toronto the healthiest city in North
America”. Note we said ‘help to’ – health is not created by a public health
department any more than it is created by
the health care system; we recognised that many other City departments –
and many other players outside City government – contibuted a great deal to the
health of the city’s people, starting with clean water, sanitation, safe and
healthy buildings and so on.
So we started to ask
ourselves’what exactly is a healthy city, how would we get one, and how would
we know we were one?’. As you can imagine, that led to a great deal of
discussion and innovation. Luckily, as it happened – and never discount luck as
a factor, but when you have it, exploit it! – 1984 was a banner year – the
sesqui-centennial of the City, the centenary of the Board of Health, the 75th
anniversary of the Canadian Public Health Association and the tenth anniversary
of the Lalonde Report. This made it possible for me – working with a great conference committee –
to put on ‘Beyond Health Care’, an international working conference on healthy
public policy, a term, but not a concept, I had created in about 1980, inspired
by the work of people like Nancy Milio and Peter Draper.
As part of the conference, we had
a theme on healthy cities, but also – because it was after all a Toronto-based
conference – we had a day we called ‘Healthy Toronto 2000’, looking at what it
would take to make Toronto a healthy city by then. One of the keynote speakers
was Len Duhl, a professor of public health and urban planning at Berkely, and
one of the attendees was Ilona Kickbusch, then the Health Promotion Officer for
WHO Europe and already working closely with Ron Draper at Health Canada -who
had invited her – on what was to become two years later the Ottawa Charter for
Health Promotion.
Ilona brilliantly saw in the idea
of a healthy city a way to take the concepts of health promotion out into the
city and make them real, and thus was born the WHO Europe Healthy Cities
initiative, which had its first planning meeting in Copenhagen (WHO Europe’s HQ)
in early 1986. Len Duhl and I were part of the planning committee, and together
wrote the original background paper – and the rest is history!
As to the aims and achievements,
they are quite simple: To put health on the agenda of city governments and governance
processes, and to help cities plan with health in mind as a key objective. In
that, I think we have been highly successful, the idea has been taken up – with
varying degrees of success – in cities, towns and villages around the world –
inevitably, with varying degrees of success.
But I think the key word here is
‘movement’. There is, inevitably, a wish to evaluate the work, but its rather
like evaluating the women’s movement, the labour movement, the peace movement
or the environment movement. They are always working, always pushing, and they
have their succeses and failures, but they just keep going; that is what a
healthy cities movement must do too.
Hauora:One of the challenges you point out for the 21st century is that we’re going to have to look at dramatically different ways of organising our cities, our countries, our neighbourhoods, our own personal ways of life etc…What progress are we making on this and how big a role can health promoters play?
TH: There are many parts to this question – or questions. For me, the central question for cities – and for governments at all levels – is ‘what business are we in?’. If you ask that of national governments the answer you get – if not in their words, at least in their deeds – is ‘grow the economy/the GDP’. (New Zealand has recently proved itself the exception, with a budget focused on wellbeing.)But this focus on economic growth and the GDP has been a tragic mistake, especially for high-income countries. First, that growth has resulted in the massive and rapid extraction and depletion of the Earth’s natural resources, in particular forests, fisheries, wildlife, freshwater, topsoils, minerals and fossil fuels. That extraction has been accompanied by massive and rapid pollution of the air, water, soils and food chains, with perhaps the most worrying – at least right now – being CO2 pollution from fossil fuel combustion, leading to the global climate emergency.
“… this focus on economic growth and the GDP has been a tragic mistake, especially for high-income countries.”
Also, some,
perhaps much of that growth is what Herman Daly, a leading ecological economist,
has called ‘Uneconomic growth’; economic activity that harms people, communities
or the planet – or all three. Yet all this uneconomic growth is included in the
GDP, which does not distingish between good and bad economic activity. In the
health field, the most obvious example is tobacco production and use (although
we could also include production of unhealthy food, alcohol, etc.) which kills
millions and maims millions more. Even worse, all the money spent on health
care for people with tobacco-caused or diet-caused disease also adds to GDP;
how stupid is that?
What’s more, this
economic growth does not improve our lives, even if it gets us more ‘stuff’. We
know that above about $20,000 GDP per capita, further increases in GDP do not
correlate well, if at all, with life expectancy and other health and social
outcomes. In The Spirit Level, Kate
Pickett and Richard Wilkinson show that in high-income countries, it is the
degree of equity, not the level of wealth, that correlates with these outcomes,
while the World Happiness Report and other studies show that GDP is not well
correlated with happiness.
As a result,
further aggregate growth is impossible, we already exceed the Earth’s
biocapacity and need to reduce our use of these ecosystem goods and services –
quite drastically in the high-income countries, whose ecological footprints are
well above our fair share, in the range of 3 to 5 planet’s’ worth of biocapacity.
Meanwhile, low income countries have the opposite problem; they do not have the
wealth it takes to achieve high levels of human and social development.
We need to take
less so that others in need can have more, which means a redistribtion of
power, wealth and resources both between and within countries and communities,
as called for by the WHO Commission on the Social Determinants of Health.
All of this leads
to the conclusion of Kate Raworth in her book Doughnut Economics: we need an economy that is ecologically
restorative and socially just, that is focused on meeting the social needs of
everyone while living within planetary limits. And that means a very different
set of values to live by, very different communities and societies to those we
have today. I have an abiding faith that this can only happen from the local
level up, it will not come down from the top, where elites have too much money
and power at stake. Progress on this is slow, but it is happening, as I will
discuss shortly.
But what can
health promoters do?
First, learn
about the global challenges of the Anthropocene – the new age of humanity as a
dominant global force that I discuss below – and what new approaches and
solutions we need. Recognise that this calls for an eco-social approach in all
our work and all our communities.
Second, discuss
it with your colleagues, your families and friends, your clients and
communities.
Third, work to
create it, identifying allies and partners who are working to create this new
world – especially young people (think of the climate strikers),
environmentalists and the new social/green entrepreneurs who are working to
create the new economy we need.
Fourth, apply the
two fundamental principles of public health that I identified 40 years ago:
Ecological sanity and social justice (today we would say sustainability and
equity), ideas that directly relate to Kate Raworth’s call for an economy thast
is both restorative and distributive.
Finally, never
lose sight of Margaret Mead’s wise words: “Never believe a small group of
people cannot change the world; indeed it is the only thing that ever has
changed the world”.
One final point: We are not simply health promoters, more importantly we are citizens. So if we can make it part of the work we do, that is definitely a bonus. But if not, we did not surrender our citizenship when we took on our professional roles. So take it on as a family, a citizen activist, a school parent, a club member or a faith community member or whatever other social role makes sense. Find your allies and work with them. Or simply change the way you live, in big or small ways. It all matters, it all makes a difference.
Hauora:You have said one thing that is important to understand about the Anthropocene is that it’s just not about climate change and we need to look at the bigger picture? Can you please elaborate on this?
TH: The Anthropocene is a new geologic epoch, identified in geological terms as a layer of new materials (e.g. glass, plastic, concrete, radioactive elements and their decay products, elevated CO2 levels) and a change in future fossil deposits (e.g. wild animals now make up only 4% of the mass of land vertebrates, with humans (anthropos in Ancient Greek) and their domesticated species making up the rest) that will be clearly seen as anthropogenic – caused by humans – by future geologists.
In May 2019 the
Anthropocene Working Group of the International Commission on Stratigraphy voted
strongly to recommend it be recognised, with a start date in the mid-20th
century. This corresponds to what has been called ‘The Great Acceleration’; a sharp acceleration, especially since 1950, in
changes in a wide variety of natural systems (e.g. climate, nitrogen and
phosphorus flows, species extinctions etc. ), in turn driven by a similar sharp
increase in socio-economic forces (e.g. population – especially urban
population, global GDP, fertiliser-use, fish catch etc.).
So the
Anthropocene needs to be understood not only as a geological phenomenon, but
one that reflects and indeed records global ecological changes that in turn are
driven by economic and social development.
In the 2015
report I led for the Canadian Public Health Association on the ecological
determinants of health, we made two key points:
First, the world’s
natural systems are our life support systems, the most fundamental determinants
of our health; we do not last long without air, water or food. Nor can
societies exist without the materials and fuels we take from nature, the
recycling of nutrients and wastes is the protection from UV radiation that all
come from nature. Moreover, for the past 11,000 years we have benefited from a
generally benign, warm and stable climate during which agriculture and cities –
what we think of as civilisation – have developed.
Second, all of
these ecosystem goods and services are being massively and rapidly disrupted,
and all at the same time. It is not just climate change, but ocean
acidification, pollution and ecotoxicity, resource depletion and the start of a
sixth Great Extinction. Moreover, they often interact and reinforce each other,
usually in negative ways.
Faced with these widespread, rapid
and massive changes, we need widespread, rapid and massive responses; again, my
belief is that these are much more likely to come up from the bottom than down
from the top. Tobacco control is but one of many examples where it has been
persistent grassroots activism and local leadership that has ultimately led to
signifant national and international change; the same can be said of gay
marriage.
But I am also very conscious of
the fact that when it comes to creating social and cultural transformation and
large value shifts, this is not done simply by applying science, evidence and
logic. We need to reach people emotionally and spiritually as human beings,
what I call ‘heart, gut and spirit stuff’, and for that we need to work with
faith communities, the arts community and other ‘unusual suspects’.
Hauora:In Victoria British Colombia where you live you started what is called “Conversations for a one planet region”. What is the aim of this initiative and how many countries has it spread to? Can you give us some tips on how to get it started in NZ?
TH: The Conversations came out of an initiative I started at the University of Victoria (UVic) before I retired. UVic in the Anthropocene is an attempt to bring together faculty and students from all disciplines across the university to address the challenge of the Anthropocene. In my opinion, this is the greatest threat facing us in the 21st century, but it also contains many opportunities. So how will universities respond (so far, no better than governments or other instituons, which is to say hardly at all!)
We realised early
on that we needed to do work with the community, in this region of 350,00
people and 13 local municipalities, to explore what should be the response to
the Anthropocene at the local level. We suggested the concept of a One Planet
Region as a way to address this locally (an idea we later learned had been
pioneered by Bioregional in the UK, a group we now work with). We defined a One Planet
Region as one that achieves
social and ecological sustainability, with
a high quality of life and a long life in good health for all its citizens,
while reducing its ecological footprint to be equivalent to one planet’s worth
of biocapacity.
We started the Conversations in early 2017 because we were concerned that people were not even talking about this issue; climate change, yes, but not the entire complex of global ecological changes that constitute the Anthropocene, and not about how we need to respond locally. So our mission isto establish and maintain community-wide conversations on One Planet living and a One Planet Region. We adopted as our slogan “Learn – Discuss – Imagine – Design – Create”, because if we are not learning about the situation we face and discussing it, we can’t begin to fully imagine both the future we face and the alternative future we want. And if we can’t imagine it, we can’t design and create it.
We
meet monthly in the Community Room at the Central Branch of the Public Library.
Our meetings are free and open to anyone, and we have no budget; use only local
volunteer speakers – since we know we have the knowledge and expertise here to
address these issues successfully. We cover a wide range of issues, from energy
and food to housing and transportation, economics, the role of the arts and of
faith communities – and much else.
But
while we have been doing this for three years, have a group of 30 – 70 people
each month, get good discussions and have a good reputation and some influence
and local political impact, we recognise that this is of limited utility. Our
participants are generally the ‘usual suspects’ – older, whiter, wealthier, better
educated, and living near the downtown. An important and potentially
influential group, to be sure, often with good connections to important people
and groups, but far from enough.
So
we have plans for broadening, deepening and connecting the Conversation. We
want to expand the Conversation to engage a much wider range of participants,
both geographically and demographically; deepen the Conversation by creating
safe spaces where people can explore the mental, social and spiritual
dimensions of the change we seek; and connect the Conversation to others doing
similar work across the region. To that end, we have recently incorporated as a
non-profit society so we can pursue funding, because while having no budegt is
in many ways commendable, it is also limiting. Some of the new activities we
want to pursue are:
Video, webcast
and livestream the current Conversations programme, enabling people in other
sites in the Greater Victoria Region to join in from where they live.
Establish a Kitchen Table Conversations programme
to facilitate and support families, neighbors, workmates and others to have
smaller, more personal Conversations.
Undertake One Planet Neighborhood Co-design Charettes
that bring community members and design professionals together to imagine and
design such a place.
Establish People for a One Planet Region, a group
of citizens in every municipality who are able to speak at Council meetings to
support the One Planet approach and to oppose proposals that take us in the
wrong direction.
[Perhaps] create One Planet Region Awards to recognise
people, organisations, businesses and governments that are working to create a One Planet region.
We also have
several spin-off projects that we are pursuing, in collaboration with others:
We are working with the Community Social Planning Council to look at the social justice and employment implications of a One Planet Region.
We are starting a discussion about an initiative around art, nature and place as a way of engaging people through the arts in considering the global ecological challenges, and possible actions.
An ecological economics group is forming, linked to the Green New Deal, looking at what an ecological economy would look like locally.
We are planning sessions based on Joanna Macy’s “The work that re-connects”, to help people come to terms with the climate anxiety and eco-grief they may be experiencing.
I hope this has
given you some ideas, but remember, it takes very little to make things happen.
You don’t need a budget, an organisation or staff, just some willing and
like-minded people, a bit of energy and good will. Remember Margaret Mead’s
wise words and just do it!
Hauora: You were in NZ for the 23rd IUHPE World Health Promotion Conference, co-hosted by HPF in Rotorua last April? What were some of the highlights of the conference for you?
TH: The first highlight was the fact that the greetings from the Maori Elders were all in Maori! Oh sorry, you don’t understand Maori? Too bad, this is Aotearoa and here we speak Maori – it was assertive and yet was done in a respectful way. I loved the self-confidence of that, and indeed the strong participation of Maori people throughout was an inspiration.
Second, of
course, the fact that ecological change and the need for an ecological awaresss
was finally getting the attention it deserves in health promotion.
Third, shmoozing!
Not only do I love seeing my friends from all over the world (and yes, I am aware
of the irony, if not ineed the incompatability, of the carbon footprint
involved), but those personal contacts facilitate the sharing of ideas, work
and commitments for years to come. There is a lot you can do apart, via Skype
and webinars and teleconferences, but there is an energy that comes from being
together in the same place, sharing food and drink and relaxation, that boosts
your energy and enthusiasm when you return home.
