Find out what’s being done to improve the health of New Zealanders in the areas covered by the key results of the New Zealand Health Survey.
On this page:
- Smoking – what’s being done to reduce smoking rates
- Hazardous drinking – what’s being done to reduce hazardous drinking
- Obesity – what’s being done to prevent and manage obesity
- Mental health and addiction – what’s being done to improve mental health and addiction
- Access to health care – what’s being done to improve access to primary health care
- Oral health – what’s being done to improve New Zealanders’ oral health
- Māori health – what’s being done to improve Māori health
- Pacific health – what’s being done to improve Pacific health
- Rainbow community health – what’s being done to improve the health of the Rainbow community
The Government has set a goal of making New Zealand an essentially smokefree nation by 2025. New Zealand’s progress in reducing smoking rates is the result of a range of initiatives over many years. In the past 5 years these have included the following initiatives:
- tobacco tax increase of 10% each year from 2010 to 2020
- a ban on displaying tobacco products in stores
- a reduction in duty-free tobacco allowances
- implementation of the Better help for smokers to quit health target
- improved quit smoking services and better access to them
- health promotion campaigns through the Health Promotion Agency
- legislation requiring standardised tobacco packaging and refreshed health warnings, which came into force on 14 March 2018
- legislation to improve the regulation of vaping and smokeless tobacco products, which is being prepared
- preparations to establish a pre-market approval system for smokeless tobacco and nicotine delivery systems that can demonstrate they are significantly less harmful that tobacco smoking
- legislation to amend the Smoke-free Environments Act 1990 to prohibit smoking in vehicles carrying children under the age of 18
- 24/7 Quitline telephone and texting service.
The Government funds telephone, online, text and face to face smoking cessation services, and a number of smoking cessation aids are heavily subsidised.
The Government is committed to reducing the overall negative impact that alcohol has on New Zealand individuals, whānau and communities. There are a number of approaches being taken to prevent and reduce hazardous drinking, including:
- strengthening regulation through the Sale and Supply of Alcohol Act 2012 – this Act introduced maximum trading hours, strengthened restrictions around irresponsible promotion of alcohol, and tightened the law around the supply of alcohol. It also increased the ability of communities to have a say about alcohol licensing in their local area
- reducing the maximum driving blood alcohol limit
- running national social marketing campaigns to raise awareness about alcohol harms
- supporting community-led resilience building through organisations like Community Action Youth and Drugs
- expanding school-based health services to improve early identification and referrals for treatment of young people with an alcohol problem
- providing self-help tools such as the Alcohol Drug Helpline website
- supporting people to address their alcohol issues through primary care and specialist services.
The Health Promotion Agency is funded from the levy on alcohol produced or imported for sale in New Zealand to make people more aware, motivated and able to drink at low-risk levels or choose not to drink. It also influences physical, social and policy environments and services to support New Zealanders to drink at low-risk levels or not drink.
The Government is using a range of approaches to both prevent and manage obesity, and to support and encourage healthy eating and physical activity.
The Ministry is reviewing its approach to obesity and is taking a broad population approach to achieving healthy weight through improved nutrition and increasing physical activity. The approach is designed to help address significant health losses associated with non-communicable diseases in New Zealand.
Examples of actions underway include:
- identifying opportunities to support schools to become water-only and encourage healthy food and physical activity
- the Government by Example programme (government agencies showing leadership by adopting the National Healthy Food and Drink Policy) is commencing with a few early adopter agencies in 2018/19
- updating the Food and Nutrition Guidelines for pregnancy and 0–2 year olds (last updated in 2008) and integrating them into the Eating and Activity Guidelines
- co-leading New Zealand’s response to the World Health Organization’s Global Action Plan on Physical Activity, with Sport New Zealand
- supporting the implementation of the Clinical Guidelines for Weight Management in New Zealand Children and Young People, initially through improving measurement and monitoring of growth and weight in primary care and Well Child providers, which includes providing an online BMI calculator
- the Food Industry Taskforce on Addressing Factors Contributing to Obesity report to Government in December 2018, which is under consideration.
Other resources or initiatives that encourage healthy eating, physical activity and adequate sleep include:
- Eating and Activity Guidelines for New Zealand Adults
- Physical Activity Guidelines, including sleep and screen time, for children under 5 years and for 5–17 year olds
- Clinical Guidelines for Weight Management for Adults and for Children and Young People
- Healthy Families NZ – an initiative that supports families to make changes to improve their health and wellbeing. The initiative has been rolled out in 10 locations across New Zealand and has the potential to impact the lives of more than 1 million New Zealanders
- Fruit in Schools – provides a piece of fruit each day to children in decile 1 and 2 primary schools
- breastfeeding – all DHB maternity facilities must ensure support for breastfeeding is available from birth. Other activities include peer support networks, social media, free lactation consultation services and events such as the Big Latch On
- Green Prescriptions (GRx) – a script from a doctor or practice nurse refers the patient to a green prescription support person, who provides support to enable the person to be more active
- Active Families – community-based health initiatives designed to increase physical activity and improve nutrition in children and young people aged 5–18 years of age and their whānau/families.
