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 – what’s being done to improve mental health
- 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
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.
- Annual tobacco tax increases of 10% 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 will come into force on 14 March 2018.
- Legislation to legalise the sale of e-cigarettes and e-liquid as consumer 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.
- 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’s overall approach to minimising alcohol-related harm is set out in the National Drug Policy 2015–2020. One of the priority areas for reducing hazardous drinking is positively shifting thinking and behaviour in relation to the culture of drinking and intoxication. Actions related to this include building on existing public education campaigns and publishing, as set out in Taking Action on Fetal Alcohol Spectrum Disorder: 2016–2019: An action plan.
The Government is also using a range of approaches to prevent and reduce hazardous drinking.
- Strengthening regulation through the Sale and Supply of Alcohol Act 2012. The Act introduced maximum trading hours, strengthened restrictions around irresponsible promotion of alcohol, and tightened the law around the supply of alcohol.
- 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 and the Social Sector Trial sites.
- Expanding school-based health services to improve early identification and referrals for treatment of young people with an alcohol problem.
- Expanding alcohol screening and brief interventions in health services and other sectors.
- Developing self-help tools such as the Alcohol Drug Helpline website.
- Supporting people to address their alcohol issues through primary care and specialist services.
The Government is using a range of approaches to both prevent and manage obesity, and to support and encourage healthy eating and physical activity.
Childhood Obesity Plan
The Childhood Obesity Pan was launched in 2015. It consists of 22 initiatives grouped into three themes:
- targeted interventions for those who are obese
- increased support for those at risk of becoming obese
- broad strategies to make healthier choices easier.
There is also a public awareness campaign to encourage healthy lifestyle choices, supported by the Big Change Starts Small website, which offers affordable meal and activity ideas.
Raising healthy kids
The Raising healthy kids health target was introduced in July 2016. This target relates to referrals for children identified as obese at the B4 School Check. The Health Promotion Agency has developed videos on a range of relevant topics to help support implementation of the target.
Healthy Families NZ
Healthy Families NZ is an initiative that challenges families to think differently about the underlying causes of poor health and to make changes. It has been rolled out in 10 locations across New Zealand and is supported by $10 million of funding per year. The programme has the potential to impact the lives of more than 1 million New Zealanders.
The Green Prescriptions initiative is where a script from your doctor or practice nurse refers you to a local activity and nutrition programmes (face to face, group or by phone).
In 2016/17, 51,000 Green Prescriptions (GRx) were issued to patients to support them to make healthy lifestyle changes. Of the total referrals almost a quarter (24%) were for Māori and 10% for Pacific peoples.
Although GRx is not an obesity initiative, a 2016 survey of participants found that 53% of those surveyed cited ‘weight problems’ as the reason for receiving their GRx. 68% had received specific advice on healthy eating and 75% had made changes to their diet, mainly reducing meal sizes and sugary foods and drinks. Almost half had lost weight since been given their GRx.
GRx Active Families programmes are 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.
In 2016/17, $2.1 million was allocated to 10 district health boards (DHBs) to provide nutrition and activity programmes for obese 4-year-olds and their families, to support the Raising healthy kids target. This means younger children are being included in Active Families programmes.
Guidelines for weight management
- Clinical Guidelines for Weight Management in New Zealand Adults
- Clinical Guidelines for Weight Management in New Zealand Children and Young People
- Supporting healthy weight health education resource for consumers
Updated Clinical Guidelines for Weight Management in New Zealand Adults were released at the end of November 2017, along with supporting resources. An online BMI calculator is being developed.
Breastfeeding may help reduce the risk of obesity and diabetes in later life. DHBs have targets for breastfeeding rates and 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.
Increased bariatric surgery
The Ministry has funded approximately 400 bariatric surgery operations in the past year.
Eating and Activity Guidelines for New Zealand Adults
The Eating and Activity Guidelines for New Zealand Adults were released in 2015.
Focused on adults, the Guidelines provide fundamental advice on healthy eating and regular physical activity that applies across all ages. These guidelines, along with the Ministry’s age-specific guidelines (Food and Nutrition Guidelines) can be used as the basis for healthy lifestyle advice for families and whānau.
The Eating and Activity Guidelines bring together the eating and physical activity statements, identify the international evidence that underpins the statements and provide some information for putting the statements into practice. There are also supporting documents and health education resources for the public.
