campaigns for smokefree carsNorthland Health Provider Te Hiku Hauora is leading a campaign to encourage Government to legislate against smoking in cars carrying children under 18 years of age. Cathy Cherrington, manager of Te Hiku Hauora’s health promotion team in Kaitaia presented a 2000 signature petition to co-leader of the Maori party Marama Fox earlier this month. The petition calls on Government to protect children agains passive smoking in cars. New rules in Britain now ban smoking in vehicles with children on board. The petition calls for a similar ban here and will be presented to Parliament by Ms Fox. Marama Fox – an ex-smoker and anti smoking campaigner – was delighted to accept the petition. She said she will accept support for her battle to eliminate smoking in New Zealand by 2025 from wherever it comes.
“It seems inevitable […] that an SSB tax will be a major part of reclaiming our children’s health, considering the growing public support for its implementation,” say the authors of the NZMJ paper. “The only question that remains is when.”To read the full article, click here. You will need to subscribe to the NZMJ. OECD, OECD Obesity Update 2014. 2014. www.oecd.org/health/ obesity- update.htm Singh G, Micha R, Khatibzadeh S, Lim S, Ezzati M, Mozaffarian D. Estimated Global, Regional, and National Disease Burdens Related to Sugar-Sweetened Beverage Consumption in 2010. Circulation. June 29, 2015. Jo Lawrence-King
Equity at the Centre Conference in Alice Springs (4-5 September 2014), HPF Senior Health Promotion Strategist Karen Hicks reports on some of the presentations made during the two day event. “Austerity kills” – that was the claim of Sharon Friel, Professor of Health Equity at the Australian National University, Canberra in her presentation Power and People: a game plan for health equity in the 21st Century. “Health promotion is about freedom and empowerment; giving people a voice,” she said. “What is shaping our everyday living resources is power.” She characterised budget cuts as ‘structural violence’ that threaten equity and wellbeing. “Injustices are everywhere and they affect peoples’ health. These injustices can and should be eliminated. ….. How we understand, frame, communicate and engage around matters to do with health equity guides the types of actions that are taken, or not, to improve the lives of all groups in society.” “Health promotion is about freedom and empowerment; giving people a voice,” she said. “What is shaping our everyday living resources is power.” She characterised budget cuts as ‘structural violence’ that threaten equity and wellbeing. Asked what health promoters can do in their everyday practice, Prof Friel said “We need to think about our work with an equity lens on every day; otherwise we are not addressing the social determinants of health.” Prof Friel’s game plan for health promoters consisted of three steps: 1. Keep equity at the centre. Rather than focusing on selective social determinants of health (such as housing or education) we need to keep equity as a whole at the centre of everything we do. 2. Frame your messages to fit your audience. Realpolitik (based on power and on practical factors) rather than ideology is the way to go in the current Australian climate, for example. Data is powerful. Evidence will support the value of health promotion and initiatives. Social media is a powerful way to create a movement. It will succeed where traditional media often meet with resistance from the industry that fund them. 3. Release the power. The strength of health promotion lies in its ability to work collaboratively with a range of people and disciplines. We can release the power of these networks by: Recognising the skills and capacity of our workforce and empower them to make a difference. Foster relationships with a wide range of complementary disciplines to create a team effort. About Sharon Friel Sharon Friel is Professor of Health Equity, incoming Director of Regulatory Institutions Network (RegNet) and Director of the Menzies Centre for Health Policy, The Australian National University, Canberra She is is from the east end of Glasgow. After leaving Scotland in 1990, she pursued an academic career in public health following a brief stint making carpets in Germany and smelling beer in England. Sharon Friel is currently Professor of Health Equity at the National Centre for Epidemiology and Population Health and Director of the Menzies Centre for Health Policy at the Australian National University. Between 2005 and 2008 she was the head of the Scientific Secretariat, based at University College London, of the World Health Organisation’s global Commission on Social Determinants of Health. In 2010 she was awarded an Australian Research Council Future Fellowship to investigate the interface between health equity, social determinants and climate change (particularly through food systems and urbanisation), based at the National Centre for Epidemiology and Population Health, ANU. Before moving to Australia, she worked for many years in the Department of Health Promotion, National University of Ireland, Galway. She is co-founder of the Global Action for Health Equity Network (HealthGAEN), a global alliance concerned with research, training, policy and advocacy related to action in the social and environmental determinants of health equity, and chairs Asia Pacific-HeathGAEN. Jo Lawrence-King 10 September 2014Following her attendance at the
- How Roma communities are responding to inequalities;
- The adaptation of health promotion and disease prevention interventions for migrant and ethnic minority populations;
- The Glasgow Declaration;
- Learning from each other – where health promotion meets infectious diseases;
- Public health monitoring and reporting;
- Changing your health behaviour – regulate or not;
- Developing the public health workforce;
- Building sustainable and resilient health care systems;
- Leaving a legacy in Glasgow;
- Conclusions; and Eurohealth Monitor.
