August 2012 - Public Health Association of New Zealand

From the PresidentNew PHA CEOThe PHA ExecutiveCouncil is delightedto announce theappointment of new CEOWarren Lindberg.Warren is a longstandingPHA member and a leaderwithin the public healthcommunity. He is anexperienced not-for-profitCEO, well versed withframeworks and evidence useful to public health analysis,and an articulate public and media spokesperson.Since March 2007 Warren has been Group Manager,Public Health (now part of the Ministry of Health’s NationalHealth Board) where he was responsible for contractingpublic health services, including those with nongovernmentorganisations.However he is best known for his 12 years as the firstExecutive Director of the New Zealand AIDS Foundation(1986 to 1998), and as Manager of the Project to CounterStigma and Discrimination Associated with Mental Illnessfrom 1999 to 2001, including the launch of the mass mediacampaign “Like Minds, Like Mine”.Warren has been a Human Rights Commissioner (2001-2006), a lecturer in management in the Bachelor ofCommunity Practice at Unitec, a team manager in theAuckland Regional Public Health Service and PublicHealth Planner with the Northern DHB Support Agency .In 1999 he was made a Member of the New ZealandOrder of Merit for services to welfare.Warren says the public health sector has given him greatopportunities over the last 26 years.“I’ve been able to contribute my passion (and hopefullysome modest skills) towards better health for communitieswith which I have closely identified.“Working in the Ministry, with responsibility for funding thesector I had been a part of, has challenged me in ways Icould not have anticipated. I now know a lot more aboutdoing more for less.“As Lord Rutherford reputedly said, ‘We didn’t have themoney so we had to think.’”The PHA was established to provide leadership in thinkingabout Public Health, and Warren says he feels veryprivileged at this new opportunity to work collaboratively tohelp improve health for all New Zealanders.Warren will start with the PHA on Sunday 2 September atthe Executive Council meeting leading into the WellingtonGateway Events and conference.The Executive Council would also like to say a very bigthank you to Janice Burns who has been Acting Managersince November 2011. She and the team have updated alot of PHA systems and processes, and Janice has workedwith the Executive Council to enter negotiations with theMinistry of Health around our contract as a consequenceof the alignment review conducted by Bruce MacDonald.Janice has been consulting with branches and caucusesaround other recommendations from the review whileworking with PHA staff around submissions and ourcontract. She has also begun some of the planning workaround our organisation’s increased membership focus.Janice and Warren will be having a formal handoversession and Janice has kindly offered to remain on handto help with queries once Warren has taken over the reins,which bodes well for a seamless handover.With the appointment of a new CEO a new chapter willunfold for the PHA. We will continue to move forwardand learn from our history and rise to challenges andopportunities in the environment around us.I am sure you will all join me and the Executive Council inwelcoming Warren to this critical public health leadershipand influence role.Review updateAs members will know, the PHA Executive Councilcommissioned a “whole of organisation alignmentreview” of the PHA, which was conducted by BruceMacdonald and completed in March this year.The purpose of the review was to examine the structure,roles, capacity and finances of the organisation to ensureit is in the best position to meet present and futurechallenges.The review affirms there is a clear and ongoing role forthe PHA as an umbrella voluntary association for all thosein public health. The PHA potentially provides a meansof collective focus across a wide range of disciplines/professions/occupations within the sector. But to achievethis, the PHA must be an organisation that provides realand perceived value to its members, and that has broadappeal to the wide range of public health groups andindividuals.A key theme of the review was that there is enormouspotential for the PHA to grow in terms of membershipand effectiveness by demonstrating its relevance andimportance to members, to potential members, andto those who work in similar public health workforceorganisations.The review was largely about assessing how well the PHAis achieving this, and how things could change so we canachieve it better.2PHA News August 2012

