Public Health Infrastructure
Public health infrastructure (PHI) is the legislation, workforce, leadership and advocacy needed to reduce preventable illness and death and increase health equity.
Investment in Aotearoa’s public health infrastructure is inadequate, and this means preventable disease and death – and the burden this brings to health services – will continue to increase.
HCA is advocating for increased investment in public health, Te Tiriti-led initiatives to re-balance inequitable health outcomes, and protection of evidence-based prevention from commercial influence.
Public health is a branch of health care that creates healthy environments and protects against preventable disease and death with evidence-based policy and initiatives. It looks beyond medical treatment of individuals and health care services to the aspects of society that shape the health of populations including education, housing, safe water supply, employment, freedom from discrimination and financial security.
HCA is focussed on achieving better prevention policies to address the harms of alcohol, tobacco, unhealthy food and health inequity – and these are part of public health.
To this end, HCA is seeking better control over the influence of harmful commodity industries that seek to intervene in public health policy to protect their commercial interests – often to the detriment of health outcomes and prevention measures.
Key facts
- Prevention funding for tobacco, alcohol and unhealthy food is less than half of one percent of the Health Budget, whereas these harmful commodities create about one third of Aotearoa/New Zealand’s premature death and disability
- Non-Māori are more advantaged than Māori across all socioeconomic indicators presented – this includes school completion, employment rates, income level and quality of housing.
- 27% (290,000) of Aotearoa/New Zealand children live in households with low incomes
Where should we be heading?
Aotearoa/New Zealand can be a country that values equitable health outcomes, where we invest in adequate measures to limit the impact of harmful products and systems for all populations.
Goal
- At least 5% of health budget is spent on prevention policies and initiatives by 2040
- The gap between Māori and non-Māori health outcomes has reduced.
- Public health policy is protected from commercial interests through robust lobbying legislation.
Reality
- Less than 0.5% of health budget spent on prevention policies, initiatives, services
- Māori experience more harm and preventable death from NCDs than non-Māori.
- New Zealand has no lobbying regulations.
Making our environments healthy
These actions will create healthy, equitable environments:
- Ensure prevention measures address health inequity and honour Te Tiriti o Waitangi, including provision for Tino Rangatiritanga (self-determination) over Māori health
- Increase public health spending to at least 5 per cent of the health budget by 2040
- Develop robust lobbying legislation, policies and procedures on commercial conflicts of interest, and reform the Official Information Act
- Protect the right of public sector employees to advocate for evidence-based policy change. This is important to protect the independent voice of health professionals, public health entities, and NGOs as a critical tool for improving the health system.
- Build a stronger public health ecosystem for health equity through greater collaboration between government agencies and NGOs, academia and health unions to fully utilise available expertise, research and frontline experience.
HCA advocacy on tobacco and vaping control is informed by a Public Health Infrastructure Expert Advisory Panel .
For more information on Aotearoa’s public health please visit: Hāpai Te Hauora, Health Promotion Agency, Hauora – Health Promotion Forum of New Zealand, and Public Health Association NZ.