Fourth, of
course, New Zealand itself, a beautiful country I have now visited twice, with
friendly and welcoming people, certain challenges notwithstanding. Certainly
the New Zealand government is proving inspirational, both in its response to
the Christchurch mosque shootings and in its commitment to a wellbeing budget.
Hauora:You retired in July 2018 from your position as a Professor and Senior Scholar at the School of Public Health and Social Policy at the University of Victoria. What have you been doing since then and what are your plans for the future?
Well, I only retired from a job, not
from life or work – or dancing for that matter! I have been busy organising the
Conversations – as noted above, writing, speaking at all levels from global
events such as IUHPE to local community groups about these ideas and generally
being an activist. I am very excited by the growing activism of young people
and looking for ways I can help and support them – without taking over or
getting in the way!
In particular, I hope to write
several books for the general public about the work of public health. I have
been writing a weekly column on population and public health issues for five
years (see https://trevorhancock.org/) and I have come to recognise that we do a lousy job of
communicating what we do, and the importance of our work – and then we wonder
why nobody knows about us or loves us or funds us! So, I have committed to do
no more writing for academic or professional journls or books, other than the
commitments I already have.
And of course I am dancing. I have
been a Morris dancer for 40 years – traditional English folk dance, think
non-violent rugby involving dancing, singing and drinking! It brings me great
pleasure, even joy, and is an antidote to the serious nature of so much of my
life – although that too is fun, it has to be if you are to keep doing it.
I dance twice a week, walk our dog
in the woods, parks and coastlands every day with Franny, my wife and companion
for almost 50 years (her retirement project is a Masters in Medieval Studies,
we are well matched) and generally stay active. In one of the two Morris sides
I dance with I am, at 71, the second youngest dancer; our oldest dancer is
almost 95, and comes to practice every week and then to the pub. I intend to be
Fred when I grow up!
With HPF’s online courses you can study at your own pace and time and
from anywhere in the world.
If you are already working in the field of health promotion or public
health, these courses will further enhance your knowledge and skills. The
courses are also designed to enable those who are new to health promotion and
public health to learn new knowledge and skills.
“We are
responding to the need of the health promoters and other health and social
service workers, by taking the knowledge to them through technology,” says HPF
Executive Director Sione Tu’itahi.
“Learners
can always contact our health promotion team for questions and discussion, if
they need to.”
The courses
are on Maori health promotion, Pasifika health promotion, and mainstream health
promotion. All are at level one but future courses in the three categories will
be designed for level two and level three.
HPF’s Executive Director Sione Tu’itahi talks to Hauora about the outcomes, goals and lasting impact of the global Health Promotion Forum conference in Rotorua from April 7-11, 2019
Last April the Health Promotion Forum co-hosted the 23rd International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion in Rotorua. With a timely theme of ‘Hauora: Promoting Planetary Health and Sustainable Development for All’, more than a 1000 delegates and organisations from 73 countries participated.
H: There has been very positive feedback about the conference. Are you happy with the results, and did you achieve the outcomes you set?
Sione Tu’itahui speaking at IUHPE2019
ST: Yes, I am happy to say we achieved our three major outcomes, and more. The knowledge that was exchanged was very relevant, crucial and very timely for the needs of health promotion, and the world today. Health promoters and other health workers, as well as those who work in sustainable development enhanced existing networks and formed new ones. And the legacy initiatives of two legacy statements, and initiating the process for a healthy city, were also achieved.
H: Let’s talk more about those outcomes in details. What is some of the relevant knowledge shared?
ST: Among other important features, at least three major areas emerged and moved closer together, offering comprehensive knowledge and practical tools for the delegates to take home and implement on addressing the health of the planet and its peoples. These were the social determinants of health with an equity and social justice approach, planetary health and ecological determinants with an eco-social approach and an inter-generational understanding and goal for health and wellbeing, and indigenous knowledge and health promotion with a clear philosophy and practice that humans are inseparable from the ecology. On another level, the spiritual dimension of wellbeing, and spiritual health promotion also came to the fore during the conference. It was great to see these major areas of health knowledge coming together, offering a profound understanding on planetary health, and relevant, practical tools.
What was
significant was that the presenters in all these areas of knowledge were
complementary in their addresses, presenting a balanced, and comprehensive big
picture of where the health of the planet and its peoples are at, and the
comprehensive set of strategies to address those challenges at all levels.
H: What else was significant about the knowledge shared at the conference?
ST: Two other significant contents of the conference were the leading contributions of Maori research, policy, practice and leadership to Indigenous health promotion, and how pronounced climate change and ecological challenges are in our Pacific region. In fact, we decided to host the conference here in order for our New Zealand knowledge and experience to be shared with the world, and for the world to understand our greater Pacific region and its challenges, as well as our collective effort to address those challenges. For example, 20 years after introducing Te Pae Mahutonga as a health promotion model for New Zealand, Sir Mason Durie presented a new model, Matariki, at the conference for Indigenous peoples. Tuhoe Nation Leader Tamati Kruger shared the challenging but progressive and resilient journey of his tribe from the ravages of colonisation to mana motu hake/autonomy today. Delegates were in awe at such profound knowledge and courageous, moral leadership.
H: You mentioned some legacy initiatives. What are they?
ST: There were three legacy initiatives: two legacy statements, and Rotorua to become a healthy city under the WHO (World Health Organization) scheme of the same name. Led by two editorial teams, the conference delegates drafted and approved by acclamation the two statements on the final day. The first statement is the Rotorua Statement which summarises the important themes and knowledge that emerged from the conference, calling for action on those crucial areas for the health and wellbeing of the planet and its peoples. The second statement is the Waiora Indigenous Peoples Statement. It outlines the loss of Indigenous peoples under colonisation around the world, and calls for privileging indigenous knowledge as a right, and articulates how Indigenous health promotion can contribute to addressing the challenges on planetary health. On the healthy initiative, Rotorua’s mayor Steve Chadwick agreed to explore with us how Rotorua can become a ‘healthy city’ under the WHO’s scheme of the same name. Rotorua can be the model for other cities. All social, economic, cultural and ecological challenges, health included, are related, and cities are a manageable setting where these challenges can be addressed in a well-coordinated and effective way. The vision is for our cities to become healthy, liveable and sustainable.
H: So, it was not just a talkfest?
ST: No, certainly not. You can watch the videos of those keynote speakers on the IUHPE and HPF YouTube channels. Maori equity and social justice were articulated by the likes of Sir Michael Marmot and Fran Baum, indigenous health promotion was clearly embedded by the addresses by Sir Mason Durie, Tamati Kruger of Tuhoe Nation, Dame Anne Salmond, and Professor Anthony Capon. Professor Capon and Professor Trevor Hancock also highlighted planetary health, ecological determinants and the eco-social approach.
H: What lessons have you learned as a result of hosting the conference?
ST: Quite a few. One is that our nation’s founding document, Te Tiriti o Waitangi, was very effective as a framework for negotiating the terms of the conference and for co-hosting it with the International Union for Health Promotion and Education. Using Te Tiriti enables us to work as equal partners, sharing our knowledge and experience, and achieving outcomes agreed on, such as the theme of the conference where we highlight Indigenous knowledge, having Te Reo Maori as one of the four languages of the conference.
Twenty years after introducing “Te Pae Mahutonga” as a framework for health promotion in New Zealand at an HPF conference in 1999, Sir Mason Durie introduced another star-based framework to guide health promotion for Maori and other Indigenous peoples.
Sir Mason Durie
Sir Mason introduced “Matariki” at the 23rd World Conference on Health Promotion in Rotorua, last April.
“Matariki is the Māori name for the cluster of stars also
known as the Pleiades (or Subaru in Japan). It rises in mid-winter and for many
Māori, it heralds the start of a new year, a time for remembering the dead,
celebrating new life and planting new crops,” he said. “The focus on stars
reminds us that we are part of an unbounded universe.”
Based on the eight main stars in the cluster, he named eight
Matariki dimensions of health: Mana Tangata -Human dignity, Whānau Ora –
Families, Hapori – Communities, Ranginui – The sky, Papatuanuku-
The land, Nga Wai – Rivers and oceans, Ngahere – The forests, and Te Ao
Tuturu – Rhythms of nature.
“Matariki provides a health promotion agenda for Māori and
Indigenous peoples that endorse Indigenous rights, keep our skies clean and
fresh, protect our lands, preserve our native forests, enable whānau and
families to flourish, support community initiatives, safeguard our rivers and
ocean, and restore nature’s balance, ” Sir Mason asserts.
He also pointing out that when combined, the six stars of Te
Pae Mahutonga and the eight stars of Matariki can continue to guide health
promotion for Indigenous peoples into the future.
Details of Sir Mason’s presentation can be found on the IUHPE2019 website.
Dr Viliami Puloka, HPF’s Pacific Strategist looks back at the amazing Pacific experience at IUHPE2019 in Rotorua.
Fakafeta’I, malo lava, vinaka vakalevu are the words that come to mind – hearts full of joy and gratitude to be part of this world-wide event right here at home in Aotearoa New Zealand.
All the Pacific
participants especially those from the islands were so thrilled and
appreciative of the fact that they did not have to paddle far to get here. It
was only a three-hour flight from Tonga, Fiji, Samoa, Vanuatu, Kiribati,
Solomon Islands and New Caledonia. It confirmed the fact that Aotearoa is
squarely part of the Pacific islands.
Arriving in Rotorua
was heart-warming to many who thought New Zealand was the land of the palangi. But all were excited to meet and share the
experience of their Maori cousins. Many commented on the spiritual experience
they had during the Powhiri, which reminded them of their own version at home.
Some were moved to tears
when exchanges the “breath of life” with Maori delegates while walking between sessions
or at various meeting venues.
We really felt at home
and immediately identified with our Maori cousins and their environment. When
Tamati Kurger spoke, we were already in awe, excited, joyful, appreciative and
motivated for action. It was a big deal for us to come in to a very enabling,
encouraging and empowering environment. That really prepared our hearts and
minds to focus on the contents of the conference.
Pacific Community (SPC)
commitment and partnership through sponsorship of participants to attend, give
presentations led by the Director General Colin Tukuitoga as one of the Plenary
speakers shows great leadership and very much appreciated.
A highlight for Pacific Youth was the SPC Pacific Youth WAKE UP art project unfolds itself through out the days of the conference. It was a call on young people to wake up to the facts that “today is the tomorrow you dreamt about yesterday”. What you do today as far as Noncommunicable diseases are concerned will return to haunt you at your later years.
Mr Simpson is one of the principal architects of the Waiora Indigenous Statement
HPF’s Deputy Executive Director Trevor Simpson, one of the principal architects of the Waiora Indigenous Statement reflects on its significance
The Waiora Indigenous Statement adopted at this year’s IUHPE World Conference in Rotorua provided a watershed moment for indigenous health promotion at the global level. It is a call to action which leverages on the assertion that indigenous people’s perspectives, worldviews and human experience informs a “new” way to think about health promotion and by virtue of this, a different perspective on planetary health and human wellbeing.
Of course, health promotion in its current format, largely based on western world views associates human health with the health of the planet. The Ottawa Charter identifies eight prerequisites, the fundamental conditions for health amongst which a stable eco-system and sustainable resources are but two. As broad fields of study these two areas remain vitally important, but it seems odd that planetary health and wellbeing is not specifically addressed within the existing health promotion framework. From observation it is more implied than defined. Further, it is difficult to discern where health promotion makes a clear and concerted effort to think past the Anthropocene, the current focus on an individual, human centred approach to health.
The Waiora Indigenous Statement provides some interesting
componentry to help us understand at a fundamental level where indigenous
thinking positions itself in the planetary and human wellbeing discussion. As the
document rightfully points out, indigenous people and worldviews are diverse. However,
when we overlay these aspects of diversity, we can then identify the
commonalities which draw indigenous peoples together.
This provides a powerful construct, particularly when we
centre on the core features; the interactive relationship between the spiritual
and material realms, intergenerational and collective alignments and that the
Mother Earth is a living being. It posits that Planet Earth and human beings
have a special relationship to each other, one founded on interconnectedness
and interdependence. We are therefore in the indigenous perspective, part of
nature and not above it.
In a pre-conference discussion with Tamati Kruger, one of
the highly acclaimed plenary speakers at this year’s event, he touched on a key
principle of the Tuhoe Iwi’s Waitangi claim settlement outcome, principally the
section in the Te Urewera Act 2014 in which the Crown (Government of Aotearoa
New Zealand) and the Tuhoe people agreed that the Urewera (previously the
Urewera National Park) was a “living person”. He suggests that this aspect was
an imperative in the settlement negotiations. Without it, it would have been
very difficult to reach an agreement.
As a significant precedent in law it is also nevertheless an
assertion of world views.
It comes with a necessary proviso of course, duties on both
parties: a living person should be cared for and nurtured. Care and nurture
have in turn strong elements of responsibility and obligation. Indigenous Tuhoe
people, therefore, have no choice but to provide for and nurture their piece of
nature and in return have their place and wellbeing secured. As Tamati said in
his plenary speech in Rotorua, “the Tuhoe people do not own the Urewera. The
Urewera owns itself”.
This indigenous viewpoint leaves much to ponder. It
questions our current thinking. It touches on the need for a paradigm shift in
the way human beings see themselves in their relationship with this living
planet. And it is now urgent.
As a living document we encourage all to endorse, use and
critically analyse the Waiora Indigenous Statement. It is an offering for
health promoters, policy makers and leaders. An intergenerational gift that
seeks to define what health promotion means from an indigenous worldview. It is
also a very useful resource to inform the development of health promotion
itself- to be part of the actual framework rather than sitting outside it. To
be part of a new design for people and planet.
The Waiora Indigenous Statement is a statement for all. It
asks that we make space for and privilege indigenous peoples voices and
indigenous knowledge in promoting planetary health and wellbeing. It offers a
new way of thinking, resetting the course for health promotion and sustainable
development. It suggests that if we listen carefully, we just might hear
something beautiful and profound. Something to learn, something to embrace. Something
for you, me and the generations to come.
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.
3 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. This includes: 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.
References:
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 2015;386(10007):1973-2028.
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 2004;15:181-85.
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.
