It is a pleasure to invite you to join us in Otautahi Christchurch for the 2017 Public Health Association New Zealand Conference, to explore the connections and values of public health as we continue to build a healthier, stronger Aotearoa New Zealand.
This article originally appeared on Community Scoop. It was written by Warren Lindberg, our CEO.
Minister of Health Jonathan Coleman said back in April, “There is still no evidence a [sugar] tax would actually decrease obesity. There is no simple answer otherwise people would have tried it”.
We can agree with the part of his statement that says “there is no simple answer”, but there’re also quite a few people in the health sector determined to help the Minister find a range of answers – some complex, others quite simple.
I would also go so far as to agree that taxes on things people like, such as sugary drinks, don’t work very well if people don’t understand why they should have to pay more for them. If the potential benefits are not understood or valued – consumers may rebel. There are still enough politicians around who remember what happened in response to the Labour Government’s ‘black budget’ of 1958 that increased taxes on beer, cigarettes and petrol..
However, there is increasing evidence that the effect of tax on price has a role to play. A new study (in which Otago University’s professor Tony Blakely was a co-author) published recently in the journal Lancet Public Health “adds to the growing body of evidence that fiscal policy tools [taxes or levies] applied to sugar-sweetened beverages (SSBs) may benefit health, particularly child health, and may save costs for health systems”. Implications of the study for New Zealand are discussed by Tony Blakely in the Otago University’s Public Health Expert blog, December 16.
Meanwhile, a coalition led by the NZ Dental Association, supported by about a dozen non-government organizations, including the National Heart Foundation, Hapai te Hauora Tapui and the Public Health Association, has developed a new strategy that includes tax, but has a quite different starting point.
The consensus statement adopted by the Sugar-free Drinks Coalition starts with the need for consumers – individuals, families and communities – to be able to quantify the problem for themselves.
I think the problem of poor oral health and obesity among children are generally well understood. Both have lifetime health consequences, both are preventable and both impose avoidable costs on the health system.
Sugary drinks are cheap, readily available, widely advertised and the major source of sugars consumed by children and young people. Excessive consumption of sugary drinks is associated with dental caries, weight gain and obesity, so they must be an obvious target for change.
What is not so well understood is how much sugar is in our food and drink – and technical measures in grams per millilitre are not much help. The first step is simple: we need the information expressed in a familiar form – teaspoons.
The World Health Organization recommends a daily maximum of ten teaspoons of free sugar for kids – 3 teaspoons for littlies – and 12 for adults. A 600ml bottle contains about 16 teaspoons of sugar, and a regular 375ml can has about 10.
The strategy also includes some things Government needs to do to help. Mandatory teaspoon icons on packaging, regulation of marketing to children, a media campaign – and an excise tax – would all help.
But I think that starting with the humble teaspoon can empower individuals and families to make their own most important decisions to improve their health.
There are unacceptable levels of child poverty in New Zealand and not enough progress has been made to reduce the numbers says Warren Lindberg, CEO of the Public Health Association of New Zealand, in response to the release today of the Child Poverty Monitor 2016.
The Public Health Association, Health Promotion Forum and College of Public Health Medicine support calls by Children’s Commissioner Andrew Becroft for an urgent plan of action to cut the numbers of children living in poverty.
The new report shows that thousands of kiwi children are experiencing hardship due to poverty. At a time when our economy is growing it is shocking to learn that 14% of children are living in material hardship while 8% (85,000) of children are experiencing severe material hardship, living in households where they miss out on 9 or more essential items.
It is not fair that so many children living in our country have to go without the things every child should have a right to: warm, safe, healthy homes; access to medical care; good quality education and access to healthy food.
Children should not have to live in cold and damp homes which we know lead to higher rates of infectious disease such as rheumatic fever. They should not have to live in a car or in overcrowded conditions where they find it hard to do their homework. It is not fair that kids should miss out on medical care because there is no way for them to get to the doctor, yet that was the case for an estimated 26,000 children in 2015, while in that same period 197,000 children had an unmet primary health care need due to poverty.
There are lifelong and intergenerational consequences for children living in severe and prolonged poverty. They will grow up with no expectation of a better life because they have never known anything but hardship and have not had even their basic needs met.
The PHA, Health Promotion Forum and College of Public Health Medicine urge the government to honour its commitment to the United Nations Sustainable Development Goals which it signed up to in 2015. SDG 1 is to end poverty in all its forms everywhere with a target of halving poverty by 2030. The rates of child poverty in New Zealand have stayed pretty much the same since 1994, which clearly indicates that a business as usual approach is not going to work. The PHA’s Ceo, Warren Lindberg, commented today that, “We’re pleased to note that the new Prime Minister has promised a Government that will ensure 'the benefits of growth are widely shared’.”