On 4 December 2018 the Government Inquiry into Mental Health and Addiction released their report He Ara Oranga. This is a substantial and considerable piece of work which charts a new direction for mental health and addiction in New Zealand.
The Government is currently working through the report’s 40 recommendations.
To ensure that we provide the best advice, the Ministry is engaging widely with stakeholders including people with lived experience, Māori, and the workforce.
For more information, you can view He Ara Oranga on the Inquiry website.
The Government has also pushed ahead with a number of mental health and addiction initiatives.
Mana Ake – Stronger for Tomorrow
Mana Ake is a holistic approach to mental health that seeks to support children in Canterbury and Kaikōura to be resilient, and to experience positive mental health so they can engage and learn at school. In addition, Leading Lights, a school-facing web-based education and navigation tool, will support schools to provide systematic responses to the needs of their children.
Leading Lights is a website designed specifically for teachers and education professionals which helps them to identify children with specific health, learning or wellbeing needs and provide ideas and strategies of about how these children are best supported within schools.
Tu Kotahi is a student-led early intervention programme in schools which connects young people to the support they need using a group of trained peer-supporters. Tu Kotahi uses peer support networks to encourage young people to have conversations and be linked to services which can provide help.
School Based Health Services
The School Based Health Service (SBHS) is provided to secondary school students at their place of learning to improve health outcomes and inequalities for this age group. It aims to help link them with primary health care providers to improve access to youth appropriate services for mental health, alcohol and drug use, sexual health, nutrition, weight management, exercise and positive youth development programmes.
The Piki pilot provides free access to psychological therapies, counselling, and other support services for young people with mild to moderate needs in the Wellington region. The Piki pilot service utilises a suite of interventions, including problem solving, motivational interviewing, cognitive behavioural therapy, acceptance and commitment therapy, group therapy, face to face therapy and online therapy. Appropriate service provision will be matched to client needs.
Acute Drug Harm Response Discretionary Fund
A total of $8.6 million has been set aside for an Acute Drug Harm Response Discretionary Fund over four years. Up to a further $8 million (over two years – $4.6 million in 2018/19 and $3.4 million in 2019/20) will be used, from the proceeds of crime, to establish a Drug Early Warning System, develop and deliver ‘Addiction 101’ training in communities experiencing harm from synthetic drugs and fund other Ministry of Health drug and alcohol initiatives.
New alcohol and drug detoxification beds in Auckland
The Ministry of Health is funding the construction of new alcohol and drug detoxification beds in Auckland at the new Auckland City Mission building, Mission HomeGround.
On 1 December 2018 new initiatives were introduced to support better access to primary health care. These changes were part of Budget 2018 and included:
- extended access to low-cost general practice visits to all Community Services Card (CSC) holders. This includes injury-related visits (ACC)
- extended CSC eligibility to all people receiving the accommodation supplement or who are tenants in social housing
- extended zero-fee general practice visits and exemption from the standard prescription co-payment charge (usually $5 per item) on subsidised prescription items to children under the age of 14. This includes after-hours services and injury-related visits (ACC). The Zero Fees initiative previously applied to under-13s only.
Find out more at Lower cost general practice visits.
Patient portals are being rolled out nationally. A patient portal is an online service where patients can log in securely to do things like check their latest laboratory test results, order repeat prescriptions, or send messages directly to their GP. This gives patients much greater access to their own health information and lets them manage more aspects of their own care.
93% of the population is enrolled with a primary health organisation (PHO).
Very Low Cost Access (VLCA) practices
The VLCA scheme provides additional funding to general practices with more than 50% of those enrolled categorised as high need. The consultation fee charged to patients in these practices is now aligned with practices who have opted in to provide lower cost fees for Community Service Card (CSC) holders. An adult with a CSC won’t pay more than $19 for a standard visit with a doctor or nurse and young people aged 14 to 17 years, who have a parent or caregiver with a CSC will be charged no more than $13.
Prescription Subsidy scheme
The prescription charge (co-payment) is a small contribution people pay towards the cost of the medicines they receive. For most people, this charge is $5 for each new prescription item. New Zealanders can reduce their medicine costs through the Prescription Subsidy scheme.
The subsidy is aimed at reducing costs for families and people who are prescribed a lot of medicines. People become eligible for the subsidy once they have paid for 20 new prescription medicine items from 1 February each year. Once they’re eligible, they do not have to pay any more prescription charges for the rest of that year (to 31 January). People can reach the 20-item threshold by combining prescription items for their partner and dependent children aged from 14 up to 18 years.