In April next year Aotearoa New Zealand will welcome the global health promotion workforce to Rotorua City for what is arguably the most important event on the health promotion calendar. The 23rd IUHPE (International Union for Health Promotion and Education) World Conference 2019 on health promotion will bring together experts, practitioners and interest groups who will converge to discuss health promotion across a range of political, economic and social contexts.
At the earliest stages the notion of the importance of indigenous health promotion and the opportunity to leverage indigenous aspirations for wellbeing were at the fore. Elevating this discussion to the highest level became a driver – not only for the inclusion of indigenous elements in the conference programme but rather to underpin and permeate every aspect of the meeting.
There is an unprecedented opportunity for indigenous health promotion leaders to use this platform to share our ideas, strengthen our resolve and promote wellbeing from a specific indigenous perspective.
Milestones for Indigeneity – a conference with a difference
From the initial discussions around the feasibility of bringing the conference to Aotearoa New Zealand through to the eventual bid in Curitiba, Brazil, the team at the Health Promotion Forum (HPF) were deliberate in ensuring the place of indigeneity. Indeed, the bid made to the IUHPE Global Executive Board in May 2016, included an indigenous Maori approach that ensured cultural imperatives were attended to from the outset; thoughtfully laying a platform upon which the entire event will be projected. In doing so this conference will provide the basis for unity in diversity for global health promotion, aligning western, eastern and indigenous perspectives across the theme of sustainable development and planetary wellbeing.
There is an unprecedented opportunity for indigenous health promotion leaders to use this platform to share our ideas, strengthen our resolve and promote wellbeing from a specific indigenous perspective.
The overarching theme of the conference for the first time includes the indigenous term “Waiora” loosely meaning “life-giving water”. Similar to “Vaiola” in Pacific vernacular the word relates to the sacred nature of water as a life-giving element. Appropriately, delegates will be situated in the south of the Pacific Ocean, the largest body of water on Earth, the historical home to many indigenous people, all of whom maintain a deep appreciation and affection for the ocean and the islands upon which they depend.
Te Reo Maori a world-first
For the first time Te Reo Maori as an indigenous language will be one of the four official languages of the conference. It will not only be used and encouraged throughout but also built into the official programme. Delegates will be able to experience this from the opening powhiri (Maori welcome ceremony), the inaugural speech in the Maori language by a plenary speaker, Tamati Kruger through to the poroporoaki (closing ceremony) where in each case the language will take precedence. Broadly, indigenous Maori themes, language, storytelling, arts and performance will provide a wonderful array of cultural features to enhance what is shaping up to be a wonderful scientific programme.
Significantly, along with Tamati Kruger four of the other 11 plenary speakers are from indigenous backgrounds. Stanley Vollant, Sir Mason Durie, Tony Capon and Colin Tukuitonga will bolster what is already a strong format for indigeneity at the plenary level. In terms of leadership this group provides a global perspective that will influence indigenous health promotion practice well into the future.
The programme also includes an Indigenous sub-plenary and opportunities to observe and participate in oral presentations, workshops and poster walks where indigenous health promoters and those working in indigenous communities can share their ideas.
Committed to the cause
Some wonderful work is also going on in the background. For the first time a team of guest editors will pull together an Indigenous Supplement to the IUHPE Global Health Promotion Journal to be released in time for the conference. The propensity for a supplement such as this to reach across the globe is not underestimated and the leadership of the IUHPE team working on the journal, the editors and guest editors to engage in such a project is a fine example of commitment to an important cause.
Additionally, a small team is working on drafting a Rotorua Indigenous Statement (yet untitled) to be considered for ratification in Rotorua. Not underestimating the magnitude of this project, the team is looking to include a wide range of perspectives, draw on expert knowledge and finally put out a call for support. At this stage the proposal is to release draft one version early in the New Year for members to consider, followed by a second draft in early March. The third and final draft will be presented at the conference itself and with the support of the delegates, formally endorsed.
In mentioning Rotorua, it should be noted that Te Arawa, the tribal hosts and supporters of the conference are renowned not only for their hospitality but also for their cultural strengths in history, language and arts. These are significant factors which have contributed to tribal, social and economic development not only in the city but across the lake’s region. It is impossible to escape indigeneity in this part of the world. It is an indelible asset that speaks to a world of possibilities, not only for Aotearoa New Zealand but for everyone and every place.
Trevor Simpson is HPF’s Deputy Executive Director / Senior Health Promotion Strategist (with Portfolio in Māori development).
More speakers have been confirmed for the world conference on health promotion in Rotorua next year adding to the diverse line-up.
They include respected indigenous leaders from around the world and New Zealand who will be sharing their knowledge and expertise at the 23rd International Union of Health Promotion and Education World Conference from April 7 to 11.
Registrations for the conference which is co-hosted by the Health Promotion Forum of New Zealand are now open and the call for abstracts has gone out.
We take a look at: Dr Stanley Vollant, the first indigenous surgeon in Quebec, Canada; Sir Mason Durie, one of New Zealand’s most respected academics, knighted in 2010 for services to public and Māori health and Tamati Kruger, Māori advocate and social and political analyst.
Dr Vollant who grew up in the Côte-Nord region of Quebec was exposed at a young age to the traditional teachings of his grandfather, which were marked by the importance of community values.
He received his degree in medicine from the Université de Montréal in 1989 and his specialisation in general surgery in 1994.
During the first annual “Stanley Vollant Challenge,” a six-kilometre walk to promote health and wellness he told CBC News that he wanted to inspire Indigenous youth across Quebec to follow their dreams, while also leading healthy lifestyles.
He said it was important to bring Indigenous and non-Indigenous walkers together in the spirit of reconciliation.
“My vision is to bring people to celebrate wellness and also to celebrate [being] all together, Indigenous and non-Indigenous people.”
Sir Mason who was born in 1938, of Rangitane, Ngāti Kauwhata and Ngāti Raukawa descent, grew up in Feilding, where his hard-working parents showed him the importance of a strong work ethic.
Between 1986-1988 he served on the New Zealand Royal Commission on Social Policy and in 1988 accepted a position at Massey University as Professor and Head of Te Pūtahi a Toi, School of Māori Studies. Up until retirement in June 2012 he was Deputy Vice-Chancellor and Professor of Māori Research and Development.
He has been at the forefront of a transformational approach to Māori health and has played major roles in building the Māori health workforce for more than 40 years.
He has also championed higher education for Māori and has published widely on Māori health, Māori policy, the Treaty of Waitangi, Māori education and whānau development.
In his book Nga Tini Whetu NAVIGATING MAORI FUTURES he says in the introduction that, “If there is a single message to this book, it is that Maori have the knowledge, skills and foresight to create a future where younger generations yet to come can prosper in the world, and at the same time live as Maori”.
The model he created for healthcare, Te Whare Tapa Wha, successfully challenged the notion that health is the same for people of all cultures.
He has also made significant strides with his work in mental health, and most recently, the prevention of suicide in Maori and Pasifika communities.
During 2009 he chaired the Ministerial Taskforce on Whānau Centred Initiatives and from 2011 was chair of the Whānau Ora Governance Group. In 2018 he was also a panel member for the Inquiry into Mental Health and Addictions.
Upon being awarded the Blake Medal at last year’s Sir Peter Blake Leadership Awards Sir Mason told the NZ Herald: “The most important thing has been the difference to health. That’s where my career started and it’s continued to be what I spent most of my time doing.
“It’s really how to make people more aware that health is not just a question for doctors and nurses, but a question people have themselves.”
Mr Kruger is a Māori advocate and social and political analyst who has dedicated his career to the development of his iwi. From the Ngāti Koura, Ngāti Rongo and Te Urewera hapū of Tūhoe, Mr Kruger was instrumental in securing the largest Treaty of Waitangi settlement to date ($450 million) for the Central North Island Iwi Collective.
He is now a director of CNI Holdings, representing Tūhoe.
More recently, Mr Kruger was chief negotiator of the Tūhoe-Te Urewera Treaty of Waitangi Settlement. The landmark settlement included a Crown apology for historical grievances, a social service management plan for the Tūhoe rohe and a financial and commercial redress package totalling $170 million.
The settlement also included legislative changes to transfer Te Urewera National Park to its own separate legal entity, looked after by the Te Urewera Board, of which Mr Kruger is chair.
Mr Kruger’s contribution is not limited to his tribe. He chaired the Second Ministerial Māori Taskforce on Whānau Violence and developed the Mauri Ora Framework and was awarded the Kahukura award in 2013 in recognition of this work.
In an interview with Asia Pacific Report he said an important part of leadership involved navigating the difference between Māori and Pākehā politics.
“Part of the blessing of Pākehā politics is you have this apparatus called law, where you can bend people to one’s will. But in Tūhoe politics you have to depend on your reputation and integrity for people to find that whatever you have to say has some wisdom and truth in it.”
The official languages of the conference are English, Spanish, French and in a world-first for Māori and other indigenous cultures Te Reo Māori.
Abstracts must be in by August 31 and submissions can be made in the official languages.
For the first time, the World Conference on Health Promotion will be held in New Zealand from April 7-11, 2019. Rotorua is the venue. The conference provides rare opportunities for New Zealand health promoters, other health professionals, policy makers and others whose work impacts directly on our health and wellbeing, to share knowledge with colleagues from around the world, and to co-construct health promoting pathways into the future.
Hauora catches up with HPF’s Executive Director, Sione Tu’itahi, on the significance of the conference for New Zealand and the world.
What made you decide to invite the conference to NZ?
There were three major reasons. First, New Zealand is part of the global community. And we have common, global challenges that determine our health and wellbeing, such as the environment, economy, education, governance and leadership, which directly impact at the national and local levels.
To address these challenges, we must engage on all levels, especially at the global level. No man is an island anymore. The world is but one country.
Second, and as part of the significant damage caused mostly by us humans to our natural and built environment, climate change is the most urgent issue to be addressed today. Our Pacific region, is where climate change is most evident – eroding and sinking islands, sea level-rise because of global warming, tsunamis, cyclones, and people having to migrate from their homelands because of these disasters. Clearly, the environment is one of the major determinants of our health and wellbeing. So our region must engage in finding solutions to these issues through health promotion and other professional fields. And it is timely and propitious to have that conversation in our region so that health promoters, other health workers, policy makers and other professionals whose work impacts on our health and wellbeing, come together to share experience and explore solutions. That is why we have the conference over-arching theme as “Waiora: Promoting Planetary Health and Sustainable Development for All,” and the 17 UN Sustainable Development Goals (SDGs) as the framework.
Third, New Zealand is a world leader in Indigenous knowledge and health promotion. Indigenous knowledge systems are now being acknowledged as contributors of solutions to world problems. We can share our experience with the rest of the world, and we can learn from their experience too. For example, Indigenous cultures see humanity as part of and inseparable from the environment. Therefore, we humans must live in harmony with nature, and within its limits. The dominant cultural paradigms of the last two centuries regard humans as not only separate from but also owners of the environment, which is seen as a limitless resource to exploit for their insatiable wants. Today we all experience the folly of such perspectives and practices. I think we are beginning to learn some lessons from that erroneous worldview and its underlying values and principles.
Overall, we decided to host because we think that New Zealand health promotion can contribute to addressing inequities and the wellbeing of the world. But also, we have a lot to learn from colleagues around the world, and to strengthen our relationship with IUHPE which leads the ongoing advancement of health promotion, including the development of the global accreditation framework for health promoters. HPF is party to the development of that global accreditation framework which will enhance the efficacy of the health promotion profession for the competency of health promoters and the wellbeing of peoples and communities they serve around the world. Among other benefits, it will also give international recognition to national health promotion qualifications, with positive implications for work in other countries.
What other benefits can New Zealand gain from the conference?
There are a few major benefits, not just for New Zealand but for the rest of the world. Evidence-based knowledge that works will be shared and everyone will learn at the conference. Also, national, regional, and international networks and collaborative efforts will be further enhanced and strengthened among professionals across health and other sectors. We have no choice but to work together, or we suffer and perish together, whether we like it or not.
A third benefit is that two statements from the conference will provide future pathways for policy makers, health professionals and communities on how to address our common, global challenges that impact on our common home, planet earth. One of these two future-focus statements will be on Indigenous health promotion.
A fourth benefit is that Te Reo Maori is elevated to one of the four official languages of the conference. This is a world-first for IUHPE and for New Zealand. It might be a small step, but to have an indigenous language as one of the official languages of a world conference is a giant step for indigenous human rights. It is also a most empowering message to indigenous peoples and ethnic minorities in terms of championing their rights, their wellbeing, and preserving their knowledge systems through preserving their languages. Actually, having Te Reo as an official language is part of our using of Te Tiriti o Waitangi as the framework for organising the conference. It is another way of sharing our New Zealand experience with the rest of the world.
A fifth benefit for New Zealand is the aspirational goals for Rotorua to be a ‘healthy city’ under the World Health Organization (WHO) system. And, of course the 2000 participants will bring economic gains for the country, and not just the tourism sector. It is our experience that participants travel to gain knowledge and enhance their professional networks, but they also take their families and loved ones to visit the host country. It’s a great way of promoting our beautiful country to the world. So you see, the conference will bring many benefits to all parties. It is a win-win initiative.
But what challenges do you and your team face in organising this world event in NZ?
There are the usual logistical challenges that come with organising events, such as finance, appropriate venues, communication, transport, accommodation and food. All this while trying to create a high-quality scientific and social programmes that will attract the top of your profession as keynote speakers, as well as other participants who will bring their latest research findings and professional experience to share and to learn from one another.
What makes it more challenging is that you have to build an international organisational structure at three levels – global, national and local – to plan and manage across different time zones with colleagues around the world. Put on top of that the fact that you have to have keynote speakers from the four official languages of the conference – English, French, Spanish, and Te Reo Maori, and consider gender balance, linguistic & ethnic diversity, and age. But thanks to technology, our 100 HPF member organisations, our professional conference company (The Conference Company), and the help of Tourism New Zealand, as well as our co-organiser, IUHPE, we are managing well, with the usual hiccups, of course. Challenges are good and timely incentives to help ensure you do your utmost best and become more innovative and prudent at the same time.
(Sione pictured catching up with Pacific delegates from Tuvalu and Kiribati at the WHO congress on health promotion, Shanghai, 2016)
From an educational perspective, this is excellent professional development training for our team and others in the country and overseas who have volunteered to help organise the conference. It gives you a real sense of how we live and work as a global village – i.e. we work together across national, geographic and cultural borders to address challenges that confront us all as one human family. As for the conference programme, we have a line-up of public health and health promotion leaders, such as Sir Michael Marmot, Professors Fran Baum, Anthony Capon, and Sir Mason Durie, as keynote speakers. And we are shaping up a highly educational and informative scientific programme that our expected 2000 participants will enjoy and learn a lot from.
