Getting people out of their cars is good for the health system says Associate Health Minister Julie Anne Genter, whose responsibilities include encouraging more walking and cycling-friendly towns.

Genter is the first associate health minister to be given the new health responsibilities of “population health: built environments” and climate change.

She said she sees these newly created health delegations as providing an opportunity for the health sector to be part of the solution when it comes to both climate change and supporting active, healthy transport environments.  Particularly through organisations like the Ministry of Health, district health boards, local authorities and the NZ Transport Agency working more closely together.

Genter said while built environments might be brand new to the portfolio of  New Zealand’s health ministers’ it wasn’t unknown internationally.

“Elsewhere in the world it was understood for a long time that there is a huge connection between the quality of the built environment, people’s physical activity levels and their overall health.”

“And since non-communicable diseases are just such an enormous looming problem all across the Western World.  It’s become ever more important that we recognise the towns and cities we are building are affecting people’s health.”

Genter said built environments and active transport (like cycling or walking) were already a focus in her associate transport minister role.

“Because the transport sector holds the levers to how people get around and whether they walk, cycle or use public transport – or whether they are trapped in cars and commuting for long-hours.

“But most of the benefits of increased active transport (people cycling or walking instead of taking a car) and even public health transport will actually be felt in the health system.  Especially in New Zealand because we have the third worse rate of childhood obesity, we have a very steep increase in non-communicable diseases like type 2 diabetes – which have a whole host of flow-on impacts.”

Genter said the point of her being delegated “population health: built-environments” to her associate health minister’s role was to join-up health and transport so as to be able to have all of the government agencies, local government and DHBs working together for outcomes that were both better for people’s health and the transport network.

She said ‘active transport’ was not just about promoting healthier options like walking and cycling but also ease of access to public transport.  As she said there had been many studies showing that people who use public transport were likely to walk more and get their daily recommended physical activity by just walking to the bus or train.

“We want the Ministry of Health and DHBs to be very actively involved in supporting a shift to more walking, cycling and public transport along with changes that need to be made to the infrastructure needed to support that coming through local authorities and transport authorities.”

Genter said while there had been previous interest in the health impacts of transport but there hadn’t been a formal role for the Ministry of Health to be involved.  “I think there is a real huge potential for positive benefits.”

Climate change and health

Genter said her ministerial work on climate change and health would concentrate on two aspects – firstly preparing to deal with the expected impacts of climate change* and also addressing the health sector’s own contribution to the country’s carbon footprint.

“Health sector is estimate to produce between three and eight per cent of total greenhouse emissions.”  She said this included the materials procured and used by health providers, hospitals that were heated by coal-fired boilers and hospital waste.

Genter believed there were “benefits across the board” if the health sector started measuring and making a concerted effort to reduce greenhouse gas emissions from health. She said Counties Manukau DHB have led the way in doing this and and had made a huge reduction in their emissions and their overall carbon footprint.  “I think they have demonstrated what can be achieved in a short period of time and what the benefits are.  And it will be my role to see this rolled out across the country.”

She added that there was already health professionals active in the area of climate change action, including groups like OraTaiao, the NZ Climate & Health Council.

Overlooked women’s health issues

Genter is also Minister for Women and said she saw it as really useful to link that role with her associate health role so also has a delegation for women’s health issues – including breast and cervical screening.

Some of the women’s health areas she believed need more attention include endometriosis, maternity issues (particularly equity of access to maternity care) and postnatal depression. “Historically some women’s health issues have not received as much attention as other health issues – so I think there’s really good opportunity with ministerial responsibility to make some good progress in that area.”

Still new to her portfolio she says she hasn’t had a chance to look indepth at many issues, including midwifery shortages.  “It is early days… but I am concerned about both the shortage of midwives and the working conditions for midwives – because that affects the experiences that parents have.”  (See related story: PMs pregnancy will help highlight women’s health issues)

Sexual health

Another area that Genter believes needs more attention is sexual health which is another one of  responsibilities as associate health minister.  “Again it is another area which I think was somewhat languishing under the previous government because it wasn’t included in the National Health Targets.”

Genter said with the major population increase in Auckland the country was actually seeing a  surprising increase in some sexually transmitted infections (STIs) like HIV and syphilis.  “So there is a real urgent need to ensure that the sexual health action plan that has been developed is actioned.”

Disability Services also priority

Last on her list of  associate health minister delegations is Ministry of Health-funded disability services for under 65 year olds but Genter says disability services is definitely a priority for both her and the Green Party.

She said disability services was already in a process of transition when the Government was elected, as a national roll-out is due to get underway this year of a new disability support system.

The system, built on “Enabling Good Living” demonstrations in Christchurch and Waikato, is to be rolled out in MidCentral in July 2018.  Genter said the implementing and monitoring the roll-out would be a priority for 2018.  “I think it is really important to ensure we get lots of feedback and make sure we are getting this right.”

Genter said also to be implemented was the Faiva Ora 2016-2021 National Pasifika Disability Plan and the Ministry of Health was currently refreshing Whāia Te Ao Mārama: The Māori Disability Action Plan and the Community Residential Strategy.  “So there is quite a lot happening in the disability space and this is an area that has been a real priority to the Green Party generally so I’m really pleased to be able to have some oversight and input to make sure we are meeting the needs of everyone in the community”.

*The World Health Organisation last year said it was predicted that climate change would cause about 250,000 additional deaths between 2030 and 2050 from malnutrition, diarrhoea and heat stress because of weather-related natural disasters, variable rainfall and extreme heat.

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