Good oral health matters to everyone’s wellbeing, including basics such as being able to eat, speak, smile and socialise.
Poor oral health is largely preventable, yet it is also one of the most common chronic health problems experienced by New Zealanders of all ages.
In 2017/18, the Government spent $198 million on oral health services, provided or funded by DHBs.
Publicly funded oral health services for children
Public funding for oral health care in New Zealand focuses on universal oral health services for children and adolescents (up to their 18th birthday). This is supported by evidence indicating that oral health status at age 5 determines oral health status at age 26. Child and adolescent oral health services aim to contribute to a good start in life for all New Zealand children. Facilitating and supporting good oral health from an early age helps set people up for life and reduces the likelihood of needing costly dental care in later years.
The past decade has seen significant reinvestment into the infrastructure, model of care and capacity of child and adolescent oral health services. The reinvestment was initiated in Budget 2006. The purpose was to move from a ‘drill and fill’ approach towards a preventive model of care. New fixed and mobile clinics are now in place, and there are signs of improvements in oral health outcomes for children.
Publicly funded oral health services for adults
Some publicly funded oral health services are available for adults when treatment is required for accident or injury, for people with medical conditions or disabilities whose conditions prevent them from accessing community-based dental care, and for low-income adults who need emergency dental treatment for pain relief or treatment of infection.
Community water fluoridation
The Ministry of Health supports water fluoridation as an effective, safe and affordable public health measure to improve oral health. Community water fluoridation has been endorsed by the World Health Organization (WHO) and other international health authorities as the most effective public health measure for the prevention of dental decay.
Legislation was introduced in Parliament in 2016 to transfer decision-making responsibilities for water fluoridation from territorial local authorities to DHBs. Moving the decision-making process from local councils to DHBs recognises that water fluoridation is a health-related issue. The Health (Fluoridation of Drinking Water) Amendment Bill passed its first reading on 6 December 2016 and the Health Select Committee report was presented in the House on 29 May 2017. The Bill is currently awaiting its second reading in the House.
Child oral health promotion initiative
The Ministry of Health recently delivered an oral health promotion initiative to promote regular tooth brushing with fluoride toothpaste. It was aimed at family and whānau of pre-school children. The initiative involved a social marketing campaign that was rolled out in 2016/17 and continued in 2017/18.
The campaign is centered on a reimagined Tooth Fairy, who is a stern yet loveable ‘aunty’ figure with a big heart who doesn't sugar-coat her words. A post-campaign survey carried out by UMR Research showed that 35% of the target audience surveyed said they had made a change to their child's tooth-brushing as a result of seeing the campaign.
Listed below are some of the strategies and initiatives across the health sector which contribute to better health outcomes for Māori.
He Korowai Oranga
As New Zealand’s Māori Health Strategy, He Korowai Oranga sets the overarching framework that guides the Government and the health and disability sector to achieve the best health outcomes for Māori.
He Korowai Oranga also sets expectations that the health system will work with Māori to improve health outcomes and achieve health equity. Implementing He Korowai Oranga is the responsibility of the whole health and disability sector. This includes all 20 DHBs that are responsible for providing health services that address local population need.
Whānau Ora is about increasing the wellbeing of individuals in the context of their whānau. It aims to empower whānau by placing them at the centre of services to make decisions and opportunities about what they need and how they access them, and achieve better outcomes in areas such as health, education, housing, employment and income levels.
The Ministry of Health supports the Te Puni Kōkiri-led programme Whānau Ora, its outcomes framework and commissioning for outcomes model.
Primary care enrolment
On 1 December 2018, low-cost general practice visits were extended to all Community Services Card (CSC) holders. As at 1 January 2019, 97% of eligible Māori Community Services Card holders are enrolled with a practice that offers lower fees.
Each year DHBs are required to develop an Annual Plan and a Regional Service Plan. These annual planning documents outline each DHBs’ effort to reduce disparities and achieve health equity for all New Zealanders.
DHBs previously produced Māori Health Plans each year to set out how the DHB planned to reduce health disparities between Māori and non-Māori. In 2017/18 Māori Health Plans were incorporated into DHB Annual Plans with the focus on equity strengthened in these plans.
Māori Health Profiles
In 2015 the Ministry released DHB Māori Health Profiles which present a snapshot of Māori health compared with non-Māori across a range of health and disability related indicators. These are a good source of information on Māori health in each DHB and nationally. The next update is planned when new demographic data becomes available from the Census.
Equity of Health Care for Māori framework
The Equity of Health Care for Māori framework guides health practitioners, health organisations and the health system to achieve equitable health care for Māori.
'Ala Mo'ui: Pathways to Pacific Health 2014-2018 sets out the priority outcomes and actions that contribute to achieving better health outcomes for Pacific peoples, families and communities.
