TAKING OUR PULSE
The good news is that New Zealanders are living longer than ever. Yet that longer life comes with its own challenges. Recent medical findings and research provide a snapshot of the country’s health: how everything from obesity and heart disease to cancer
Just how healthy are New Zealanders? New figures give us a good idea.
Data from the Ministry of Health show that New Zealanders generally enjoy a high health status and a good publicly funded health and disability system by international comparisons. However, our diverse population experiences significantly different health outcomes. In particular, Māori health outcomes are significantly worse than those for other New Zealanders.
Ministry of Health statistics show that New Zealanders are living longer
– the life expectancy for New Zealanders in 2020 was 82.36 years, compared to a global life expectancy of 72.63 – and every year, more of us are aged over 65 years. However, this longer life expectancy also comes with challenges, such as the associated care and cost of an ageing population. Additionally, some of New Zealand’s population groups do not benefit from the health and disability system as much as others. For example, while New Zealanders overall are living longer, Māori and Pacific peoples still have lower life expectancies than the population as a whole. People with an intellectual disability can also expect to live for 18-23 fewer years than the general population. Disabled people generally experience worse health than the rest of the population.
The most recent Health and Disability System Review was charged with recommending system-level changes to the health system that would be sustainable, lead to better and more equitable outcomes for all New Zealanders and shift the balance from treatment of illness towards health and wellbeing. There are also lifestyle recommendations for preventing the most common diseases. Key findings from the New Zealand Health Survey show that health behaviours and risk factors of most concern include smoking, hazardous drinking and obesity.
HEART DISEASE & OBESITY
Coronary artery disease and stroke are the top causes of death and disability in New Zealand. One in 20 adults have been diagnosed with heart disease. According to the Heart Foundation, 170,000 people are living with heart disease, and every 90 minutes a New Zealander dies from heart disease. There are many recommendations for improving the health of your heart, including not smoking, exercise, healthy eating, managing high blood pressure and cholesterol, maintaining a healthy weight and learning how to check your pulse.
Smoking (Kaipaipa) is particularly damaging because the chemicals in cigarette smoke damage your heart and blood vessels, which can lead to cardiovascular disease.
In addition to permanently damaging your heart and blood vessels, cigarette smoke can change your blood chemistry and cause plaque to build up in the arteries.
Obesity is associated with many health conditions including heart disease, type 2 diabetes, stroke, several common cancers, osteoarthritis, sleep apnoea and reproductive abnormalities in adults. New Zealand has the third-highest adult obesity rate in the OECD. One in three adult New Zealanders (over 15 years) is classified as obese, and one in 10 children.
The most recent findings from the Ministry of Health show the prevalence of obesity among adults differed by ethnicity, with 63.4 per cent of Pacific, 47.9 per cent of Māori, 29.3 per cent of European/Other and 15.9 per cent of Asian adults obese.
Adults living in the most socioeconomically deprived areas were 1.8 times as likely to be obese as adults living in the least deprived areas. The NZ Government is taking a broad population approach to achieving healthy weight with a focus on improved nutrition and increased physical activity. Yet recent research by Kobe University shows that obesity in adulthood is linked not only to factors such as social environment (for example, economic circumstances and education), but also to childhood experiences, in particular abuse.
The researchers said childhood experiences of adversity included physical violence from a parent, insufficient food or clothing, and emotional trauma originating from a parent’s comments or insults.
Project Professor Tamori Yoshikazu explains that while the main causes of obesity are conventionally considered to be overeating and insufficient exercise with the tendency to perceive those who are overweight as lacking in self-discipline, this study has revealed the social background of the individual is also connected to the
onset of obesity. This highlights the importance of taking social factors into account when implementing policies to tackle obesity.
According to the latest New Zealand Health Survey, one in five adults (20.9 per cent) were hazardous drinkers, and of Māori adults, 36.1 percent were hazardous drinkers. ‘Hazardous drinking’ refers to an established alcohol drinking pattern set by the World Health Organization that carries a risk of harming the drinker’s physical or mental health or having harmful social effects on the drinker or others. While 18 to 24-year-olds maintain the highest prevalence of drinking in the country at 32.4 per cent – with 36.8 per cent for men, 27.9 per cent for women – hazardous drinking patterns remain prevalent throughout older age groups in New Zealand, particularly among men. According to the Te Hiringa Hauora/Health Promotion Agency, you can reduce your long-term health risks by drinking no more than:
• Two standard drinks a day for women and no more than 10 standard drinks a week;
• Three standard drinks a day for men and no more than 15 standard drinks a week; and
• At least two alcohol-free days every week.
