Canterbury Health in All Policies Newsletter: July 2020
Our last communication was mere days before we went into the level 4 response to COVID-19. It’s difficult to accurately remember those days before the pandemic triggered a worldwide crisis and consumed global politics. These unprecedented times have prompted conversation on public health, equity and racism like never before.
We would call these issues wicked problems - social or cultural problems that are so highly interconnected that are difficult to define and are always evolving. There are no definitive solutions to wicked problems - approaches rather than clearly right wrong. Solutions involve a wide range of sectors and need action at a range of levels from individual to intercontinental. The COVID-19 pandemic can be understood as a wicked problem in itself and as a contributor to existing already identified wicked problems.
In recent months we, as a society, have become acutely aware that life is not the same for everyone. The pandemic has highlighted and magnified existing inequities. To be isolated with a job, a full pantry, local access to nutritious food, a warm home that is large enough to accommodate its occupants all day every day, money to pay for devices and broadband to keep connected with schooling and loved ones, and a neighbourhood conducive to walking is far different from being in lockdown or self-isolation when you are hungry, cold, lonely or trapped in overcrowded or inadequate accommodation or an unsafe situation, as many New Zealanders. Similarly, people with disabilities or existing health conditions who rely on others for care and day-to-day support faced unmet needs and increased vulnerability. Racism, discrimination, and social inequality have contributed to increased case numbers and risk of death from COVID-19 among ethnic minority groups, especially black people in the UK and USA. The longer-term impacts of the lockdown on jobs and incomes will disproportionately affect already disadvantaged populations, especially children.
Health is All Policies (HiAP) is an approach to tackling such wicked problems. The HiAP team at Community and Public Health know that health and wellbeing outcomes at a population level are largely dependent on policies created by those outside the health sector. The pandemic has highlighted how well different sectors and levels of government can work together and be agile, adaptable, and perform well quickly when their is a will. We have long been working alongside partner organisations in Canterbury support health and wellbeing, sustainability and equity being into consideration in policy and planning processes.
During recent months our team and colleagues at Community and Public Health (the Canterbury DHB’s Public Health Unit) have been working on the ground actively manage, investigate, and support those with COVID-19. Our partners in central and local government have been responding to the emergency in myriad ways and preparing for the economic and social response to the consequences of the pandemic. At the same time colleagues in non-government and iwi agencies have been supporting vulnerable people - as they do every day of the year - and planning for the future needs of their populations.
In the midst of this, we have been inspired by New Zealand’s incredible collective action in the name of public health, and we want to support a greater vision - one of a healthy and thriving New Zealand society, supported by central and local government agencies, where environmental sustainability is prioritised and with zero tolerance for inequity, and for conditions that result in preventable illness, both physical and mental.
Like many others, we see this pandemic as an opportunity to do things differently. Instead of setting the bar at stamping out COVID-19 and returning to as close to “normal” as possible, we recognise that normal was never good enough for a large section of our population. The need to involve all sectors in this has been clear for many years. The challenge was explicitly laid out in the 2019 Waitangi Tribunal Hauora report which stated that the achievement of equitable health outcomes for Māori is the responsibility of all sectors.
If Aotearoa is to achieve the vision of a healthy and thriving New Zealand, it is now clearer than ever that all households and whānau need a reliable and sufficient source of income, social connectivity and support, equitable access to appropriate transport, health and social services, nutritious food, high quality warm housing, and education. There is an opportunity now to reimagine our policy platforms in a way that prioritises health and equity outcomes for everyone - to reorient cities, to meaningfully address racial justice, and to rethink our economy. The false dichotomy of healthy people or a healthy economy needs to be confronted – an economy that does not support a flourishing community is not performing as it should. This is also the perfect opportunity to finally get serious about combating the climate crisis.
Our national response to COVID-19 has shown that there is political will to prioritise health, to use evidence-based policy making and to work across agencies to provide solutions – this is HiAP in action and this work is now as important as ever. As a country and a region we need to ensure that the decisions being made not only keep us on the path to recovering from this pandemic, but also address existing inequities, protect the planet and lead to improved population health in the long-term. We encourage our partners, as well as organisations across New Zealand and further afield, to consider these issues in their planning at this time. HiAP approaches and tools can and should support this work and we look forward to working with you on this journey.
Read the July 2020 issue of the CDHB Health in All Policies Newsletter online.
In this issue:
- New resource: Key questions for pandemic recovery planning;
- Working together on psychosocial recovery;
- Rethinking the health system;
- NZTA: Investment Decision-Making Framework;
- Building Health for All® in the face of COVID-19;
- Connecting: Events, Resources, News; and
- Broadly Speaking: Book now for remaining 2020 dates.
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Health in All Policies (HiAP) is a structured approach that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts, in order to improve population health and health equity.
Canterbury's Health in All Policies Team is based at Community and Public Health, part of the Canterbury District Health Board.