Faiva Ora 2016–2021 National Pasifika Disability Plan
The Faiva Ora 2016–2021 National Pasifika Disability Plan focuses on:
- improving outcomes for Pacific disabled children, youth and their families
- encouraging Pacific communities to better engage with and support individuals with disabilities and their families to participate in their communities
- ensuring disability services and supports meet the needs of Pacific disabled people and their families
- encouraging stakeholders to work in partnerships to address challenges experienced by Pacific disabled people and their families.
Pacific health scholarships
The Pacific Health Scholarships contribute to improving access to health services for Pacific peoples by assisting the development of the Pacific health and disability workforce.
The Scholarships provide financial assistance to Pacific students who are undertaking a course in health or disability-related studies accredited by the New Zealand Qualifications Authority (NZQA) or the New Zealand Vice Chancellors Committee.
Last year over 150 Scholarships were offered to Pacific students undertaking a course in health and disability related studies.
The priority workforce areas of this year’s cohort are medicine, dentistry, nursing, midwifery and allied health.
Pacific Health Innovation Fund
The Pacific Innovation Fund invests in Pacific health initiatives that demonstrate innovation through the application of new strategies, models and methods of service delivery. The Fund, supported by a total budget allocation of $4.5 million (excluding GST) for the three year period 2018/19, 2019/20, 2020/21, will be applied in equal annual amounts of $1.5 million (excluding GST). To achieve its purpose, the Fund has four operational objectives:
- implement and evaluate effective Pacific models of care and approaches that improve health outcomes for Pacific populations
- contribute towards the achievement of better health outcomes for Pacific peoples and health targets for priority areas including:
- improving outcomes for mothers and babies, especially during pregnancy (for example early enrolment with a Lead Maternity Carer)
- ‘healthy kids’, for example, reducing avoidable hospitalisation of children (also referred to as Ambulatory Sensitive Hospitalisations or ASH)
- mental health and suicide prevention.
- promote sustainable Pacific service delivery systems that value health and social service integration and family centred interventions
- support community action and strengths-based approaches that lead to Pacific communities having greater control over decisions concerning their health and wellbeing.
Primary health care
In 2018, the Government announced its commitment to improving access to primary health care along with initiatives to lower GP fees for under-14s and Community Services Card holders.
This initiative means approximately 15,500 more Pacific people with a Community Services Card across the country will be eligible for very low cost fees in primary health care, increasing the total number to 74,000.
Waka Hourua – The FLO: Pasifika for Life
The FLO: Pasifika for Life suicide prevention programme (FLO) aims to engage and empower Pasifika families and communities in a sustainable way to ensure they know how to prevent suicide, and to respond safely and effectively when and if suicide occurs.
FLO is part of Waka Hourua: the National Māori and Pacific suicide prevention programme. Te Rau Matatini leads Waka Hourua in partnership with Le Vā.
Funded health services for low decile schools
The Ministry of Health currently funds school based health services for students in decile 1–3 secondary schools, teen parent units and alternative education facilities. Budget 2018 expanded this service to include decile 4 secondary schools.
The expansion means approximately a further 24,000 students will have access to an on-site nurse. Pacific learners will benefit from this expansion as they are predominantly in lower decide schools.
What’s being done to improve the health of the Rainbow community
The Government is committed to improving health care for our Rainbow communities. Rainbow is an inclusive term used to refer to anyone with a diverse sex, gender identity or sexual orientation. It is important that health services meet the needs of all New Zealanders, with inclusiveness and dignity for all.
The Ministry is committed to continuing its support for the NZ Aids Foundation and its Ending HIV campaign, which includes the aspiration goal of ending new HIV transmissions in New Zealand by 2025. In 2017, the rate of newly diagnosed HIV cases reduced. Last year, it was announced that New Zealand was a front-runner in publicly funding the use of Pre-exposure Prophylaxis (PrEP) to prevent HIV infection for people who are at high risk. It is hoped that PrEP, with the support of regular and early screening, condom use and treatment of other STIs, will lead to a continued decline in rates of new HIV transmission in New Zealand.
He Ara Oranga
The government will also be looking to better meet the mental health and addiction needs of the Rainbow community. He Ara Oranga – the Report of the Government Inquiry into Mental Health and Addiction – found that Rainbow communities had unmet mental wellbeing needs, as well as not feeling safe accessing mainstream services and suffering harm from discrimination. The government is committed to providing services that will be responsive to people from different cultural backgrounds, life experiences and perspectives by providing a greater variety of options. The system will put people and their needs at the centre of service response, and not further stigmatise or marginalise them.
These work programmes supplement a range of initiatives occurring across government and the community sector to create a more inclusive society and promote the wellbeing of Rainbow New Zealanders.