In this issue:From the President 2What has the PHA beendoing for you?4A farewell to Dr AlisonBlaiklock5Warren LindbergHealthy skin – a publichealth success story6The review makes recommendations around the PHA’sinternal and external alignment and you can read aboutthese in the summary report. The recommendations had todo with the PHA’sAround the branches 7• strategic focus and work plan• Executive Council composition• staff composition• relationship with the Ministry of Health• bilateral relationships• annual conference• finances• membershipand more.He taonga te mokopuna –the child is specialPost Budget Breakfasts2012910The Executive Council is excited about the road aheadin light of the review and will intend keep members up-todatewith further developments as they arise.However, if you have remaining questions – about eitherthe review or the chief executive officer role – you arewelcome to contact me: monicabriggs@xtra.co.nz.Conference 2012 12While the main report remains confidential to the ExecutiveCouncil, a summary report has been prepared and isavailable to all members atwww.pha.org.nz/documents/Summary-PHA-Review-May-2012.pdf.Monica BriggsPHA PresidentChanging the language ofpublic health14Vol XV No 2 PHA News3

What has the PHA been doing for you?PHA staff at a breakfast celebrating Matariki in Wellington; from left to right: Keriata Stuart (Strategic Advisor, Māori Public Health),Janice Burns (Acting Manager), Leona Head (Administration and Membership Manager), Diane Reay (Office Assistant)So far, 2012 feels like it’s been a non-stop roundof developing submissions, presenting to SelectCommittees, and talking about submissions to themedia.The major focus of the year has been child wellbeing anddevelopment.For many years, organisations such as the PHA have beentrying to get politicians and media interested in improvingthe health and wellbeing of New Zealand children.In 2012 it looks as though the issue has finally cometo the fore. So far we’ve had the government’s GreenPaper for vulnerable children, the Māori Affairs SelectCommittee inquiry into the determinants of wellbeing forMāori children, and the Health Select Committee’s inquiryinto preventing child abuse and improving children’shealth outcomes – and sometimes even PHA staff wereconfused about which inquiry we were dealing with!However, the PHA has taken a consistent approach,encouraging government to take action on the ‘causesof the causes’ of New Zealand’s poor child outcomes,including housing, income and other disparities.When we presented to the Māori Affairs Select Committee,we urged government to introduce child/tamariki impactassessment. This would mean that that all new central andlocal government initiatives would be tested for their likelyimpact on tamariki Māori, and all New Zealand children.The PHA’s Keriata Stuart told the committee that notonly would this stop many policies having unintendedconsequences for children but, more importantly, it wouldmean children being seen as worth taking notice of, and asa national asset to be invested in, rather than as a cost asat present.Reducing child poverty was also the topic from this year’sPost-Budget Breakfast in Wellington. The PHA took theinitiative to bring together many of the groups who havebeen active in making submissions and advocating forchildren, including Every Child Counts, Plunket, Unicef,the Cancer Society and the New Zealand NursesOrganisation.We’re continuing to work collaboratively with these andother organisations to seize the opportunity of making realchange for New Zealand children.4PHA News August 2012