Sit Less, Move More, Sleep Well
In the past year, new Physical Activity Guidelines have been developed for under 5s and for 5–17 year olds that integrate sedentary time, physical activity and sleep for the first time. Supporting resources are currently being developed. The 5–17 year old guidelines were jointly released by the Ministries of Education and Health, and Sport NZ, recognising the importance of working across sectors to support healthy growth and development.
How We Eat
In May 2017, the Ministry published a review of the literature, How We Eat, along with evidence-based key messages to support people to make better choices around behaviours that influence what and how much they eat. The messages cover all life stages from pregnancy, childhood to older adults.
Voluntary Health Star Rating system
The Health Star Rating system for front of pack labelling will make it quicker and easier for New Zealand consumers to make informed and healthy food choices. Foods are rated half a star to 5 stars with more stars having better nutritional value. There are already over 2,000 food products with health stars and this is expected to increase.
Fruit in Schools
The Fruit in Schools programme provides a piece of fruit each day to children in decile 1 and 2 primary schools, along with some decile 3 schools ($6.6 million per year).
Urban cycleways programme
Led by the New Zealand Transport Agency, the Urban Cycleways Programme is a $333 million investment in 15 urban centres from July 2015 to July 2018. This will help to establish cycling as an integral part of New Zealand's transport network and hence increase physical activity.
National Cycling Education System
The NZ Transport Agency and ACC have partnered to develop a National Cycling Education System to increase the reach of cycling education in New Zealand. The system will improve quality and consistency, and provide a monitoring and evaluation framework so we can assess how effective the system is.
The new national approach is based on giving people the skills they need at the right time in their life – from learning bike handling skills in primary school through to learning road rules and how to ride on-road when they are ready. Adults who haven’t ridden a bike for a while and want to brush up on their skills will also have opportunities to build their confidence.
Community Sports Strategy
Sport New Zealand is working to get more people participating and volunteering in sport and recreation through the Community Sport Strategy 2015–2020.
Several surveys inform the Government’s work to encourage healthy eating and physical activity.
Sport New Zealand’s 2013/14 Active New Zealand Survey is a nationwide survey that gives detailed insights into Kiwi adults’ participation in sports, active recreation, and volunteering. It also measures how participation has changed since the last Active NZ Survey was conducted in 2007/08. Sport New Zealand currently has a new Active NZ Survey in the field.
In October 2015, the Ministry of Transport introduced an ongoing national Household Travel Survey that collects data on travel (including active travel modes) from 2,200 households a year using Global Positioning System (GPS) technology.
The Government’s 5-year plan for mental health and addiction service delivery is outlined in Rising to the Challenge: The Mental Health and Addiction Service Development Plan 2012–2017. The primary focus of the plan is to assist health services across the spectrum – from health promotion through primary care and other general health services, to specialist mental health and addictions services.
The following initiatives are currently in place.
Primary mental health services
The Government invests approximately $24 million per year on primary mental health services for people with mild to moderate mental health and/or addiction issues. This includes increased access to psychological therapies, other psychosocial interventions and packages of care.
The Ministry also funds computerised Cognitive Behavioural Therapy for adults and young people with depression and/or anxiety through e-therapy tools Beating the Blues for adults, and SPARX for young people.
An electronic depression decision support tool has also been implemented in general practices to make it easier for GPs to assess the severity of depression, access other resources and encourage self-management where appropriate.
Youth Mental Health Project
The Youth Mental Health Project is a package of 26 initiatives that aim to improve mental health and wellbeing for young people with, or at risk of developing, mild to moderate mental health issues. This is a 4-year cross-agency project. It aims to reach young people in their families and communities, their schools, the health service and online.
Improving access to specialist mental health and addictions services
The number of people accessing specialist mental health and addictions services has increased by 78% since 2005/06 – from 96,310 in 2005/06 to 171,693 in 2016/17. The increase is greater for Māori (169%), Pacific (156%) and young people (113%). Increasing access to services will continue to be a major focus, especially for children and youth and for people with common mental health disorders or problems.
Reducing waiting times
The Ministry of Health is working with DHBs to reduce waiting times for access to specialist mental health and addiction services. DHB performance measures have also been introduced to ensure 80% of non-urgent new referrals are seen within 3 weeks and 95% are seen within 8 weeks.
In 2016/17, 78% of non-urgent referrals were seen within 3 weeks and 93% were seen within 8 weeks by mental health services. For addiction services, 82% of people were seen within 3 weeks and 94% were seen within 8 weeks.
In 2016/17, 45% of referrals were seen within 48 hours.
There are a range of initiatives across the health sector to support better access to health care.
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 then manage more aspects of their own care.