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 ….. “The
Now More Than Ever outlines Primary Healthcare (PHC) reforms to mee the health challenges of today’s 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
2014 Child Poverty Monitor released this month shows that reducing child poverty will require bold and sustained commitment from government. Child Poverty Action Group welcomes the latest Child Poverty Monitor and congratulates the Office of the Children’s Commissioner, the JR McKenzie Trust and the University of Otago’s NZ Child and Youth Epidemiology Service on their commitment to measuring and monitoring child poverty. The Monitor brings together all the known statistics about child poverty in Aotearoa New Zealand with current statistics on health outcomes. CPAG health spokesperson Dr Nikki Turner says, “The 2014 Child Poverty Monitor shows there has been little change over the past year and far too many New Zealand children still live in poverty. This problem is too difficult to be addressed by piecemeal measures – substantial commitment is needed to improve incomes and housing for families with children.” Nikki Turner says, “We know childhood poverty has life-long consequences for people’s health and well-being. For children to stay healthy, families need enough money for affordable, decent and stable housing, nutritious food, doctor’s visits and prescription fees. They need cooking and laundry facilities, access to hot water, soap, clean towels, clothing, shoes, bedding and basic first aid. Income adequacy is pivotal and insufficient money continues to affect children’s health, as the statistics in the Child Poverty Monitor show. There are a range of issues to be tackled and some progress is being made, such as the reduction in costs for GP visits, but income adequacy is an urgent need, particularly for our most vulnerable children.” Child Poverty Action Groups calls on the government to lead a cross-party agreement on an action plan to reduce child poverty, including: • Treating all low-income children equally. • Improving incomes significantly for low income families and access to affordable housing and healthcare for all children • Ensuring an accelerated rate of poverty reduction for Mäori and Pasifika, so they achieve equity with other children. • Introducing child poverty legislation to ensure proper, regular measurement of child poverty on a range of measures. In addition, targets and timelines for child poverty reduction should be set with annual reporting to Parliament on progress towards these targets by the responsible Minister.The
- health equity
- child poverty and child health
- climate change
- nutrition and physical activity
- workforce development
- indigenous health promotion and health issues.
The equity action spectrum: taking a comprehensive approach Alcohol and inequities Injuries and inequities Obesity and inequities Tobacco and inequitiesThe 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.
Public Health Service Health Promotion Tier Two Service Specification, published by the National Health Board Business Unit, the MoH emphasised the importance of tackling the factors that determine health: “Because of the focus on determinants of health, there should be less focus on the activities in personal knowledge and skills section, and a move toward approaches such as health in all policies,” it says. The Health Promotion Forum of New Zealand (HPF) welcomed this new emphasis. “It is encouraging to see the Ministry recognise the foundations of health promotion in the social factors that determine the hauora of an individual, community or population,” says HPF Executive Director Sione Tu’itahi. “We will certainly be putting forward a submission to the Ministry to encourage this crucial approach to hauora and would encourage all organisations in health promotion to do the same.” As the National leaders in health promotion, HPF has 25 years’ experience in the area; providing training and capacity-building to thousands of individuals and organisations. Tu’itahi continues: “Health promotion is most effective when all five strands of the Ottawa charter are applied in an integrated way. HPF would love to work alongside the Ministry to help it gain the best outcome from this crucial work here in Aotearoa New Zealand.” As part of the Ministry’s greater focus on the health inequity and the social determinants of health, Health Minister Hon Tony Ryall recently announced a proposed new initiative Healthy Families New Zealand. See our news articleabout the initiative here. The consultation document is part of a review of public health service specifications. Jo Lawrence-King 18 March 2014In a consultation draft published in 2013, the Ministry of Health (MoH) renewed its commitment to health promotion as one of five core functions for public health. It is inviting submissions on the service specification by 16 May. In the
PublicationsThe Ministry of Health has an extensive collection of publications about child health in New Zealand These include the 1998 Child HealthStrategy. Child health publications
Influences in Childhood on the Development of Cardiovascular Disease and Type 2 Diabetes in Adulthood: An Occasional Paper (2005)This paper examines the medical literature on the childhood determinants which correlate to adulthood diabetes and cardiovascular disease in an effort to inform policy decisions and program implementation in the health sector. It also provides important information for health practitioners who are striving reduce the chronic disease trends for adults in NZ. Influences in Childhood