We would love to see all our health promotion and public health colleagues around the world, especially those here in the country, join us. Because public health and health promotion is so relevant to other sectors, such as education, local government, social work, community development, and sustainable development, we would like to think that this is also a conference for colleagues working in those sectors. Health and wellbeing in its broadest meaning and dimensions, such as physical wellbeing, mental wellbeing, economic wellbeing, social wellbeing, cultural wellbeing, and environmental wellbeing, are at the core of the work of most sectors.
You started planning the conference in 2016, but you have been involved with IUHPE for more than 10 years now. For example, you have been a member of the IUHPE Global Executive Board, and Vice President of IUHPE for the South West-Pacific region for some six years. What prompted you to be involved with IUHPE?
The main reason is we are now a global village. Our global challenges are not only inter-connected but they impact on all levels – from the local to the global, and vice-versa. IUHPE provides that global platform and network for health promotion and HPF, hence my involvement. Our focus is still New Zealand, but we include other levels in our work here at HPF. Take smoking and climate change as two health challenges. They impact on all levels. New Zealand’s involvement at the global level helps to find more lasting solutions at its national level for both issues.
The other reason is that good governance and effective leadership is needed if we are to be effective in whatever field we work. HPF saw the opportunity to lead and we took it up on behalf of the South-West Pacific region, which covers NZ, Australia, all other Pacific island nations, and some countries in South East Asia.
My first IUHPE world conference on health promotion was in 2007 in Vancouver, Canada. I attended along with former HPF Executive Director, Dr Alison Blaiklock, and another former HPF co-worker, Joanne Aoake. I saw then the opportunity to build the relationship with IUHPE, and bring my experience and learning to our team and the health promotion workforce. Hosting the conference is the latest development of that professionalrelationship with IUHPE. But there are other developments such as having our Deputy Executive Director, Trevor Simpson, as the Chair of the International Network for Indigenous Health Promotion Professionals (INIHPP) of IUHPE. HPF is also leading the work for New Zealand health promotion to become part of the global accreditation framework for health promotion, recently established by IUHPE. IUHPE has a standing work relationship with WHO, which is a partner of the conference, along with the Secretariat of the Pacific Community (SPC), being led by Dr Colin Tukuitonga, and the Australian Health Promotion Association.
(Taking time out for a photo with Professor Ilona Kickbusch, one of the architects of the Ottawa Charter, 1986.)
You have years of working as a journalist in Tonga and the Pacific, then retrained as a teacher and taught at some of the tertiary educational institutions here in New Zealand. Why did you later choose to work in health? And what has the experience been like for you?
Health and education are two important and related determinants of the wellbeing and prosperity of Pacific peoples, in fact, all people. Good education means not only you are enlightened, but you also have a decent income which enables you to afford a healthy life, and be in control of your future. I learned these things early on through my family experience, especially from my grandparents and parents. They were humble folk from humble beginnings in Tonga, but education, being prudent, hard work and serving others were central values and goals.
My mass communication, teaching, and strategic capacity-building experience were very handy when I was invited to set up a Pacific team at the Auckland Regional Public Health Service some 20 years ago. At the time I was starting to build the Pacific capacity of Massey University. I saw the invitation as an opportunity to do the same strategic work for Pacific peoples in the health sector as well. I was later seconded to build the Pacific capacity of HPF, which led to where I am today. For more than 10 years, I shared my time between Massey University and HPF, until I decided recently to focus on my health work, for now.
And your strategic outcomes for the conference?
There are at least three strategic outcomes. And the conference is a platform to enhance those long-term outcomes: Strengthen our co-leadership in health promotion at the global level, such as our work with IUHPE, which not only elevates the prestige of HPF, but more importantly, helps to build the capability and capacity of the health promotion workforce and sector in NZ and the world, for the wellbeing of society. Enhance our leading contribution to the world in Indigenous health promotion; Ensure the sustainable strength and longevity of HPF and the health promotion sector in New Zealand.
Having Te Reo Maori as one of the four official languages of the World Conference on Health Promotion in New Zealand next year is a world-first for Maori and other Indigenous cultures.
The 23rd IUHPE World Conference on Health Promotion: WAIORA: Promoting Planetary Health and Sustainable Development for All will be held in Rotorua from April 7-11.
Like the other dying languages of the 370 million Indigenous peoples of the world, Te Reo Maori is the repository for the Maori culture – values, knowledge, practices and history.
Sione Tu’itahi, the conference co-chair and Executive Director of the Health Promotion Forum which is the local co-host, says having Te Reo Maori as one of the four official languages of the conference is one way of acknowledging the rights of Indigenous peoples.
“Te Reo Maori is the native tongue of Maori, the Indigenous peoples of Aotearoa New Zealand. It is also one of the official languages of our country,” says Mr Tu’itahi.
“Given that we are co-hosting this world conference, it is only right that we honour Te Reo Maori this way, especially when it is rights guaranteed for Tangata Whenua under Te Tiriti o Waitangi, the founding document of modern New Zealand.”
One of the underlying themes of the conference, Indigenous knowledge on health promotion and sustainable development can offer solutions to our global challenges today, adds Mr Tu’itahi. “Indigenous knowledge enunciates that humanity and its environment are one. But we are confronted by environmental challenges, including climate changes, because of our dominant mainstream approach of separating humanity from the rest of the environment and exploiting the latter for our socio-economic gains.”
Trevor Simpson, the Deputy Executive Director/Senior Health Promotion Strategist (with Portfolio in Māori development) says “for the first time an indigenous plenary speaker will address the IUHPE World Conference in our indigenous language, Te Reo Maori”.
“This in turn will be simultaneously translated into the other three official languages of the conference – English, French and Spanish. This presents a wonderful opportunity for Aotearoa, New Zealand to take a leading role in building indigenous notions of health promotion through promoting the use of indigenous language.”
Mr Simpson points out that Maori Health Promotion is premised on the idea that world views and cultural identity are central and imperative to achieving positive Maori health outcomes.
“Te Reo Maori provides the basis for understanding how these views are formed in the first place and also illustrates how identity, language and wellbeing are intertwined.”
The conference theme sets the direction and intent of the conference that will attract health professionals, development experts, policy-makers and other professional leaders to Rotorua, the first city to be bi-lingual, and also the cultural capital of New Zealand.
A highly educational and informative scientific programme is being drafted while an equally attractive social programme is being shaped up.
Abstracts for the World Conference on Health Promotion that will be held in New Zealand next year must be in by August 31.
Submissions for the 23rd International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion to be held in Rotorua from April 7 to 11 can be made in English, Spanish, French and Te Reo Māori.
The Health Promotion Forum of New Zealand (HPF) is hosting the conference in association with the IUHPE.
The approximate date of acceptance of abstracts is October 22 and all abstracts must be submitted through this online form.
All abstract submitters, including individual contributors, are encouraged to interact and collaborate with other presenters and participants wherever possible. Participatory, collaborative and non-traditional session formats will be given priority in the selection process.
Abstracts can be submitted in eight different formats: symposium; workshop; research oral/poster presentation; innovation in policy and practice oral/poster presentation; round table discussion; alternative showing/new technology; alternative showing/art and lunch with an author.
The committee is encouraging submissions to match the sub-themes of the conference. Abstracts can be submitted under one of the four conference sub-themes:
Health equity
Ensure health equity throughout the life course, within and among countries, making each member of the global society an empowered lifelong learner.
Inclusive habitats
Make all urban and other habitats inclusive, safe, resilient and sustainable and conducive to health and wellbeing.
Climate change adaptation strategies
Design and implement effective and fair climate change adaptation strategies.
Build effective, accountable and inclusive governance
Build effective, accountable and inclusive governance at all levels that promotes, peace, justice and respect of human rights.
For further information on each of these formats please click here.
A top line-up of speakers from around the world and New Zealand has been confirmed for the world health promotion conference in Rotorua, New Zealand next year.
The theme of the 23rd IHUPE (International Union for Health Promotion and Education) Health conference to be held from April 7 to 11 is Waiora: Promoting Planetary Health and Sustainable Development for All.
The Health Promotion Forum of New Zealand (HPF) is co-hosting the conference which is expected to be attended by 2000 delegates from all over the world..
Co-chairs of the conference Sione Tui’tahi, Executive Director, Health Promotion Forum of New Zealand and Graham Robertson, President, IUHPE, say the conference will be invaluable for those in the sector to exchange knowledge and build networks in order to: share strategies, policies and practices; present results and assess progress; influence policy and bring about positive change and promote health and equity amongst all people.
The chance to hear from internationally-recognised speakers such as Professor Anthony Capon from the University of Sydney and Professor Fran Baum from Flinders University, Adelaide is also too good an opportunity to miss.
Prof Capon is the world’s first professor of planetary health and an authority on environmental health and health promotion while Prof Baum from Flinders University, Adelaide is one of Australia’s leading researchers on the social and economic determinants of health.
Prof Capon, who was born in New Zealand and moved to Brisbane with his family when he was a young boy, is a public health physician with more than 25 years of senior leadership experience, spanning academic, policy and practice roles.
“Planetary health is about safeguarding the health and wellbeing of current and future generations through good stewardship of Earth’s natural systems and by rethinking the way we feed, move, house, power, and care for the world (something missing here?), “ Professor Capon told Lancet recently.
Capon thinks that, “the central challenge of planetary health is to greatly reduce per capita resource consumption in high-income countries (HICs) to make room for further sustainable development in other countries”.
He also told the journal that: “If everyone in the world lived as the average Australian does, we would need four or five planets … we urgently need to contract per capita consumption in HICs to about 20% of what it is now so that all people can have a fair share of the Earth. And with less focus on materialism, we may indeed lead more fulfilling, and healthier, lives in tune with nature for the world.”
The former director of the global health institute at United Nations University (UNU-IIGH) has also since 2008 advised the International Council for Science on its global interdisciplinary science programme on health and wellbeing in the changing urban environment using systems approaches.
Prof Baum is Matthew Flinders Distinguished Professor of Public Health and Foundation Director of the Southgate Institute for Health, Society and Equity at Flinders University.
Prof Baum was named in the Queen’s Birthday 2016 Honours List as an Officer of the Order of Australia (AO) for “distinguished service to higher education as an academic and public health researcher, as an advocate for improved access to community health care, and to professional organisations”.
Prof Baum told ABC Online, in an article on mental illness and poverty last month, that reducing levels of mental distress, and closing health inequalities, would require a rethinking of Australia’s direction as a society.
“I would have thought in the last 30 years, when rates of anxiety and depression have gone up in Western countries, there’s some clear clues from the economic system and society we’re creating.”
This system includes a dramatic rise in precarious and casualised work, a trend Prof Baum says could exacerbate pressures of powerlessness and poverty.
According to ABC Online she is writing a book on the subject of health inequality, and one of the unavoidable conclusions of her research is that health reform is political.
Her preliminary recommendations include reducing economic inequality, making public education free and available to all and providing more affordable and secure housing, to name a few.
Prof Baum holds grants from the National Health & Medical Research Council and the Australia Research Council which are considering a wide range of aspects of health inequities and social determinants of health. These grants include an NHMRC Centre for Research Excellence on Policies for Health Equity of which she is one of the two co-directors.
Her book, The New Public Health (4th ed. published January 2016 Oxford University Press), is widely cited and used in many public health courses.
Other speakers confirmed for the conference are: Anne Bunde-Birouste, director of the UNSW Yunus Social Business for Health Hub; Dr Trevor Hancock, a public health physician and health promotion consultant from the University of Victoria, Canada; Patrick Mwesigye Sewa, founder and team leader at the Uganda Youth and Adolescents Health Forum; Colin Tukuitonga, Director General of the Pacific Community and Dr Stanley Vollant who practises at the Notre-Dame community hospital in Montreal.
The IUHPE world conferences are renowned events for bringing together leading professionals in all corners of the world to take stock of the present state of knowledge and experiences, bring forward future challenges and shape the agenda to advance developments in health promotion.
Every three years, the conference defines the “state of the art” in health promotion practice, research, and theory.
The aim of the 2019 conference is to provide an unparalleled opportunity to link and demonstrate the contribution of health promotion to the achievement of the Sustainable Development Goals and to acknowledge the way SDGs contribute to improvements in health and wellbeing.
The leaders of two highly regarded international bodies have signalled their support of the next World Health Promotion Conference. United Nations Development Programme (UNDP) Administrator the Rt Hon Helen Clark and Dr Colin Tukuitonga, Director-General of the Secretariat of the Pacific Community (SPC) have both indicated their organisations’ support of the Conference, to be held in Rotorua in April 2019.
Representatives of host organisation Health Promotion Forum met with both Ms Clark and Dr Tukuitonga during a conference in Tonga this month.
Ms Clark who, as New Zealand’s Prime Minister has spoken at Health Promotion Forum’s annual symposium, acknowledged the importance of planetary health and sustainable development and expressed her organisation’s interest in being involved.
Ms Clark was the keynote speaker on Monday at the Pacific NCD Summit in Nuku’alofa, June 20-22, for health ministers of the Pacific, which was organised by the Secretariat to the Pacific Community (SPC).
Dr Tukuitonga has expressed his wish for a strong Pacific presence at the conference and has pledged the involvement of his Pacific-wide organisation to support this aim.
The theme of the triennial conference of the International Union for Health Promotion and Education (IUHPE) is “Promoting Planetary Health and Sustainable Development for All.”
Pictured from left
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.
Health Promotion Forum of New Zealand – Runanga Whakapiki Ake i te Hauora o Aotearoa (HPF) has been successful in its bid to host the next World Conference on Health Promotion. This will be the first time New Zealand has hosted the conference and represents the country’s recognised leadership in health promotion: particularly indigenous wellbeing.
Set to take place in Rotorua, April 2019, the triennial conference of the International Union of Health Promotion and Education (IUHPE) will receive 2,000-3,000 health promotion and education professionals from around the world.
The win was announced on May 27 (NZ time) at the closing ceremony of the 22nd world health promotion conference of the International Union for Health Promotion and Education (IUHPE) that was held on May 22-27 in Curitiba, Brazil.