Healthy skin –a public healthsuccess storyThose working in public health can often feel likethey’re “up against it”. The foresight of preventioncan be a struggle in an environment where thereare insufficient resources or too many policychallenges. So it’s great, every now and then, tocome across a story that helps us celebrate whatcan and has been successfully done in publichealth. Keeping Well’s ‘Healthy Skin in GreaterWellington’ initiative is just such a story.Keeping Well is the population health strategy forthe Wellington region and its implementation isled by Regional Public Health.By 2010, Wellington and Hutt Valley DHB data showedthat, for children under 14 years, 65.7 per 10,000 werebeing admitted to hospital with serious skin infections. Thiswas quite a shocking increase from 1996/7 figures of just15.4 per 10,000.What’s more, there were the usual ethnic and socialdisparities with the significant majority of children admittedcoming from Māori and Pacific families, and from thepoorer parts of greater Wellington.Alarmed by these increases, Regional Public Healthreviewed what it was doing about serious skin infectionsand organised an inter-disciplinary hui attendedby representatives from the DHBs, Primary HealthOrganisations and numerous health providers andgovernment agencies.Together they formed an initiative called Healthy Skinin Greater Wellington and developed a Roadmap forcombating the increasing burden and disparities of seriousskin infections among children.The Roadmap identified a number of required actionareas, but one of the most significant was ensuringa common approach to the prevention, assessment,management and treatment so that health professionalsacross the region were consistent in the treatment andadvice they provided.To achieve this more standardised approach Healthy Skinin Greater Wellington was supported by five resources,mainly focussed on children.The first resource, the Healthy Skin Tool, was originallyfor clinicians to use to educate their patients about skininfections, how they should be treated and how to avoidthem in future. However, it quickly also began to be usedmore widely by other community organisations highlightinga widespread recognition of the problem in the region.The Healthy Skin Tool uses pictures to feature fivedifferent stages of the development of a serious skininfection (using traffic light colours), from healthy to inneed of hospitalisation, and lists advice and guidelines fordealing with each stage.“One significant achievement is that thesame messages about skin health arestarting to be used by the health sector andthe wider community across the region.”The resource has been in circulation since November2011, and, based on feedback, an updated version isabout to be released.While it is too early to officially evaluate the success of thisresource alone, Barry Gall, a Senior Public Health Advisorat Regional Public Health, said the Healthy Skin Tool hadbeen very widely welcomed.“We’ve had people asking for the resource from all aroundthe country and, at the request of some stakeholders,we’ve adapted the tool for adult cellulitis.”The second resource is a set of protocols for healthprofessionals aimed at promoting evidence-basedpractice for the prevention, assessment, management andtreatment of skin infections in people of 25 years of ageand under.Endorsement for the final version is currently being6PHA News August 2012

Healthy skin Minor cut, sore or other Minor skin infection Skin infection that isskin conditiongetting worseSerious skin infectionsought from several DHB and PHO clinical and qualitycommittees.The third and fourth resources are targeted directly atparents and children, and include a poster, postcards,stickers and a colouring-in sheet that present basic healthyskin messages, such as CLEAN , CUT, COVER; CLEANhands often, CUT nails and wash and COVER sores andcuts.Based on feedback, these resources are simple and clear;show healthy, happy children to draw in the reader; andgive succinct advice about treatment for a skin infections.The final resource is the Skin Health Supports Directory, aguide to the many resources and services available in theregion that support families and whānau to better manageskin conditions and infections.It contains practical information on first aid and infectionprevention as well as medication and financial supports.Public Health Physician Dr Ruth Richards says theresources are already achieving some success.“One significant achievement is that the same messagesabout skin health are starting to be used by the healthsector and the wider community across the region.Patients are getting the same advice wherever they turnup.“And although any change cannot be attributed solelyto these resources, we are anecdotally hearing thatpresentations to hospitals are reducing.”Combined, these resources address the need for amore focussed approach to the prevention, assessment,management and treatment of skin infections in children,and that’s great public health news.Regional Public Health will officially launch the resourcesin August 2012.Around the branchesHere’s a roundup of what some of the branches have been up to since the last PHA News.Welcome back Auckland!The PHA is pleased to announce the re-forming of theAuckland PHA Branch, consisting of Nicole Coupe andSitaleki Finau (co-chairs) along with Bruce Macdonald andIsis McKay (co-treasurers/co-secretaries).Nicole Coupe Sitaleki Finau Isis McKay Bruce MacdonaldThe branch re-formed in the beginning of April and had itsfirst meeting to determine the future structure and committee. At our next meeting we are looking forward to creatingvision and direction for the Auckland branch. We would appreciate any ideas from Auckland branch members and lookforward to meeting in July.Nicole Coupe has a PhD in Whakamomori: Māori suicide prevention and feels privileged to be elected co-chair of theAuckland Branch. She has worked as an academic researcher using kaupapa epidemiological methodologies to improveMāori health outcomes for the last 14 years. Until recently she managed the Public Health Groups Infrastructure Teamwithin the National Health Board.Siteleki Finau is the Professor of Pacific Health Development at the School of Public Health, Massey University, and amember of the of the New Zealand Order of MeritIsis McKay is the Maternal and Child Health Promoter at Women’s Health Action. She also chairs the Metro AucklandBreastfeeding Network and sits on various consumer and stakeholder groups.Bruce Macdonald has qualifications and work experience in social work, law and public health. He has worked as a publichealth planner and funder with North Health, the Health Funding Authority and the Ministry of Health. From 2000 to 2004he managed the Ministry of Health’s Public Health Team in the Northern Region.Vol XV No 2 PHA News7

