Thoughts on NZ Adopting an Aussie Community Health Programme … and Forthcoming Nutrition Policy Events

Professor Tony Blakely and Associate Professor Nick Wilson

Late last year Health Minister Tony Ryall visited Victoria, Australia, to examine their “Healthy Together Victoria” programme. This week, the Prime Minister announced that NZ will adopt this programme, and it will be known as “Healthy Families New Zealand”. This blog post gives a high level overview of this initiative and anticipates a series of four forthcoming blog posts here at Public Health Expert.

The Australian programme has healthy nutrition as a large focus, but it also extends to include alcohol, physical activity and smoking. Actually, large chunks of it sound like the old Health Eating – Healthy Action programme.

 

So, what is the “Healthy Together Victoria” programme that, apparently, the NZ Government is adopting? In short, solid health promotion at the community-level, right out of the Ottawa Charter top drawer – it would seem.

The programme involves health promotion outreach into families, workplaces and communities. In particular, it involves local government, health promotion agencies and stakeholders coming together to devise strategies and actions. This has real potential, and goes upstream a bit. For example, rather than chastising kids and their parents for drinking sugary drinks at the local sports club, the approach might be to work with the sports club committee and sponsors to understand why sugary drinks are provided, and change that practice.

All good so far. In lieu of Boyd Swinburn’s forthcoming analysis on Public Health Expert, we will simply make three remarks in this blog post.

First, this type of health promotion activity requires a skilled health promotion workforce. Indeed, the Healthy Together Victoria programme says as much:

“Through investment in local partnerships and a skilled health promotion workforce, these areas are finding local solutions to local needs, supporting healthy living.”

The irony for NZ is that since the scrapping of the “Healthy Eating – Healthy Action” programme in New Zealand, and much other public health activity, that workforce is currently rather depleted. Capacity building will be required, and is welcomed.

Second, we hear echoes of the Bolger-led Government adoption of social capital in the late 1990s. Remember that? It placed social problems and their solution-generation with ‘communities’. There is a worthy role for this type of policy in a wider package, but it can also be used as a distancing policy to shield a government and the state from its responsibilities (e.g. on welfare benefits), deflecting the blame and responsibility for solutions to the level of communities. Flip back to “Healthy Together Victoria” and its kiwi descendant “Healthy Families New Zealand”. Whilst an important and welcome part of an overall response to nutrition policy, and obesity in particular, it could also become a foil that diverts attention and excuses the central government from addressing the really big policy levers at a national-level that probably matter most, e.g. regulating food marketing, proper nutrient labelling of food, and using taxes/subsidies to change the food environment (just like the taxes on tobacco and alcohol).

Third, and presaging Boyd Swinburn’s blog next week, it is important to build a “Healthy Families New Zealand” policy and programmes on evidence. Apparently, there have been positive evaluations of the Victoria policy. And an evaluation arm has been established to evaluate the Victoria programme as it evolves. It will be important that “Healthy Families New Zealand” adopts a rigorous evidence-based and evaluation approach, and one that considers value for money (e.g., cost-effectiveness) relative to other options such as taxing sugar sweetened beverages.

In the next few weeks Public Health Expert will have a series of blog posts on nutrition, focusing on the above Victorian programme and other forthcoming food and nutrition policy events. Namely:

1. A more in depth critique of the Victorian “Healthy Together Victoria” programme by Professor Boyd Swinburn to appear in the next week.
2. The likely health impact of a 20% fizzy drink tax in New Zealand, and the revenue it will generate, to accompany a letter appearing shortly in the New Zealand Medical Journal (probably 14 February).
3. A post-symposium summary of the Big Food: food policy, politics & population health symposium to be held on 17 February in Wellington, by Associate Professor Louise Signal.
4. A post-symposium summary of the Sugary Drink Free Pacific by 2030? symposium to be held on 19-20 February in Auckland, by Dr Gerard Sundborn.