“We are delighted by the IUHPE’s confidence in our ability to host one of the most important events in the health promotion calendar,” said HPF’s Executive Director, Sione Tu’itahi. “We are also grateful for the hard work and expertise from our partners in preparing our bid. Now the real work begins to plan and stage a top class conference that upholds our reputation around the world.”
HPF was supported by NZ Tourism and engaged the help of The Conference Company to conduct a thorough feasibility study before making its bid. Rotorua was selected for its world-class meeting facilities and accommodation as well as for its reputation as the cultural heartland of New Zealand. The area showcases initiatives in socio-economic development, sustainability, holistic wellbeing and environmental protection: all of which are aspect of health promotion.
The organisation received overwhelming support for its bid from influential New Zealanders including Sir Mason Durie, Rt Hon John Key, Hon Dr Jonathon Coleman, as well as tertiary institutes and key local Rotorua bodies.
Health Promotion Forum is the national umbrella organisation for health promotion in Aotearoa New Zealand. It also plays a leading role in the development of health promotion in the Pacific region and internationally.
IUHPE is an international organisation that leads the on-going advancement of health promotion in the world.
Health Promotion Forum was fortunate to get some time with Emeritus Professor John Raeburn recently, to ask him about his more than 40 years as a health promotion advocate.
As one of two NZ delegates at the WHO’s first International Conference on Health Promotion, from which the Ottawa Charter emerged, Professor Raeburn made a small but significant contribution to the content of the document; the inclusion of a sentence emphasising the importance of empowerment. This was the only time the word appeared in the Charter. He has upheld the principles of community and health promotion ever since.
Invited to attend the 1986 Conference in Ottawa by the Ministry of Health, Prof Raeburn had recently returned from a sabbatical in Canada from his teaching role at the University of Auckland Medical School. There he had been working alongside Ron Draper; head of the Health Promotion Directorate at Health Canada. He considered this the ‘Mecca’ of health promotion and Ron Draper one of his heroes. “Canada actually invented health promotion in the 1970s,” says Prof Raeburn. Little did he know that his year’s sabbatical would see him caught up in the preparations for the seminal Conference at which he was to later play such a significant role.
The other New Zealand delegate to the Conference was a Canadian man called Larry Peters, who was asked to go in his capacity as the first director of the Health Promotion Forum (Larry later went back to Canada and worked in the Health Promotion Directorate).
What was the experience of participating in the conference like?
It was a mixed experience, and I wrote an article about it for a public health magazine in New Zealand when I got back, which was essentially a critique. I’ll start with the negative aspects. It was mainly organised by WHO, who did things in a very grand style with multiple flags and so on, much formality, and participants invited from all around the world. (It wasn’t open to everyone – governments were asked to send representatives). The conference process was awful.
First of all, it was organised out of Europe, and the organisers succeeded in somehow alienating most of the developing world, with the result that most of the attendees were European, white and from industrialised countries.(Only 46 countries were represented).
Second, it was conducted in a very disempowering and top-down way – the opposite of “real” health promotion! They went through the motions of having a participatory workshop format, but the European bureaucrats had already decided the outcomes beforehand.
Third, they didn’t tell us until almost the end of the several-day conference that they had a charter in mind, and it was clear that it had already been pre-written by them. So we were basically there to rubberstamp it. Well, the anger that surged around the huge room when the hundreds of delegates realized what had happened was spectacular.
WHO then had to back down somewhat, and then said they’d accept some of the workshop material. They also said that, although the Charter was ready to be printed, if people wanted to scribble something down and hand them into the printing room, they would be considered for inclusion as well.
I hurriedly wrote a sentence down on the back of an envelope (literally) and handed it in. You can imagine how delighted I was to find that whole sentence in the final Charter. My passion has always been the community dimension of health promotion, and the empowerment of ordinary people, and I’m happy to say that the only time that the term “empowerment” appears in the Charter is in that sentence. It’s in the community action stream (of course!) and says: “At the heart of this process [of community action] is the empowerment of communities, their ownership and control of their own endeavours and destinies”. The sentiments expressed in the sentence are as important to me now, 30 years later, as they were then, and sums up for me the very essence of the health promotion enterprise.
And also on the positive side, on a wider level, thanks to the various changes done at the last moment, the world got a health promotion charter that still remains a brilliant document. And I have to say, that when the conference participants heard what WHO had finally came up with after they had incorporating the workshop materials, there was thunderous applause. What a transformation! By some miracle, WHO had got it right. Once again, it’s proof of how important it is to have full-scale participation.
Did you realise at the time how seminal the conference and charter would be?
Yes I think we were all aware that we were at a history-making event. When Larry and I got back to New Zealand, we spent the next year going around the country promoting the Charter, with the result that New Zealand had arguably the biggest uptake of the Charter of any country in the world, including Canada.
You talk about health promotion moving away from the focus of changing lifestyles and behaviours to one of policy ‘changing society so that people and communities can more easily live healthy lives’. How far do you think NZ (and global) society has come?
This question is a slightly tricky one for me. I have over the last few years presented in various settings a critique of the Ottawa Charter, including one memorable occasion in Canada when I was invited to do a keynote on this topic at a conference to mark the 25th anniversary on the Charter. I was nervous, because the Ottawa Charter is like a sacred document in Canada. Happily it went down well.
Part of my critique is that the movement of health promotion away from the older style of health promotion which emphasised changing lifestyle, behaviour and community, threw the baby out with the bathwater. It’s not by chance that the first action stream in the Charter is to do with policy – that was definitely the main interest of WHO. However, my main interest, and clearly that of most of the participants at the conference, was in people. In the late 90s, I published a book co-authored with Canadian grandfather of health promotion, Irving Rootman, called “People-Centred Health Promotion”, which makes just this point.
My argument is that the focal point of health promotion should be community, a stance that enables one both to look “up” to the larger picture of policy and environment, and “down” to the more intimate and personal level of personal skills and family life. Community is where people do their lives, and is the great meeting point of those two perspectives.
My fear has always been that health promotion would increasingly become preoccupied with policy – with statistics and abstract documents – and as far as most academic health promotion is concerned, that’s definitely the case. The result has been, I believe, a major gap between grassroots practitioners of health promotion and communities, and academics and policymakers. And largely, the public likes a lifestyle/community approach, and is turned off by policy approach. I’m not saying we shouldn’t have policy in health promotion – of course we should. But we equally need the community and people level.
My favourite image, which I’ve shown in multiple PowerPoint presentations, is a picture of a gannet in the sky with its wings spread, with one wing labelled “policy”, and the other “people”. This balanced approach is the one I strongly advocate.
So as to the question about how far NZ and global society has come in regard to these issues, I see that health promotion is probably going backwards, and has lost its broad public constituency, mainly because it has got lost in the arid desert of too much policy.
Community development is your passion. In an increasingly populous and multi-cultural society how do you think we are progressing with this area of health promotion?
I don’t think we are progressing at all well. In short, I feel health promotion has gone too far in the policy direction, and needs to go back to its heartland, which is community.
There was a time in the ‘70s and ‘80s when there was fantastic progress, with all sorts of great community initiatives around. One of the best contributions of government here was something called CHIFS; the Community Health Initiatives Funding Scheme, which supported communities coming up with their own empowering projects.
What changed all that was the arrival around 1985 of “Rogernomics”, followed by “Ruthanasia” in the ‘90s, which is to say that both Labour and National governments swung far to the right by adopting wholeheartedly the fashionable new economic policies of neoliberalism. These were first introduced by Maggie Thatcher in the UK, who was famous for a statement that “there’s is no such thing as society”. Rather, she said, there are ony individuals, and unequal ones at that.
Such a philosophy is harmful to community and empowerment of ordinary people, and we still largely live under this system globally and In New Zealand today. So community remains an unpopular concept. But at least now many are more aware of how damaging to society this approach is, and how it favours corporates and the wealthy, and makes the already miserable life of the poor and disempowered even more miserable.
On the other hand, this is offset in Aotearoa by the bicultural and multicultural nature of our society, where Māori and Pacific people in particular see society very much in “true” community terms. This is a perspective where people are indeed the most important thing in life, and where life is about cooperation, whanau, aroha and connectedness with others. So definitely, the saving grace in Aotearoa is the health promotion approach of these populations, and also in other cultural populations. So it’s a mixed bag here. Because government policy is not generally supportive of community and the less well off, it’s an uphill battle. At the same time, we in this country have a deeply embedded belief in the value of community, which for health promoters applies to health and wellbeing in particular. A well-connected and well-liked local community means healthy and happy people. (There’s lots of research to back that statement up). However, for the present time, in spite of positive aspects, at a general level, the community approach to health promotion is currently on the back foot, and has been so for at least two decades.
Talking about your Public Health Champion award 2015, you are quoted as saying that health promotion is the area of public health with which that you identify most. What are your thoughts behind seeing health promotion as a subset of public health?
This is a fascinating question, and when I was working at the University of Auckland’s School of Population Health, I was continually aware of it; surrounded as I was by public health people such as epidemiologists.
Because it has its roots in disease prevention and medical approaches to health, mainstream public health has always had an uneasy relationship with the ‘upstart’ called health promotion, which is largely a non-medical enterprise, and operates out of an entirely different model.
I’ve worked hard over the years to make the point that public health is a combination of three components – protection, prevention and promotion – and it’s important to distinguish the three of them.
One of the other things that has put health promotion on the back foot for decades is the fact that it frequently gets confused with prevention, and therefore is based on concepts of disease rather than concepts of health and well-being. And, while I definitely think that health promotion is part of public health, it has yet to carve out its full identity within that context. I constantly see health promotion being seduced off in the direction of disease-oriented prevention, largely because it doesn’t have a strong kaupapa to the contrary
At the same time, I also think that health promotion goes well beyondwhat is conventionally regarded as public health. All sorts of things affect our wellbeing outside what’s conventionally regarded as public health. For example, at the simplest level, going to Weight Watchers, playing rugby, being on a marae, or having a good time with friends, all contribute to health and wellbeing in their various ways (again supported by research evidence). In a way, the whole of life can be either health promoting or health destroying.
So yes, while public health has an arm called “health promotion”, I really think that it’s only one expression of health promotion, which is much wider than that. But I can’t say that seems to be a popular view either. Of recent years, I have become enamoured of the concept of wellbeing promotion rather than health promotion, and I think this represents a more inclusive type of health promotion than the public health version currently provides.
You were recently involved in the publication of the Manifesto of Planetary Health. Can you tell us more about this paper and the project?
Well, this question relates directly to what I was just talking about – I see planetary health as also a great new inclusive concept that will benefit both health promotion and public health, and could well be the future.
I was lucky to be involved in this project through my friendship with Robert Beaglehole and Ruth Bonita, who were asked by the Lancet to participate in the authorship of the trailblazing one page article that is the Planetary Health Manifesto. When I saw the first drafts, I thought it was very light on community, and too heavy on policy and government action. So me being me, I pulled out all the stops and kept inserting references to community in the document. And if you now read that document, it almost looks as though community is the number one consideration, so naturally I’m very pleased with all that.
And what is planetary health? It’s a concept designed to revolutionise public health, which is seen as having lost ground both professionally and in terms of public engagement. It’s quite clear that the greatest threats to health and well-being in the future are quite different from what they were 30 years ago, or even 10 years ago. Global warming, terrorism, globalisation, ferocious inequity , ever-growing populations, food and water shortages, new and damaging addictions like gambling and designer drugs, robotization and fewer jobs, are just some of the factors that are going to deeply affect everyone’s health in the future. This manifesto is designed to bring public health kicking and struggling into the 21st century. But its goals won’t be achieved, in my view, simply by government policy being developed in a top-down way, and dumped onto populations. Without community participation, and indeed community leadership rather than just “consultation”, we won’t get anywhere. The only way to change the world, in my view, is by local people working with the things that concern them most, in their own settings and culture, in partnership with government.
How do you see the manifesto impacting on New Zealand health and Health Promotion?
Well so far it’s not very advanced. The manifesto was only published in 2014, and it’s not very well known here yet. I and others have given a few workshops and presentations on it, and I must say there’s been a very positive response to it at those. So definitely, there’s a huge potential for public-health people and other people of good will to become passionately involved in this enterprise. But we’ve got a long way to go yet.
I understand you are writing a book about spirituality. Can you tell us more about this?
Have you got all day? Briefly, ten years ago when I was leaving the University of Auckland, I wanted to spend more time meditating and doing “spiritual” things, given that I had a strong interest in Zen and Taoism. I have a property in the wilds of Great Barrier, and had the romantic vision of spending lots of time there in the bush in the pursuit of – whatever it is one pursues in such a setting. But when the time came, I got cold feet, and wondered whether spirituality was simply a psychological entity dreamed up by humans to provide us with hope and happiness in a stressful world. (My background is as a psychologist). I then got to thinking that there were large numbers of people in the 21st century labelling themselves spiritual, and many declare themselve “spiritual but not religious.” I decided I wanted to know what they meant. What is this thing called spirituality? It’s definitely not religion, although religion has elements of it of course. So what is it? It’s taken me all those years to figure it out , and I’ll give just a clue as to what that might be. I believe it’s in our genes, the result of millions of years of evolutionary development at both the prehuman and human level, and it serves very important survival and well-being purposes. Unsurprisingly, I believe it also has a very strong community dimension in it’s background. But at this point I’ll say no more, partly because I’m still working on it, but also partly because once I start on this topic, it could take all day!
And does it relate to health promotion? Yes indeed it does, and also to planetary health. For several years at the University of Auckland, I used to teach a postgraduate course called Spirituality and Health, and it had a strong health promotion bias. It used to attract students from every kind of background, from atheist to fundamenalist, and all cultures, and this enabled me to develop a concept of spirituality as it related to health promotion. But don’t get me started on that either!
We thank Professor Raeburn for his valuable time, warmth and considered replies.
March 2016
Jo Lawrence-King
– See more at: http://www.hauora.co.nz/prof-john-raeburn-health-promotion-advocate.html#sthash.ZfAKn7KJ.dpuf[/vc_column_text][/vc_column][/vc_row]
The International Union of Health Promotion and Education (IUHPE) has recently acknowledged the New Zealand Health Promotion Competencies as equivalent to its own European Competencies. This is a promising step towards the ultimate aim of global competencies and accreditation; which would offer health promoters the potential to broaden employment opportunities and the exchange of knowledge and experience around the world.