CANCER
The number of people diagnosed with cancer in New Zealand is projected to double in the next two decades because the population is growing and getting older. While cancer survival is improving in NZ, the rate of improvement is slower than other comparable countries. Te Aho o Te
Kahu, the Cancer
Control Agency was established by the
Minister of Health in December 2019 to better recognise the impact cancer has on the lives of New Zealanders. “We have many world-class aspects of cancer control in New Zealand, and the cancer workforce is full of highly committed and talented people, but if we are to improve our cancer survival rates compared to similar countries, focused action is needed,” says the Chief Executive of Te Aho Te Kahu, Diana Sarfati.
“There needs to be continued work in addressing inequities, strengthening prevention, expanding screening and improving diagnosis and treatment for cancer.”
Lung cancer is the leading cause of death for Māori females and the second-leading cause of death for Māori males. According to the Lung Foundation, every year in New Zealand more people die of lung cancer than of breast cancer, prostate cancer and melanoma combined. A new study by the University of Otago presents a strong case for lung cancer screening in New Zealand – particularly for Māori, whose mortality rates are between three and four times higher than other ethnic groups. About 450 Māori are diagnosed with lung cancer each year and approximately 300 die from it. Screening trials have been completed overseas, where they have resulted in a 20-26 per cent reduction in lung cancer deaths. “Around 75 per cent of early-stage lung cancer may be curable,” says Dr Karen Bartholomew of the University of Otago. “If lung cancer is caught early enough, the impact of screening could go a long way towards helping us save lives and eliminate the unacceptable inequities we currently see in mortality between Māori and non-Māori.”
“WE CAN’T MEDICATE OR TREAT OUR WAY OUT OF THE EPIDEMIC OF MENTAL DISTRESS.”
HE ARA ORANGA REPORT
MENTAL HEALTH
Mental health and addiction problems touch the lives of many people in New Zealand. The Ministry of Health reports that each year around one in five New Zealanders experience mental illness or significant mental distress, and according to the Mental Health Foundation of New Zealand, at least half of all New Zealanders will experience depression, anxiety or another mental health problem in their lifetime.
Increasing numbers of children and young people are showing signs of mental distress and intentionally self-harming. Suicide and addiction continue to be a serious concern for New Zealand communities.
The Government Inquiry into Mental Health and Addiction was announced early in 2018. The purpose of the Inquiry was to hear the voices of the community – people with lived experience of mental health and addiction problems, people affected by suicide, and those involved in preventing and responding to mental health and addiction problems – on New Zealand’s current approach to mental health and addiction and what needs to change.
The Inquiry also reported on how New Zealand is preventing mental health and addiction problems and responding to the needs of people with those problems.
In November 2018, the Government Inquiry into Mental Health and Addiction published the He Ara Oranga report on their findings. The committee concluded that “New Zealand’s mental health and addiction problems cannot be fixed by government alone, nor solely by the health system.
“We can’t medicate or treat our way out of the epidemic of mental distress and addiction affecting all layers of our society. We need to ensure practical help and support in the community are available when people need it, and government has a key role to play here. But some solutions lie in our own hands. We can do more to help each other.”
The committee also wrote in the report that “wellbeing has been a theme during this Inquiry and in national conversation in recent years. It’s hard for people struggling with poverty, abuse and deprivation to take steps to become well – yet, every day, people recover from distress, overcome addictions and find strength in their lives. Sleep, nutrition, exercise and time outdoors help recovery. So, too, does strengthening one’s cultural identity and helping others. ”
Another challenge that the Inquiry identified was that the mental health system is set up to respond to people with a diagnosed mental illness. It does not respond well to other people who are seriously distressed. “Even when it responds to people with a mental illness, it does so through too narrow a lens. People may be offered medication, but not other appropriate support and therapies to recover. The quality of services and facilities is variable. Too many people are treated with a lack of dignity, respect and empathy.”
The government formally responded to recommendations of the independent Inquiry into Mental Health and Addiction in the May 2019
Budget. Of the 40 recommendations in the He Ara Oranga report, which apply to health, the wider social sector and society as a whole, the Government accepted or agreed to further consideration of 38 of the recommendations.
This included agreeing to significantly increase access to publicly funded mental health and addiction services for people with mild to moderate and moderate to severe mental health and addiction needs among others.
Budget 2019 also set aside funding to establish a Mental Health and Wellbeing Commission, expanded suicide prevention work, enhanced primary addiction response, and improved support for people experiencing a mental health crisis, among other things.