This statement is endorsed by:
• Warren Lindberg, CEO of the Public Health Association of New Zealand
• Felicity Dumble, President Elect of the New Zealand College of Public Health Medicine
• Sione Tu'itahi, Executive Director of the Health Promotion Forum of New Zealand
The Public Health Association of New Zealand is right behind the new Consensus Statement on sugary drinks being launched today at Brooklyn School by the New Zealand Dental Association.
Warren Lindberg, Public Health Association CEO, says all New Zealanders should know that children get a quarter of their daily sugar intake from sugary drinks.
“We know there’s a strong association between sugar consumption and both dental caries and obesity. One third of Kiwi children are overweight, and 29,000 children under the age of 14 had teeth removed in 2014/15 due to tooth decay”.
An average can of fizzy drink contains about nine teaspoons of sugar; the WHO recommends a daily maximum intake of nine teaspoons for kids.
The CEO of the Public Health Association, Warren Lindberg, said, “The new Consensus Statement, being launched today, rightly targets the fact that few of us have any idea of how much sugar is contained in our food and drink – and that technical measures in grams per millilitre are not much help for families”.
“There is no longer an argument about the health problems associated with obesity and oral health – especially in children”, says Lindberg. “Sugary drinks which have no health value are an obvious target for change.“
The PHA strongly supports the New Zealand Dental Association’s call for action to reduce harm caused by excessive consumption of sugar-sweetened drinks.
“We value the Dental Association’s leadership on this issues, and we’re proud to be joining with a dozen national organisations to issue this shared call to action.”
This article originally appeared on Community Scoop. It was written by Warren Lindberg, our CEO.
I generally sympathise with local bodies when the State imposes responsibilities without giving them the cash required to implement its bidding, but the drinking water crisis in Hawke’s Bay cries out for a greater sense of responsibility from Wellington. This world-class stuff-up has thrown a strong light on a long-neglected public health issue that has made a third of the population of Havelock North sick, and is forcing us to face the fact that what comes out of the kitchen tap can no longer be taken for granted.
The campylobacter in Havelock North’s water supply is not a new problem, just an inevitability that has been ignored. As John Pfahlert, Chief Executive of Water NZ, a not-for-profit representing the water industry, says, “It was always going to be a case of when, not if, a community in New Zealand would be struck down with campylobacter. Supplying a whole community with untreated water has always been a calculated risk.”
Drinking water standards are set by the Ministry of Health, while local authorities are responsible for supply and ensuring the quality of water for their populations. In this case it involves both the Hawke’s Bay Regional Council, responsible for region-wide policy and infrastructure, and Hastings District Council, responsible for district-level services and supply. Both are charged by the Local Government Act to ensure the wellbeing of their population, including the requirement to “take all practical steps to comply with drinking water standards”. Compliance with the standards is monitored by the Ministry through the Medical Officers of Health employed by the local DHB. The Medical Officers are then responsible for tracing the source of any outbreak, and the DHB, of course, has to treat the victims of poor performance. In this case more than 5000 people seeking treatment from an already stretched health service.
It’s still not clear whether the source of contamination was a specific problem – possibly poorly maintained artesian bores in Havelock North – or a more difficult to trace seepage of animal faeces into the river and the water table.
But what also went wrong was the lack of clear accountability among the various agencies that share responsibility, but not enough to ensure the drinking water standards are robust, monitored and actually met. What’s needed is one agency that knows what’s required, has the resources, and an uncomplicated mandate to protect the public’s health – central Government.
Decisions about the risks and benefits of adding chlorine (and fluoride) to our drinking water need to be based on robust science, standardised procedures and competent health protection officers. Sharing out responsibility among a number of local agencies, each with different priorities and capabilities, is no way to protect something so fundamental to the health of the whole population.
The health system has the people capable of doing this job to a very high standard. It is a necessary job, mostly taken for granted – so long as no one falls ill. The Ministry of Health needs the certainty of knowing it has the mandate, and is not beholden to popular causes and political negotiations. And we deserve to know who’s in charge when something goes wrong.
Be inspired and focused to make a difference in public health, and have the skills and courage to act...
The Public Health Leadership Programme (PHLP) is designed for people working in public health. The programme is funded by the Ministry of Health and has been developed following extensive consultation with the sector. PHLP builds leadership competencies identified as important for leaders in public health. The programme has been developed by Catapult (leadership and organisational performance specialists) and Quigley and Watts (public health specialists).
PHLP allows participants to discover their leadership potential and equips them with practical and tested leadership tools and resources. The programme generates immediate and lasting benefits for participants, those they lead, and for public health.
Each programme has six days spread over several months. In 2017 one programme will be offered in Wellington and one in Auckland.
Applications for the 2017 Public Health Leadership Programme (PHLP) are now open.