HPF’s Executive Director Sione Tu’itahi was excited about this significant step and its potential implications for health promoters of Aotearoa. “Imagine when New Zealand health promoters can travel anywhere in the world and transfer their competencies to work in any member country,” he said.
The IUHPE has its own European-wide competencies; developed out of its CompHP project. New Zealand was represented by past HPF Health Promotion Strategist Helen Rance on the Global Advisory Committee that developed these European competencies. The IUHPE has also developed a European accreditation process to sit alongside the competencies. It identifies performance criteria to meet the competencies. Within this process individual practitioners submit a portfolio of evidence rather like nursing; identifying their evidence in meeting each competency. This submitted to their National Accreditation Organisation, which assesses the evidence successful accreditation means they can be called a European Health Promoter with the registration lasting three years. Academic institutions that deliver health promotion courses can also become accredited following a similar process.
Because the European and Aotearoa competencies were developed concurrently, the frameworks consist of the same nine competency domains. The detail below each competency domain heading is different in the Aotearoa context, from that in the European domains as ours prioritise health promotion knowledge and practice that is specific to this country’s context. In order to formalise the IUHPE recognition of the New Zealand Competencies, the HPF’s Health Promotion Strategists are providing the global body with detail around the correlation between the two competency documents.
Health Promotion Forum first produced the New Zealand Health Promotion Competencies in 2000 following two years of extensive consultation. The current – 2012 – version of the Competencies was the result of continued discussions and feedback, which identified a need to strengthen the content and context related to Māori values and Te Tiriti o Waitangi. These latest competencies identify the specific knowledge, skills, behaviours and attitudes for effective health promotion practices in the Aotearoa New Zealand context.
The decision to recognise the New Zealand competencies was made at a December 2015 meeting of the IUHPE Accreditation System meeting.
– See more at: http://www.hauora.co.nz/nz-health-promotion-competencies-recognised-by-global-body1.html#sthash.YquMnPTF.dpuf
The International Union of Health Promotion and Education (IUHPE) has recently acknowledged the New Zealand Health Promotion Competencies as equivalent to its own European Competencies. This is a promising step towards the ultimate aim of global competencies and accreditation; which would offer health promoters the potential to broaden employment opportunities and the exchange of knowledge and experience around the world.
HPF’s Executive Director Sione Tu’itahi was excited about this significant step and its potential implications for health promoters of Aotearoa. “Imagine when New Zealand health promoters can travel anywhere in the world and transfer their competencies to work in any member country,” he said.
The IUHPE has its own European-wide competencies; developed out of itsCompHP project. New Zealand was represented by past HPF Health Promotion Strategist Helen Rance on the Global Advisory Committee that developed these European competencies. The IUHPE has also developed a European accreditation process to sit alongside the competencies. It identifies performance criteria to meet the competencies. Within this process individual practitioners submit a portfolio of evidence rather like nursing; identifying their evidence in meeting each competency. This submitted to their National Accreditation Organisation, which assesses the evidence successful accreditation means they can be called a European Health Promoter with the registration lasting three years. Academic institutions that deliver health promotion courses can also become accredited following a similar process.
Because the European and Aotearoa competencies were developed concurrently, the frameworks consist of the same nine competency domains. The detail below each competency domain heading is different in the Aotearoa context, from that in the European domains as ours prioritise health promotion knowledge and practice that is specific to this country’s context. In order to formalise the IUHPE recognition of the New Zealand Competencies, the HPF’s Health Promotion Strategists are providing the global body with detail around the correlation between the two competency documents.
Health Promotion Forum first produced the New Zealand Health Promotion Competencies in 2000 following two years of extensive consultation. The current – 2012 – version of the Competencies was the result of continued discussions and feedback, which identified a need to strengthen the content and context related to Māori values and Te Tiriti o Waitangi. These latest competencies identify the specific knowledge, skills, behaviours and attitudes for effective health promotion practices in the Aotearoa New Zealand context.
The decision to recognise the New Zealand competencies was made at a December 2015 meeting of the IUHPE Accreditation System meeting.
The cluster of Zika virus outbreaks and the associated neurological disorders has caused global concern; particularly in tropical and sub-tropical areas.
HPF’s Dr Viliami Puloka offers a perspective for consideration by health promoters working to prevent disease and for the communities under threat.
Communities can be empowered with information on prevention of the spread of disease and on how to remain healthy in order to fight the virus, should they become infected, he says.
On 1 February 2016 the World Health Organisation declared a Public Health Emergency of International Concern (PHEIC) regarding the high incidence of abnormally small brains and other neurological disorders in babies born to mothers infected with the Zika virus.
Much discussion and concern has resulted from the WHO’s decision.
Health promotion will play a key role in minimising the effects of Zika on Pacific peoples. Being well, being informed and taking precautions to reduce exposure to the disease-carrying mosquito will all contribute to communities’ resistance to the virus and its associated issues, says Health Promotion Forum’s Senior Health Promotion Strategist Dr Viliami Puloka.
Here in the Pacific region the rainy season – when mosquitoes are most prevalent – has just begun. We have recently had new cases of the Zika virus declared in Samoa and Tonga. One case of Guillain-Barré was identified in Waikato and linked to the Zika virus. The patient was a man who had recently arrived from Tonga, however, and it was considered to represent no risk of an outbreak here. This is because the virus is spread via a mosquito that is not found in New Zealand’s colder climate. Meanwhile the virus has been present in French Polynesia for some time. There, at least 40 cases of Guillain-Barré syndrome have been associated with the virus.
Zika was first identified in Brazil in May 2015. Since then babies born to mothers infected with the virus have been found to have a higher incidence of neurological disorders, the main one of which has been abnormally small brains – or microencephaly. While it has not been proven that the disorders are a direct result of the virus, this is strongly suspected. In recent days another possible association has been suggested: the use of an antilarval chemical included in the drinking water of the affected residents in Brazil.
Health authorities in New Zealand and the Pacific are putting in place protection measures and public policies to prevent the spread of Zika virus, however Dr Puloka, who is responsible for the HPF’s Pacific portfolio, points out that communities have an equally vital role to play. Minimising and modifying potential breeding sites is one way in which communities can act to prevent the spread of the Zika, he says. Residents are advised to empty, clean or cover containers that can hold water. This includes receptacles like buckets, flower pots or tyres. According to Dr Puloka it is also common practice to have a layer of oil on the top of the water in a septic tank. This prevents the reproduction of the mosquitoes, whose pupae need oxygen from above the water to survive.
He suspects that immunity to mosquito-borne diseases may offer hope to those Pacific island nations to have recently seen the arrival of the Zika virus. “The mosquito that carries the Zika virus is the same one that carries dengue fever, chikungunya and yellow fever,” he says. “People of the Pacific islands have been exposed to these mosquitoes for many years and have developed a level of resistance to those diseases.” This contrasts starkly with the situation in Brazil, where the people had previously not been exposed to those mosquitoes or their diseases.
Other precautions – where practicable – include using insect repellent, wearing clothes (preferably light-coloured) that cover as much of the body as possible and using physical barriers such as screens, closed doors and windows.
During outbreaks, health authorities may also advise spraying of insecticides.
Dr Puloka’s advice to communities threatened by the Zika virus is that now, more than ever, it is important to be well, be informed and take the necessary precautions to minimise the risk of being bitten by the mosquito that carries the disease.
A glowing review by Henry March was published this month in UK paper NewStatesman of Michael Marmot’s book The Health Gap: the Challenge of an Unequal World. The review – and the book – highlights Marmot’s long-held view that mortality statistics are a question of inequity.
“If everyone in England over the age of 30 had the same low mortality as people with university education, there would be 202,000 fewer deaths before the age of 75 each year . . . 2.6 million extra years of life saved each year.” The reviewer quotes from Marmot’s book.
There has been much argument over the years, says Henry March, about how “health” should be defined. “One might scoff a little at the breadth of the World Health Organisation’s definition: “complete physical, mental and social well-being and not merely the absence of disease or infirmity”. But it is difficult to disagree with the underlying idea that good health is more than just the absence of disease.”
“We need to seek out the “cause of the causes”. Working-class people smoke more, have higher obesity rates, take less exercise and die younger as a result – but why? Those of a right-wing disposition might suggest that it is simply because they are feckless and have not exercised their free will to work hard and live healthy lives. But this, you realise as you read Marmot’s book, is the propaganda of the victors.”
Henry March is clearly convinced by this book; pronouncing it ‘splendid and necessary’.
University professor and physician Trevor Hancock has urged society to rethink the role and effectiveness of health care as a determinant of our health. According to his December 2014 article in Canadian newspaper Times Colonist “…as a society we should be investing more in creating social conditions and environments that make people healthy, rather than in increasingly expensive high-tech care.” This is very sound advice, according to HPF’s senior health promotion strategist Dr Viliami Puloka.
Traditionally, we have given hospitals, doctors and the health care system the responsibility to look after our health. “That relationship seemed to work well in the days where most of our health issues were largely acute infective processes that required urgent but short term medical interventions by doctors and nurses,” says Viliami. “However, the major health problems we face today are not acute infections from a single organism treatable with antibiotics, but chronic conditions with multiple risk factors that lie outside the remits of the existing health care system.”
Dr Hancock’s article highlights two main points that are very relevant to the situation in New Zealand. Firstly, the importance of shared responsibility for the management of people’s health; between the individuals themselves, the wider community and health care providers. This is particularly critical in the management of chronic conditions, such as diabetes and obesity, where the individual has to make healthy choices and behaviour modifications in order to be well. The role of health care providers here is to support and empower individuals to make these healthy choices. Secondly, the importance of enabling-environments where healthy choices are the easy choices. These enabling-environments must include socio-economic and political environments. Dr Hancock refers to these as the upstream – or health – determinants that are outside the reach of the individuals and the jurisdictions of the health system.
As in Canada, we here in New Zealand have identified these health problems and their solutions. The solutions include cost-effective ‘upstream’ strategies such as community health promotion. However we have, to date, failed to address the processes that prevent individuals from benefitting from these upstream approaches. “We have been busy rescuing half-drowned people downstream. It is time that we work with our leaders putting in place policies and legislations to prevent people from falling into the river in the first place.”
Two videos from the Health Promotion Forum of New Zealand (HPF) are receiving widespread praise – and calls for more – across the population health community in Aotearoa and the world.
Viewed by more than 750 people to date, What is Health Promotion? answers the vexed question for many about this much-misunderstood discipline, while Health Promotion Competencies introduces health promoters to a useful resource for developing their role.
Renowned Professor and author John Raeburn commented “Really good. Very succinct and to the point,” and, on a poignant note, he added; “Ah, if only we could achieve that!”
WHO’s Professor Margaret Barry – Head of World Health Organization Collaborating Centre for Health Promotion commented: “There are very nicely produced short videos, which provide a useful snapshot of what Health Promotion practice is about and the skills and competencies that health promoters apply. They will be of interest to all those studying and working in Health Promotion and related areas globally.”
University lecturers up and down Aotearoa, and from as far afield as Scotland, say they have added the videos to their teaching resources.
HPF hopes to produce more videos in the future. Keep up to date on our videos by liking us on facebook or by e-mailing Barb to subscribe to our biannual newsletter Hauora.
Scottish MPs (MSPs) have called for a multi-agency approach to tackle inequalities. This follows the publication of the Report on Health Inequalities after a two year inquiry, which identified the ongoing health gap between the rich and poor in Scotland.
The gap, they say, has endured; despite political will and investment in public health campaigns on smoking, nutrition and exercise. In fact the inquiry identified that such campaigns had the potential to increase inequalities. This is for two reasons:
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.
It concluded that effective narrowing of the gap will require a multi-agency, multi-initiatives approach.
The MSPs pointed out that the primary causes of health inequalities; social and economic problems; lie outside of the health sector. The National Health Service (NHS) alone cannot these issues. They identified three approaches to tackle inequalities:
Measures through the taxation and benefits system;
Agencies collaborating to work effectively on related policies such as housing and education;
NHS to provide better access to primary health services for the poorest and most vulnerable.
While the life expectancy gap in New Zealand is not as great as that in Scotland, there remain significant differences between different sectors of the population, with Māori and Pacific people faring poorly in health outcomes.
“It is particularly important to address this inequity; not only as a moral issue but as a societal one: inequities are linked to poor health outcomes, reduced opportunity, poor economic growth, lack of social cohesion and increased health care costs.,” says HPF Senior Health Promotion Strategist Karen Hicks. “HPF will watch the development of this initiative in Scotland with interest.”
The Ottawa Charter for Health Promotion is a 1986 document produced by the World Health Organization. It was launched at the first international conference for health promotion that was held in Ottawa, Canada. I lays the foundation for health promotion action.
The health promotion emblem provides a graphic interpretation of health promotion. Explanation of the emblem
The ‘Bangkok Charter for Health Promotion in a globalized world’ was agreed to by participants at the 6th Global Conference on Health Promotion held in Thailand from 7-11 August, 2005. It identifies major challenges, actions and commitments needed to address the determinants of health in a globalized world by reaching out to people, groups and organizations that are critical to the achievement of health. – See more at: http://www.hauora.co.nz/global-context.html#sthash.0YtkIBgQ.dpuf
The Declaration of Alma-Ata was adopted at the International Conference on Primary Health Care, Almaty (formerly Alma-Ata), currently in Kazakhstan, 6-12 September 1978. It expressed the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world. It recognises the primary health care approach as the key to achieving the goal of “Health for All”.
Since the World Conference in 2011, the Secretariat has observed a considerable increase in the action on social determinants of health. Published in November 2012, this report describes some of the main developments.
The Alma-Ata Declaration is considered by many to be the founding framework for health promotion internationally. It came from an International Conference on Primary Health Care, in Alma-Ata, USSR, 1978.
“The International Conference on Primary Health Care, meeting in Alma-Ata this twelfth day of September in the year Nineteen hundred and seventy-eight, expressing the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world ….. “
World Health Report 2008 – Primary Health Care – Now More than Ever
“Globalization is putting the social cohesion of many countries under stress, and health systems, as key constituents of the architecture of contemporary societies, are clearly not performing as well as they could and as they should.
People are increasingly impatient with the inability of health services to deliver levels of national coverage that meet stated demands and changing needs, and with their failure to provide services in ways that correspond to their expectations. Few would disagree that health systems need to respond better – and faster – to the challenges of a changing world. PHC can do that.” The 2008 WHO report Now More Than Ever outlines Primary Healthcare (PHC) reforms to mee the health challenges of today’s world.
