Determining our Future

The Public Health Advisory Committee (PHAC), established under the Pae Ora (Healthy Futures) Act 2022, provides independent advice to the Minister of Health on major public health challenges. ‘Determining our Future’ is the first major report on determinants of health and equity in Aotearoa in over 25 years.

The report examines trends since 2000 in the distribution of the determinants of health (such as income, housing, cultural identity and social cohesion) and in health outcomes, and why these are unevenly distributed in our society. It looks forward to 2040, and assesses challenges to health equity and wellbeing, including the impacts of commercial interests and of the ‘megatrends’ - the climate crisis, AI and digital technology.

The report has six sections.

• Section 1 introduces the factors which contribute to our health and wellbeing, and summarises changes in Aotearoa since 2000.
• Section 2 explores why the determinants of health are unevenly distributed in our society, and some of the mechanisms by which they affect our health.
• Section 3 explores trends in some key indicators of determinants and health outcomes since 2000 in more detail, including how determinants intersect in place.
• Section 4 explores some of the future challenges we need to address to improve health for us all.
• Section 5 assesses progress and evidence for what works to improve health equity and wellbeing, including the perspectives and experience of young people, community, iwi and public service leaders.
• Section 6 lays out PHAC’s recommendations for actions across government to achieve a healthy future for us all. 

Read Determining Our Future

You can access Determining Our Future online, or download the document versions or summaries below.

Determining Our Future: Online version