Health Eating Healthy Action: Strategic Framework (2003)This strategy calls for a more integrated and multi-sectoral approach to addressing nutrition, physical activity and obesity, and highlights the importance of both individual behaviour and our environment. Strategic Framework
Children and Young People: Indicators of Wellbeing in New Zealand 2008This the second indicator report published by MSD highlighting indicators of social well-being of children and young people, how these have changed and the status of health for different child and youth groups in the current population. MSD has utilized the findings from this report to advise the UNCROC report to be submitted to the United Nations. Summary of findings Full Report
Raising Children in New Zealand: The Influence of Parental Income on Children’s OutcomesThis report examines the impact parental income has on many child outcomes including health and well-being. By focusing on the correlation between net family income and child outcomes this report contributes in advising public policy on income support. Influence of Parental Income
The Social Report 2010: Indicators of Social Well-being in New ZealandThis site provides in-depth information on the social health and well-being status of New Zealand society, through the use of indicators to monitor trends over time and to make global comparisons. The site also contains the full 2008 Social report and areas dedicated to the different indicators. The Social Report 2010
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 PromotionThe Eighth Global Conference on Health Promotion: Health in all Policies. Helsinki, Finland 10-14 June 2013. Two items were produced from this conference: the Helsinki Statement and a Framework for Country action. Thestatement asserts that “health inequities between and within countries are politically, socially and economically unacceptable, as well as unfair and avoidable. Policies made in all sectors can have a profound effect on population health and health equity.” It called on governments to fulfil their obligations to their peoples’ health and wellbeing. Both the Statement and the Framework for Country Action can be found here. The Seventh Global Conference on Health Promotion, Nairobi, Kenya 26-30 October 2009, produced a Call to Action, whichidentified key strategies and commitments urgently required for closing the implementation gap in health and development through health promotion. The sixth Global Conference on Health Promotion – Thailand; 7-11 August 2005 – produced theBangkok Charter (above) The Fifth Global Conference on Health Promotion: Bridging the Equity Gap, Mexico City, June 5th, 2000. Signed by Ministers of Health, the brief 8-pointMexico Ministerial Statement for the Promotion of Health: From Ideas to Action acknowledges the duty and responsibility of governments to the promotion of health and social development. The Fourth International Conference on Health Promotion: New Players for a New Era- Leading Health Promotion into the 21st Century, meeting in Jakarta from 21 to 25 July 1997, came at a critical moment in the development of international strategies for health. It was the first to be held in a developing country and the first to involve the private sector in supporting health promotion. The Jakarta Declaration on Leading Health Promotion into the 21st Century identified the directions and strategies needed to address the challenges of promoting health in the 21st century. The Third International Conference on Health Promotion, Sundsvall, Sweden 9-15 June 1991: Supportive Environments for Health. This conference called upon people in all parts of the world to actively engage in making environments more supportive to health. Examining today’s health and environmental issues together, the Conference points out that millions of people are living in extreme poverty and deprivation in an increasingly degraded environment that threatens their health, making the goal of Health For All by the Year 2000 extremely hard to achieve. The way forward lies in making the environment – the physical environment, the social and economic environment, and the political environment – supportive to health rather than damaging to it. The Sundsvall Statement on Supportive Environments for Healthis a call to action, directed towards policy-makers and decision-makers in all relevant sectors and at all levels. The Second International Conference on Health Promotion in Adelaide, South Australia, 5-9 April 1988, continued in the direction set at Alma-Ata and Ottawa, and built on their momentum. Two hundred and twenty participants from forty-two countries shared experiences in formulating and implementing healthy public policy. The resulting Adelaide Recommendations on Healthy Public Policyreflect the consensus achieved at the Conference. The first International Conference for Health Promotion in Ottawa, Canada 21 November 1986 produced the Ottawa charter (above) The WHO has links to all its past conferences on health promotion.
position statement uses the term equity in preference to equality because it better recognises that people differ in their capacity for health and their ability to attain or maintain health. Consequently, equitable outcomes in health may require different (i.e. unequal) inputs to achieve the same result. This is the concept of vertical equity (unequal, or preferential, treatment for unequals) in contrast to horizontal equity (equal treatment for equals).”“This