The programme dates are:
Programme 1 (Wellington):
21 - 22 June, 23 - 24 August, 1 - 2 November 2017
Programme 2 (Auckland):
28 - 29 June, 30 - 31 August, 8 - 9 November 2017
Anyone working in the public health sector may apply for a place on the programme. Applications close at 5pm Wednesday 1 February 2017. For more information, application criteria and online applications go to http://www.health.govt.nz/our-work/health-workforce/public-health-leadership-programme. Places are limited to 36 in total. Applicants not previously accepted are encouraged to apply again.
Here’s what participants said about the programme:
The greatest gift this Programme has given me is the permission to speak to my values and the authority to stand on and lean into my values as my truth. I have many challenges in my daily life both professionally and personally but I stay mindful in my approach and learning as a result of the teaching through the Public Health Leadership Programme.
Thank you for providing such a valuable programme. It is the best professional development I have been involved with and so pertinent to my role within public health.
I have found this course to be enlightening, inspiring and upskilling. The confidence I have gained has enabled me to step up and take a much bigger leadership role in public health, and provided me with an endorsement and vision to take into the future. Thank you so much for the opportunity to be part of this.
Catherine Healy and Anna Reed are together the PHA’s 2016 Public Health Champion, in recognition of their decades of work in advocacy for the rights of sex workers, sexual health and HIV prevention.
Each has been nominated from a different PHA branch, but they have worked so closely together – although each with a very different style – for such a long time, it seemed to be a good idea to acknowledge their work together.
Anna and Catherine receive their PHA Champion Awards
Catherine is the national coordinator and a founding member of the New Zealand Prostitutes' Collective (NZPC). The NZPC is an influential boutique NGO set up by sex workers in 1987 to promote better working conditions for themselves and their peers. Since 1988 it has had a contract to promote sexual health as part of the Ministry-funded response to HIV/AIDS. Catherine has led and built NZPC from an informal peer group to a credible public health service provider, providing confidential sexual health and testing services and health promotion for sex workers and their clients.
Anna has been the co-ordinator of the Christchurch branch of NZPC since soon after the collective was set up. In this way, their leadership has been pivotal in preventing the spread of HIV, advocating for healthy public policy and re-orientating the health services.
Catherine and Anna were central figures in the long campaign for decriminalisation of sex work that was won with the passing of the Prostitution Reform Act 2003 on a conscience vote and a majority of one. The legislation included a requirement for a review after five years, to determine whether the fears of its opponents that the streets would be swarming with prostitutes, and a committee was established to conduct the review. In 2007 the review, conducted by Otago University’s Gillian Abel, Lisa Fitzgerald and Cheryl Brunton, concluded as Catherine and the NZPC had predicted, that violence against sex workers had been reduced, conditions of employment in brothels improved, trafficking was minimal and STIs reduced, and there has been no HIV diagnoses attributable to sex workers.
Gillian Abel, Lisa Fitzgerald and Catherine Healy subsequently co-edited the book Taking the Crime Out of Sex Work: New Zealand Sex Workers' Fight for Decriminalisation. The book argues that decriminalisation has resulted in better working condition for prostitutes as well as a successful response to the HIV/AIDS and STI epidemics. Because New Zealand was the first country in the world to decriminalise all sectors of sex work, the NZ Prostitution Reform Act has become central to debates, not only in NZ, but also around the world about the legal status of sex workers, gender politics, public health and sexual morality.
The NZPC model that Catherine and Anna worked to develop is held in high regard by sex workers globally and by a range of governments and health agencies. Catherine continues to act as a consultant for the World Health Organization in relation to HIV prevention throughout East Asia. This year she has recently returned from a return visit to Vietnam, following an initial consultancy in 1995, and a delegation of Vietnamese officials to NZ in January.
Both receive frequent invitations to share their experiences, including the recent series on Radio New Zealand’s Insight programme: The Oldest Profession. A normal job? The programme does its best to take a neutral stance, but it’s very hard not to be persuaded that the NZPC and the NZ Prostitution Reform Act are outstanding achievements in promoting and protecting the health of New Zealanders. As Anna noted at the end of her interview: “in other times we were regarded highly as wise women”.
Opening the PHA’s day-long annual meeting, Emeritus Professor Robert Beaglehole addressed the question: “What does public health in this country – in fact in all countries – need now?”
He delivered a fairly tough assessment of where public health is globally and nationally and what the PHA can contribute over the next few years. “There is a public health crisis,” he said. “And we are relevant.”
He noted that there had been progress in that life expectancy is increasing by about three months each year, and yet the gap between Maori and others has not closed - a major, unrecognised scandal. He noted national progress on tobacco control, led by Dame Tariana Turia – and yet, again, unequal outcomes, including child poverty, poor housing, and childhood obesity.
