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This month’s edition of Healthcare Review – OnlineTM is the second in a two-part series examining public health in New Zealand and Australia.
The series addresses public health in its fullest sense, incorporating the range of activities related to health promotion, health protection and disease prevention.
This edition expands on the coverage presented in the July edition, considering public health policy both within and outside New Zealand.
Complementing the paper in the July edition from Dr Gillian Durham, which considered public health policy in New Zealand, Professor Don Nutbeam, Director and Professor of Public Health, and Marilyn Wise, Executive Director, Australian Centre for Health Promotion, University of Sydney, provide an Australian perspective on the role of policy in health promotion.
Nutbeam and Wise provide an historic viewpoint on the role that public policy has played internationally in influencing the health of populations, emphasising the shift in focus from communicable to non-communicable disease over time and the more recent role of the Ottawa Charter for Health Promotion as a contemporary model for effective public health action. They consider shifts in Australian public policy to align with the public health strategies promoted through the Ottawa Charter and emphasise the fact that public policy to promote health is beyond the ’control’ of the health sector, despite the health sector’s considerable influence as a key stakeholder.
In summarising the Australian experience, Nutbeam and Wise identify several prerequisites that appear to determine the likely effectiveness of public policy as a health promotion strategy.
The paper from Professor Alistair Woodward, Professor of Public Health, Dr Tony Blakeley, Registrar Public Health, Philippa Gander, Associate Professor, and Philippa Howden-Chapman, Senior Lecturer, at Wellington Medical School, University of Otago, considers regulation in other areas that impact on health including occupational health, environmental health, housing policy, etc.
The paper sets out the current state of public health in New Zealand, incorporating discussion of the known underlying causes of disease and injury and the implications for public health actions including regulation. The important role of regulation outside the health sector is considered. In keeping with Nutbeam and Wise, Woodward and his colleagues emphasise that interventions confined to the health sector will have limited effect in improving the health of populations.
The current risk-based approach to regulation in New Zealand is discussed, along with its strengths and weaknesses. The limits of regulation are illustrated using the example of recent efforts to control illness resulting from hepatitis B infection.
In a later addition to the series, Val Orchard, Science and Research Manager at the Institute of Environmental Science and Research Limited (ESR) will expand the discussion begun by Woodward, considering in more detail the role of environmental health issues in disease prevention and health promotion.