Rural funding increase
For rural areas, funding is allocated through local Alliances and a provider is funded to provide GP and nurse practitioner locum and recruitment/retention support for rural general practices. This ensures sustainable, accessible and appropriate primary health care is available within rural communities.
94.1% of the population is enrolled with a general practice.
Zero fees for under-14s
Most children aged 13 years and under who are enrolled with a general practice will not be charged a fee for a standard visit with a doctor or nurse, or:
- an after-hours fee at participating clinics or pharmacies
- the regular $5 prescription fee.
Over 99% of general practices are providing zero free daytime visits for children aged 13 and under.
Very Low Cost Access (VLCA)
The VLCA scheme provides additional funding to general practices with more than 50% of those enrolled categorised as high need.
As of October 2018, 290 general practices were providing reduced doctors’ fees for 1.4 million New Zealanders through the VLCA scheme.
From 1 December 2018, access to very low-cost general practice visits will be extended to all Community Services Card (CSC) holders. This includes injury-related (ACC) visits.
Eligibility for a CSC will also be extended to all those receiving the accommodation supplement or who are tenants in social housing.
Community Services Card
New Zealand citizens or permanent residents on low to middle incomes are eligible for the Community Services Card. This can reduce the cost of healthcare.
The Community Services Card (CSC) can help individuals and their families with the costs of health care. It entitles the holder and their family to a reduction in the cost of some health services and prescriptions
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.
In 2015/16, the Government spent $199 million on oral health services provided or funded by DHBs.
Publicly funded oral health services for children
Children and adolescents up to their 18th birthday have access to publicly funded basic oral health services. These services are mainly provided through the Community Oral Health Service, for pre-schoolers and primary school children up to the end of school year 8, and by dentists contracted by DHBs for adolescents up to their 18th birthday.
Since 2006, $116 million has been invested in new infrastructure for the Community Oral Health Service. The service now operates from 1,263 sites around the country with 176 fixed clinics and 157 mobile clinics. A new health-promoting model of care focuses on family/whānau involvement, health education for self-care, prevention of ill-health and early intervention. Increasing parental engagement from an early age is critical to improving oral health for children.
Child oral health promotion initiative
The Ministry of Health is implementing a national oral health promotion initiative to improve the oral health of young children. Māori, Pacific and low-income families/whānau are the priority groups. The initiative was rolled out in 2016/17 with the commencement of a social marketing campaign.
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 relief of pain or treatment of infection.
Community water fluoridation
The Ministry of Health strongly supports water fluoridation as an effective, safe and affordable public health measure to improve oral health. The Ministry’s policy on community water fluoridation is consistent with other leading health organisations such as the World Health Organization, the US Centers for Disease Control and Prevention, and the World Dental Federation.
Legislation was introduced in Parliament in 2016 to amend the Health Act 1956, and consequentially also the New Zealand Public Health and Disability Act 2000, to transfer decision-making responsibilities for water fluoridation from territorial local authorities to DHBs. 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.
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.
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 in 2017/18 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 after the next 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 has been developed to facilitate the delivery of high-quality health services that meet the needs of Pacific peoples. It sets out the strategic direction to address health needs of Pacific peoples and stipulates actions, which will be delivered from 2014 to 2018.
‘Ala Mo’ui monitors 21 indicators over the 8 main DHBs that make up more than 90% of Pacific people.
There are a range of initiatives across the health sector that contribute to better health outcomes for Pacific people, including the following.
Pacific Health Scholarships
The Pacific Health Scholarships contribute to building the number of Pacific people in the health and disability workforce.
This year 325 scholarship applications were received by the Ministry. This was the highest number of applications received in a Scholarship round in the last 4 years.
This year a record 192 scholarships were awarded, totalling more than $1.4 million.
The priority workforce areas for this year’s cohort were medicine, nursing, midwifery and allied health.
The Ministry of Health Pacific Innovation Fund was established in 2012. Pacific Innovation Fund projects are aimed at reducing disease prevalence and injury in the Pacific population in New Zealand by targeting Pacific health issues.
The objectives of the 2016/17 cohort of Innovation Fund projects focused on:
- implementing and evaluating Pacific models of care
- contributing towards achieving better health outcomes for Pacific peoples, particularly in the following priority areas:
- improving outcomes for mothers and babies
- supporting healthy kids
- mental health and suicide prevention
- promoting sustainable Pacific delivery systems that value health and social service integration and family-centred interventions
- supporting community action and strengths-based approaches that lead to Pacific peoples having greater control over their health and wellbeing.
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.