As a movement, he described the PHA as “voiceless, invisible” and dependent on the Ministry of Health, which drains our energy on organisational maintenance. And yet he sees the potential for the PHA to be a strong, independent organisation “driving radical collaboration, speaking with a strong public health voice, harnessing science to create social change”.
He sees our diverse membership, connections and vision as strengths to build on.
In summary, Professor Beaglehole, who, together with his life-partner Dr Ruth Bonita, was honoured as the PHA’s public health champion in 2010, challenged us to be the strong independent voice we want to be - more relevant, flexible and opportunistic. “We are more powerful than we imagine,” he said. “We can make a slower and kinder world.”
Professor Beaglehole’s assessment was complemented by the next guest speaker, Helen Leahy, CEO of Te Pūtahitanga o Te Waipounamu, who spoke on the potential of Whānau Ora. Helen was previously Senior Ministerial Adviser for the former Minister for Whānau Ora, Dame Tariana Turia. More recently she had been a Specialist Advisor, Strategy and Influence at Te Rūnanga o Ngāi Tahu, and author of Crossing the Floor: the Story of Tariana.
Helen show-cased how Te Pūtahitanga is working to achieve its goal – Māu te ara, ki ora ai te whānau (your pathways empower whānau to thrive) and affirmed the positive mood that had emerged from the Māori caucus anniversary hui.
In addition to anecdotes illustrating the change that the Whānau Ora approach brings, Helen brought with her some seed packets to share, which she said, represent some of the learnings gained from the exercise in transformation whānau throughout the South Island have championed.
The seed packet is driven by three simple ideas:
Concluding, Helen said, “Our greatest opportunity and challenge lies in creating and fiercely protecting the optimum environment for whānau to
Download Helen's speech notes and presentation.
The 2016 recipient of the Tū Rangatira mō te Ora award is Metiria Turei.
Metiria is from Ngāti Kahungunu ki Wairarapa, Ati hau nui a Paparangi, and Rangitāne me Raukawa.
Metiria was chosen for her long-standing commitment to social justice, her work to reduce inequality and her advocacy for Māori development.
In particular, the PHA wanted to recognise the passion and energy Metiria has put into advocating for tamariki Māori and all New Zealand children, in her work to reduce child poverty.
We also acknowledge her active commitment to making Te Tiriti o Waitangi live in political and community action.
Metiria has been Green Party Co-leader since 2009. But you may not know that she has firsthand experience of the challenges Māori whānau face. As a young single Mum, Metiria used the training incentive allowance to put herself through law school. After graduating in 1999 she worked as a commercial lawyer before entering Parliament in 2002.
Waatea News: Anti-poverty advocacy earns Turei public health tohu
Green Party: Metiria Turei awarded for her work on Māori hauora
Last week's Bulletin featured a story from the New Zealand Herald (Candidates could change voter apathy, 16 September). The story purports to be part of a campaign from Local Government New Zealand (LGNZ) to increase the vote.
It described three demographics: young people, ethnic minorities, poor and uneducated as "typically apathetic voters" for staying away from the polls.
This infuriates me. LGNZ knows that, of the 58 percent of the population who did not vote last time, the largest proportion (31 percent) did not vote because they "want to vote but say it's too hard to find the information they need to make an informed decision." Just read this Radio NZ story from 12 September: Young voters feel locked out of local body politics
Me too. I have every sympathy with the young, recent immigrants, and people too poor to have an address for the postal vote to be delivered to, or the uneducated (that's four demographics, as you don't have to be poor to be uneducated or uneducated to be poor). Actually there's a significant category of educated, interested and possibly even influential voters confronted with lists of people we've never heard of, and whose views on important issues we don't know. I've been involved at the fringes of politics at local and central government level, public service and community activities for more than 50 years, and selecting from these lists of random strangers does not encourage me to vote.
In order to "lift voter numbers above 50 percent nationally for the first time since 1998" (LGNZ's campaign objective), instead of insulting us, it might be a good idea for the media and LGNZ to think about how we might become better informed.
There's no point in haranguing us about our duty to vote in the two months after the candidates are announced. We need to know about the big issues facing our electorates well ahead of that.
This would require our mainstream media to overcome its corporate apathy about local New Zealand, and work with LGNZ, the universities and activist groups such as Generation Zero, Grey Power and the PHA, to give us much more in-depth analysis of local issues. That would mean once the candidates are declared we can begin to interrogate where they stand.
Some help need not be too challenging. Just start with a single site where voters can go to find what ward/electorate etc they're in, who the candidates are and a little about them – instead of having to trawl through multiple websites. I'm sure the Minister's changes (see below) are useful, but they won't address my concerns.
Thankfully, Judith Aitken is onto a much more radical solution for the most unnecessarily complicated and ineffectual election of all – DHBs.
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