The World Health Organization (WHO) identified a need for the development of public health leadership at a conference in November. The global body called on governments, acadaemia, civil society and public health institutions to commit greater effort to developing the skills needed in the field; in order to protect public health values and to mitigate against public health threats.
WHO also emphasised the need to strengthen the collective capacity for systems-thinking*, which focuses on population-based approaches as well as personal approaches to health and wellbeing improvement.
Over 1,400 public health practitioners, researchers and policy- makers from more than 65 countries participated in sessions at the conference; covering topics such as the changing public health roles, gaps in health systems research and effective communication.
*Systems thinking involves interventions and engagement with key stakeholders and organisations across many sectors. It is a framework for seeing interrelationships; understanding that everything is connected and that every action has an effect. It is consistent with the social ecological model where health promoters appreciate the interconnectedness that exists through the relationships people have with and between family, friends, organizations, teams, communities, faith groups, etc. The social ecological model is a systems thinking model.
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 presentationPower and People: a game plan for health equity in the 21st Century.
Consumers International (CI) and World Obesity Federation (WOF) are calling on the international community to develop a global convention to fight diet-related ill health, similar to the legal framework for tobacco control.
Unhealthy diets now rank above tobacco as a global cause of preventable non-communicable diseases (NCDs).
The two international membership bodies will officially launch their Recommendations towards a Global Convention to protect and promote healthy diets at the World Health Assembly in Geneva.
The Recommendations call on governments to make a binding commitment to introduce a raft of policy measures designed to help consumers make healthier choices and improve nutrition security for everyone.
Measures include placing stricter controls on food marketing, improving the provision of nutrition information, requiring reformulation of unhealthy food products, raising standards for food provided in public institutions and using economic tools to influence consumption patterns.
Publication of the Recommendations comes on the 10th anniversary of the WHO Global Strategy on Diet and Physical Activity and Health, which recognised the impact of unhealthy diet and lifestyle.
Since then however, global deaths attributable to obesity and overweight have risen from 2.6 million in 2005 to 3.4 million in 2010, thus intensifying the pressure on governments to take stronger action to tackle the rising epidemic of obesity and consequent chronic disease.
Consumers International Director General, Amanda Long says: “The scale of the impact of unhealthy food on consumer health is comparable to the impact of cigarettes. The food and beverage industry has dragged its feet on meaningful change and governments have felt unable or unwilling to act.
“The only answer remaining for the global community is a framework convention and we urge governments to seriously consider our recommendations for achieving that. If they do not, we risk decades of obstruction from industry and a repeat of the catastrophic global health crisis caused by smoking.”
“If obesity was an infectious disease we would have seen billions of dollars being invested in bringing it under control,” said Dr Tim Lobstein, World Obesity Fediration Director of Policy. “But because obesity is largely caused by the overconsumption of fatty and sugary foods, we have seen policy-makers unwilling to take on the corporate interests who promote these foods. Governments need to take collective action and a framework convention offers them the chance to do this.”
Here in New Zealand the Government has recently announced funding for the Healthy Families NZ scheme, aimed at reducing obesity and improving the health outcomes for more disadvantaged communities around the country. Read our article from February 2014 on this initiative.
Obesity is a major risk factor for a wide range of non-communicable diseases. Figures show that in 2008, 36 million people died from non-communicable diseases, representing 63 per cent of the 57 million global deaths that year. In 2030, such diseases are projected to claim the lives of 52 million people.
Consumers International (CI) and World Obesity Federation (WOF) are calling on the international community to develop a global convention to fight diet-related ill health, similar to the legal framework for tobacco control.
Unhealthy diets now rank above tobacco as a global cause of preventable non-communicable diseases (NCDs).
The two international membership bodies will officially launch their Recommendations towards a Global Convention to protect and promote healthy diets at the World Health Assembly in Geneva.
The Recommendations call on governments to make a binding commitment to introduce a raft of policy measures designed to help consumers make healthier choices and improve nutrition security for everyone.
Measures include placing stricter controls on food marketing, improving the provision of nutrition information, requiring reformulation of unhealthy food products, raising standards for food provided in public institutions and using economic tools to influence consumption patterns.
Publication of the Recommendations comes on the 10th anniversary of the WHO Global Strategy on Diet and Physical Activity and Health, which recognised the impact of unhealthy diet and lifestyle.
Since then however, global deaths attributable to obesity and overweight have risen from 2.6 million in 2005 to 3.4 million in 2010, thus intensifying the pressure on governments to take stronger action to tackle the rising epidemic of obesity and consequent chronic disease.
Consumers International Director General, Amanda Long says: “The scale of the impact of unhealthy food on consumer health is comparable to the impact of cigarettes. The food and beverage industry has dragged its feet on meaningful change and governments have felt unable or unwilling to act.
“The only answer remaining for the global community is a framework convention and we urge governments to seriously consider our recommendations for achieving that. If they do not, we risk decades of obstruction from industry and a repeat of the catastrophic global health crisis caused by smoking.”
“If obesity was an infectious disease we would have seen billions of dollars being invested in bringing it under control,” said Dr Tim Lobstein, World Obesity Fediration Director of Policy. “But because obesity is largely caused by the overconsumption of fatty and sugary foods, we have seen policy-makers unwilling to take on the corporate interests who promote these foods. Governments need to take collective action and a framework convention offers them the chance to do this.”
Here in New Zealand the Government has recently announced funding for the Healthy Families NZ scheme, aimed at reducing obesity and improving the health outcomes for more disadvantaged communities around the country. Read our article from February 2014 on this initiative.
Obesity is a major risk factor for a wide range of non-communicable diseases. Figures show that in 2008, 36 million people died from non-communicable diseases, representing 63 per cent of the 57 million global deaths that year. In 2030, such diseases are projected to claim the lives of 52 million people.
An in-depth paper published in The Lancet this February urges policy makers to recognise and address global political determinants of health inequity. “Grave health inequity is morally unacceptable,” the authors say; it is a “global political responsibility” to ensure “transnational activity does not hinder people from attaining their full health potential.”
The paper, produced by the Commission on Global Governance for Health challenges the ‘biological’ argument for health inequalities and places the main responsibility for them firmly at the feet of national governments around the world; calling on them to redress the imbalance of fairness and justice that currently exist. “Despite large gains in health over the past few decades, the distribution of health risks worldwide remains extremely and unacceptably uneven,” say the paper’s authors.
“Health equity should be a cross-sectoral political concern, since the health sector cannot address these challenges alone”. The Commission recognises the crucial role of the health sector in addressing health inequalities it points out that the sectors efforts “often come into conflict with powerful global actors in pursuit of other interests such as protection of national security, safeguarding of sovereignty, or economic goals.”
“This is a timely development for the discourse about our health and the wellbeing of our planet,” says HPF Executive Director Sione Tu’itahi. “What happens at the international level impacts directly on the local level, whether we like it or not: take global warming and trade, for example. Worldwide political determinants are rising fast but our governance and policy framework are still largely focused on local and national interests at the expense of our collective wellbeing. As a global family, we can no longer afford to focus on the room that we occupy when the whole house is battered by the storm.”
The political origins of health inequity: prospects for change
Highlights from the International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion
– “Best Investment for Health”
IUHPE President Michael Sparks took time out of his busy schedule to present the highlights of the conference for HPF.
The 21st International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion in Pattaya Thailand was noted for its truly global focus. More than 2,000 delegates, from over 80 countries attended the event this August. The theme – ‘Best Investment for Health” – provided many opportunities to discuss and debate this crucial question, as well as to share good practice, network and socialise.
It was the first time the conference was held in a developing Asian nation. This gave participants from the region an unprecedented opportunity to participate. In turn, it afforded a greater understanding among all participants of the varying levels of investment in health promotion across countries and of the broad range of issues affecting the practice of health promotion across the different contexts.
Highlights of the 21st International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion:
Presentations on work done in the South West Pacific region with Māori and indigenous Australian populations; including a well-received presentation from HPF’s Deputy Executive Director, Trevor Simpson.
South West Pacific regional office of the IUHPE now hosted in New Zealand, with HPF’s Executive Director Sione Tu’itahi now Vice-President of the this regional arm.
An emerging issue around tobacco in Thailand during the conference provided an opportunity for delegates to throw their support behind moves to strengthen tobacco control there.
New awards were created for ‘most liked poster’ and ‘health promotion practice.
Wrap-up of the conference.
New Zealand contribution
Of particular interest was the work done by the IUHPE’s Indigenous Health Promotion Network. Work done in the South West Pacific region with Māori and Indigenous Australian populations is often viewed as cutting edge and sessions were well attended by conference participants from other countries. Presentations from the region included a well-received one by HPF’s Deputy Executive Director Trevor Simpson.
Another development of particular interest to health promoters of Aotearoa New Zealand was the shifting of the leadership in the South West Pacific region of the IUHPE to this country. The Health Promotion Forum of New Zealand Executive Director, Sione Tu’itahi, has been elected Vice-President of the South West Pacific Region of IUHPE, while Associate Professor Louise Signal, Director of the Health Promotion and Policy Research Unit (HePPRU) and Health, Wellbeing & Equity Impact Assessment Research Unit (HIA), Department of Public Health, Otago University is its Regional Director. Until now these positions have been drawn from Australia for many year.
Delegates weighed in to support local battle to improve tobacco control in Thailand
During the conference there were also interesting developments in relation to local tobacco controls. The tobacco Giant Philip Morris challenged in court the Thai Ministry of Public Health’s legislation to increase health warnings on cigarette packages to 85% of the outer surface. The country’s lower court issued an injunction against the Public Health Ministry to suspend enforcement of the regulations.
Informed of these developments, conference delegates took action: developing a letter of support to the minister and petitioning the IUHPE General Assembly to write to the minister. Delegates also participated in a local media event to publicise the global support for tobacco control clearly evident at the conference.
Following the conference The Ministry, encouraged by the support from the global health promotion community, has appealed against the injunction to the Supreme Court. A ruling is expected late this year or early in 2014.
New awards created
Two new awards were created this year: the “most liked” daily poster session and the “Health Promotion Practice” awards. Recipients of the latter were three distinguished practitioners:
Dr. Gene R.Carter, the Executive Director and CEO of ASCD (formerly the Association for Supervision and Curriculum Development)
Prof.Prakit Vathesatogkit, Executive Secretary, The Action on Smoking and Health Foundation
Dr. Don Eliseo Lucero-Prisno III, Lecturer, University of Liverpool
Commission on Global Governance for Health calls on national governments to address global political determinants
An in-depth paper published in The Lancet in February 2014 urges policy makers to recognise and address global political determinants of health inequity. “Grave health inequity is morally unacceptable,” the authors say; it is a “global political responsibility” to ensure “transnational activity does not hinder people from attaining their full health potential.”
The paper, produced by the Commission on Global Governance for Health challenges the ‘biological’ argument for health inequalities and places the main responsibility for them firmly at the feet of national governments around the world; calling on them to redress the imbalance of fairness and justice that currently exist. “Despite large gains in health over the past few decades, the distribution of health risks worldwide remains extremely and unacceptably uneven,” say the paper’s authors.
“Health equity should be a cross-sectoral political concern, since the health sector cannot address these challenges alone”. The Commission recognises the crucial role of the health sector in addressing health inequalities it points out that the sectors efforts “often come into conflict with powerful global actors in pursuit of other interests such as protection of national security, safeguarding of sovereignty, or economic goals.”
“This is a timely development for the discourse about our health and the wellbeing of our planet,” says HPF Executive Director Sione Tu’itahi. “What happens at the international level impacts directly on the local level, whether we like it or not: take global warming and trade, for example. Worldwide political determinants are rising fast but our governance and policy framework are still largely focused on local and national interests at the expense of our collective wellbeing. As a global family, we can no longer afford to focus on the room that we occupy when the whole house is battered by the storm.”
The political origins of health inequity: prospects for change
The World Health Organisation (WHO) has published five new policy guides for addressing health inequity. The guides have been produced by New Zealand Doctor Belinda Loring, a past Fellow of Health Promotion Forum with a strong interest in health equity and action on the social determinants of health. While she was still in New Zealand Dr Loring worked on health equity and public health at local, regional and national government levels, with a strong focus on Māori health inequities.
A speech to parliament on Wednesday 28 January 2014 by Minister Tariana Turia has highlighted the groundswell of support for Whanau Ora as a model for health and wellbeing applicable to all New Zealanders. Health Promotion Forum (HPF) Executive Director Sione Tu’itahi believes that the model goes even further; with relevance to people around the world.
“Whanau Ora [……] has been openly embraced by New Zealanders of all cultures and creeds,” said Ms Turia in her speech “[It is] about empowering and enabling families to set their own priorities, to focus on outcomes.” According to Ms Turia 160 providers are now using the Whanau Ora tool, with approximately 33,000 New Zealanders benefitting from the approach. Ms Turia is not alone in seeing the value of community health promotion, with Minister of Health Hon Tony Ryall reportedly considering funding for such a programme.
Ms Turia is not alone in seeing the value of community health promotion, with Minister of Health Hon Tony Ryall reportedly considering funding for such a programme. – See more at: http://www.hauora.co.nz/whanau-ora-a-model-for-people-around-the-world.html#sthash.eWk0Ul5D.dpuf
Ms Turia is not alone in seeing the value of community health promotion, with Minister of Health Hon Tony Ryall reportedly considering funding for such a programme. – See more at: http://www.hauora.co.nz/whanau-ora-a-model-for-people-around-the-world.html#sthash.eWk0Ul5D.dpuf
Tu’itahi welcomed Ms Turia’s speech and Mr Ryall’s interest in community health programmes. “We are rapidly moving from a model of hauora (health and wellbeing) by and for Māori to one that is widely recognised as being of value to all peoples of Aotearoa New Zealand,” he said. “I predict that it won’t stop there: this will become a model followed by peoples across the globe.”
Aotearoa New Zealand – and HPF – are highly regarded internationally. In particular our approaches to indigenous health promotion were well-received at last year’s International Union of Health Promotion and Education (IUHPE) conference. Key elements of these approaches include a focus on the holistic view of health and wellbeing, increased control by communities over interventions and incorporating indigenous world views into health promotion planning. All of these aspects are reflected in the Whanau Ora approach.
Whanau Ora is founded on the principle of self-determination. Unlike the conventional models of health care, the Whanau Ora approach empowers whanau and communities to have control over their own wellbeing. Instead of focussing on illness and its treatment, Whanau Ora helps participants identify those elements that determine hauora and to prioritise strategies to improve outcomes.
“This is not an exclusively indigenous issue,” says Tu’itahi. “There is a broad movement towards self-determination – in health and many other issues. People around the world are taking an increasing interest in being well, rather than treating illness; on looking at the big picture of what affects our ability to fulfil our potential and doing something to address those determinants of our health.” He believes that the Whanau Ora model will be one that is taken up and adapted for people around the world. “Once again New Zealand will be a pioneer,” he said. “Perhaps what we do need to recognise is that we owe Māori a debt of gratitude for a model that has the potential to revolutionise the hauora of people around the world.”
HPF – and New Zealand – is making a significant contribution to world health agendas. Its most recent input was to the scientific programme of the 16thWorld Congress on Tobacco or Health. As a member of the board of the International Union for Health Promotion and Education (IUHPE), HPF’s Executive Director Sione Tu’itahi ensured the needs of indigenous peoples and ethnic minorities were included in the recommendations invited from the global organisation.
“This is a big step for New Zealand, the HPF and for Maori and all other indigenous peoples,” says Sione. Smaller countries and ethnic minorities are often overlooked and vulnerable to the driving force of large companies and countries. “Having a voice at this level is a wonderful opportunity to advocate for the rights of these less-represented peoples.”
Recommendations about the conference from the IUHPE included:
Discussions about the post-2015 development agenda to ensure health, including non-communicable diseases and social determinants are given the appropriate attention.
Discussion around support for politicians in the battle with tobacco industry on initiatives such as plain packaging.
Seeing outputs and outcomes of the WHO Europe NCD ministerial event focussing primarily on tobacco.
Focussing on ‘how to do’ as much as ‘what to do’
Including the health needs of indigenous peoples and ethnic minorities in all strategies.
Sione is the first indigenous person from the Pacific region to hold an official post with the IUHPE. He is a member of the global board in his role as Vice-President of IUHPE, South West Pacific Region, which covers New Zealand, Australia, all small Pacific island nations and some countries in Asia.
IUHPE is a global umbrella organisation for health promotion professionals and organisations of the world. Its headquarters are in Paris. For the next three years (2013-2016) its South West Pacific Region office will be co-hosted by the Health Promotion Forum and the Health Promotion and Research and Evaluation Unit (HePPRU) of Otago University’s School of Public Health. HePPRU’s Director, Associate Professor Louise Signal, is also the Director of IUHPE for the South West Pacific Region.
Sione recently attended a meeting of the IUHPE’s Global Executive Board in Paris. Read moreabout the trip here.
TheHPFis a national umbrella organisation for health promotion organisations and teams in New Zealand.
Health Promotion Forum (HPF) Executive Director Sione Tu’itahi is calling on health promoters at all levels to join forces and make a difference to hauora here and around the world. “They say think globally, act locally, but these days we must think and act on all levels,” says Sione .
Sione returned last Friday from Paris, France, where he attended a two-day meeting of the GlobalExecutive Board of the International Union for Health Promotion and Education (IUHPE). At the meeting the Board put together a work plan to contribute to solving global health challenges and ensuring the long-term sustainability of the IUHPE. One of the key resolutions was to redouble efforts to unify and energise the health promotion movement and Sione hit the ground running when he arrived back in Aotearoa New Zealand.
“The world is but one global village and challenges impacting on the international level influence the national and local levels as well,” said Sione. “Take the economic recession or global warming, for instance. Both challenges affect everyone at every level, whether you are in Paris, Auckland, or Ha’ano, [Sione’s home Island in Tonga]. “We must work together or we will all be affected by these common challenges, many of which are human-made and, therefore, can be resolved.”
Sione is the first Indigenous person from the Pacific region to hold an official post with the IUHPE. He is a member of the global board in his role as Vice-President of IUHPE, South West Pacific Region, which covers New Zealand, Australia, all small Pacific island nations and some countries in Asia.
IUHPE is a global umbrella organisation for health promotion professionals and organisations of the world. Its headquarters are in Paris. For the next three years (2013-2016) its South West Pacific Region office is co-hosted by the Health Promotion Forum and the Health Promotion and Research and Evaluation Unit (HePPRU) of Otago University’s School of Public Health. HePPRU’s Director, Associate Professor Louise Signal, is also the Director of IUHPE for the South West Pacific Region.
The HPF is a national umbrella organisation for health promotion organisations and teams in New Zealand. While its primary focus is on the national level, HPF has both a global reach and a local impact.
Sione issued a personal invitation to health promoters around the country: “If you wish to be part of the solution on all levels, join a global movement and a national organisation.”
IUHPE President, Professor Michael Sparks, of the Australian National University, Ms Marie-Claude Lamarre, Executive Director of IUHPE, and Sione Tu’itahi, HPF Executive Director and Regional Vice-President of IUHPE, at the meeting held at the Paris Global Centre of Columbia University.
30 October 2013: The World Health Organisation (WHO) has released a review, which “answers policy-makers’ demands for practical guidance on social policies that work to reduce inequities in health”. The review identifies 12 “best buy” priorities for policy; particularly child poverty and unemployment in young people.
“For the first time we have an unprecedented evidence-based set of practical policy recommendations about what all countries can do to address the so-called “upstream” causes of health inequities, specifically targeted to their income level,” says Zsuzsanna Jakab, WHO Regional Director for Europe
Professor Marmot visited Australia and New Zealand in April 2011 to attend a meeting hosted by the Asia Pacific hub of Global Action for Health Equity Network (AP-HealthGAEN) (reported in the Autumn/Winter issue of Hauora 2011). Here the Asia-Pacific applications of the global work in health equity were discussed. In her Hauora article on the subject Dr Belinda Loring pointed out that over 60% of the world’s population lives in the Asia Pacific region. “Life expectancy across the region varies by over 20 years,” she commented. “The scale of health inequities and the intensification of influences on health in this region demand specific attention and assessment through an Asia Pacific lens.” Dr Loring is Senior Policy Officer at HealthGAEN and an HPF Fellow
The Global Action for Health Equity Network (HealthGAEN) is an informal alliance for health equity through action on the social and environmental determinants of health. It was established to build on the momentum, expertise and partnerships generated through the WHO Commission on Social Determinants of Health (CSDH). The Asia-Pacific hub of HealthGAEN (AP-HealthGAEN) was established in 2009 to build a network for support and joint action on addressing health inequity across the region. The Health Promotion Forum of New Zealand (HPF) is an active member of AP-HealthGAEN.
The CDSH, chaired by Professor Sir Michael Marmot, was established in 2005. It was the start of a global movement for health equity. It focused on action on the social determinants of health; generating worldwide interest among governments, civil society, academics and non- government organisations.
Health promotion programmes in Aotearoa New Zealand were held up as models of best practice in August at the annual conference of the world’s most highly respected health promotion organisation. Senior Health Promotion Strategists from the Health Promotion Forum (HPF) are participating at the conference of the International Union of Health Promotion and Education (IUHPE) in Pattaya, Thailand, August 25-29 2013.
Trevor Simpson – Deputy Executive Director at the HPF – presented a plenary session to showcase a health promotion module developed by Maori and in close collaboration with the Maori service users for whom it was being designed. “This is a point of difference from many other health promotion approaches to indigenous peoples,” says Trevor. Very often health promotion resources and practices are developed centrally, with little or no involvement of – or representation from – the people for whom they are being developed. “We have found our approach to be highly successful in inspiring and empowering people to make beneficial changes to their health.”
The HPF’s Senior Health Promotion Strategist Karen Hicks presented her abstract “A Contribution to the Global Dialogue”. In her presentation she will discuss how health promotion competencies, the advent of a professional society and a code of ethics together give health promotion professionals the tools they need to make effective improvements in health.
New Zealand is strongly represented in health promotion globally. The HPF’s Executive Director, Sione Tu’itahi, is Vice-President of the South West Pacific Region of IUHPE, while Associate Professor Louise Signal, Director of the Health Promotion and Policy Research unit (HePPRU) and Health, Wellbeing & Equity Impact Assessment Research Unit (HIA), Department of Public Health, Otago University is its Regional Director. Together the HPF and HePPRU co-host the IUHPE’s South West Pacific Regional Office.
“New Zealanders are the 13th happiest in the world.” That’s the finding of the recently published World Happiness Report 2013.
A post this month on Otago University’s Public Health Expert blog highlights some of the relevant findings of the report, which looked at the happiness of 156 countries.
Of particular note to health promotion professionals is the finding in the report that public spending needs to focus more on prevention than on care. It acknowledged the need for better evidence to support this shift.
Also highlighted in the Otago University’s blog is the emphasis on mental health as the “single most important determinant of individual happiness.”
Milestones in Health Promotion. Published by World Health Organisation (WHO) in 2009, this is a collection of global statements in one booklet. Or you can access individual statements below:
Adelaide Statement on Health in all Policies -Report from the International Meeting on Health in All Policies, Adelaide 2010. The purpose of this report was to engage leaders and policy-makers at all levels of government – local, regional, national and international. It emphasizes that government objectives are best achieved when all sectors include health and well-being as a key component of policy development. This is because the causes of health and well-being lie outside the health sector and are socially and economically formed. Although many sectors already contribute to better health, significant gaps still exist.
WHO Global Conferences on Health Promotion
The Eighth Global Conference on Health Promotion: Health in all Policies. Helsinki, Finland 10-14 June 2013. Two items were produced from this conference: the Helsinki Statement and a Framework for Country action. Thestatement asserts that “health inequities between and within countries are politically, socially and economically unacceptable, as well as unfair and avoidable. Policies made in all sectors can have a profound effect on population health and health equity.” It called on governments to fulfil their obligations to their peoples’ health and wellbeing. Both the Statement and the Framework for Country Action can be found here.
The Seventh Global Conference on Health Promotion, Nairobi, Kenya 26-30 October 2009, produced a Call to Action, whichidentified key strategies and commitments urgently required for closing the implementation gap in health and development through health promotion.
The sixth Global Conference on Health Promotion – Thailand; 7-11 August 2005 – produced theBangkok Charter (above)
The Fifth Global Conference on Health Promotion: Bridging the Equity Gap, Mexico City, June 5th, 2000. Signed by Ministers of Health, the brief 8-pointMexico Ministerial Statement for the Promotion of Health: From Ideas to Action acknowledges the duty and responsibility of governments to the promotion of health and social development.
The Fourth International Conference on Health Promotion: New Players for a New Era- Leading Health Promotion into the 21st Century, meeting in Jakarta from 21 to 25 July 1997, came at a critical moment in the development of international strategies for health. It was the first to be held in a developing country and the first to involve the private sector in supporting health promotion. The Jakarta Declaration on Leading Health Promotion into the 21st Century identified the directions and strategies needed to address the challenges of promoting health in the 21st century.
The Third International Conference on Health Promotion, Sundsvall, Sweden 9-15 June 1991: Supportive Environments for Health. This conference called upon people in all parts of the world to actively engage in making environments more supportive to health. Examining today’s health and environmental issues together, the Conference points out that millions of people are living in extreme poverty and deprivation in an increasingly degraded environment that threatens their health, making the goal of Health For All by the Year 2000 extremely hard to achieve. The way forward lies in making the environment – the physical environment, the social and economic environment, and the political environment – supportive to health rather than damaging to it. The Sundsvall Statement on Supportive Environments for Healthis a call to action, directed towards policy-makers and decision-makers in all relevant sectors and at all levels.
The Second International Conference on Health Promotion in Adelaide, South Australia, 5-9 April 1988, continued in the direction set at Alma-Ata and Ottawa, and built on their momentum. Two hundred and twenty participants from forty-two countries shared experiences in formulating and implementing healthy public policy. The resulting Adelaide Recommendations on Healthy Public Policyreflect the consensus achieved at the Conference.
The first International Conference for Health Promotion in Ottawa, Canada 21 November 1986 produced the Ottawa charter (above)
The WHO has links to all its past conferences on health promotion.
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.”
Dr Vollant who grew up in the Côte-Nord region of Quebec was exposed at a young age to the traditional teachings of his grandfather, which were marked by the importance of community values.
Sir Mason who was born in 1938, of Rangitane, Ngāti Kauwhata and Ngāti Raukawa descent, grew up in Feilding, where his hard-working parents showed him the importance of a strong work ethic.
Mr Kruger is a Māori advocate and social and political analyst who has dedicated his career to the development of his iwi. From the Ngāti Koura, Ngāti Rongo and Te Urewera hapū of Tūhoe, Mr Kruger was instrumental in securing the largest Treaty of Waitangi settlement to date ($450 million) for the Central North Island Iwi Collective.
For the first time, the World Conference on Health Promotion will be held in New Zealand from April 7-11, 2019. Rotorua is the venue. The conference provides rare opportunities for New Zealand health promoters, other health professionals, policy makers and others whose work impacts directly on our health and wellbeing, to share knowledge with colleagues from around the world, and to co-construct health promoting pathways into the future. 
What makes it more challenging is that you have to build an international organisational structure at three levels – global, national and local – to plan and manage across different time zones with colleagues around the world. Put on top of that the fact that you have to have keynote speakers from the four official languages of the conference – English, French, Spanish, and Te Reo Maori, and consider gender balance, linguistic & ethnic diversity, and age. But thanks to technology, our 100 HPF member organisations, our professional conference company (The Conference Company), and the help of Tourism New Zealand, as well as our co-organiser, IUHPE, we are managing well, with the usual hiccups, of course. Challenges are good and timely incentives to help ensure you do your utmost best and become more innovative and prudent at the same time.
Hosting the conference is the latest development of that professionalrelationship with IUHPE. But there are other developments such as having our Deputy Executive Director, Trevor Simpson, as the Chair of the International Network for Indigenous Health Promotion Professionals (INIHPP) of IUHPE. HPF is also leading the work for New Zealand health promotion to become part of the global accreditation framework for health promotion, recently established by IUHPE. IUHPE has a standing work relationship with WHO, which is a partner of the conference, along with the Secretariat of the Pacific Community (SPC), being led by Dr Colin Tukuitonga, and the Australian Health Promotion Association.
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