Asian CaucusLifeng ZhouAsian Caucus RepresentativeThe Asian Caucus is working on the Asian PHO enrolment project to improve enrolment with GPs andaccess to primary care in the Auckland region.Two presentations will be made at the Fifth International Asian and Ethnic Minority Health and Wellbeing Conference2012, with one on “Reflections on health needs of Asians and the strategies for improving Asian health”.An Auckland regional cervical screening governance group has just been set up on behalf of the Asian/migrantcommunities, with Dr Lifeng Zhou providing epidemiologic expertise. The cervical screening rates of Asians are verylow when compared with Europeans.There is also a plan to have the first caucus meeting of Asian PHA members this year.Māori CaucusWaitangi WoodMāori Caucus RepresentativeWe are pleased to announce that the Māori Caucus will be facilitating the National PHA Conference 2013.The theme for the conference is Partnership. We will be catching up with Maori Caucus members andother Branch Members whohave expressed an interest in being part of the Conference 2013 development.If you would like to advise your interest in being part of the Convening Group, please email Waitangi Wood:waicommunications@gmail.com.Otago/Southlandthe year.Jean SimpsonOtago/Southland Branch RepresentativeThe PHA/Department Seminar Series has continued to run smoothly. You will notice it has been moved toa lunchtime slot. So far there have been favourable comments, but that decision will be revisited later inMembership continues to be a major challenge for us: one that is shared with many other PHA branches nationallyand internationally.We have work to do to re-engage with the public health sector working in the District Health Board. We have work todo to increase our engagement with the academic community, and I think we have to think beyond the traditional areasto recognise, support and seek collaboration with people working in a range of NGOs that we may not necessarilyseen as doing public health, but who have common concerns and values.Canterbury-West CoastMartin WittCanterbury-West Coast RepresentativeMid-year finds the Canterbury-West Coast branch with some new faces.In June we held our AGM at which we sadly said farewell to Lynley Cook, who, as Chair, provided sterlingleadership and encouragement to the branch following the February 2011 earthquake. Lynley was, in no small way, thedriving force behind the branch’s decision to continue with its role as conference host in 2011, despite the need to finda new venue. We will miss her contributions to the branch and trust that she will return before long.At the AGM, members were also treated to a reflection on public health over the last 30 years by long time memberAssociate Professor Pauline Barnett (Public Health Champion 2004). Pauline has also stepped down from branchactivities and Canterbury-West Coast owes Pauline a huge amount for her drive, enthusiasm and teaching on manyaspects of public health – thank you!At the same time we welcomed Dr Rachel Eyre as our new Chair. Rachel is a Public Health Medicine Specialist with abackground in rural health, health promotion, policy analysis and health services research, now working at the SouthIsland Alliance Programme Office. We confirmed Lynne Haslett as our Treasurer and Nicola Laurie as Secretary.The branch is now looking forward to developing its advocacy strategy as well as to planning a branch seminar later inthe year.8PHA News August 2012

On 25 May the PHA Wellington and the Child Poverty Action Group hosted the annual WellingtonPost-Budget Breakfast with the theme “How do children fare?” Similar breakfasts were held inAuckland, Whangarei and Christchurch.Here are some speaker snapshots from the various Breakfasts.Sue Bagshaw, University of Otago, (Christchurch Breakfast)New Zealand’s pipeline policy approach to dealing with youth denies them the opportunity tocontribute, participate and flourish on their own terms.A worrying change is the way school data, including reports, are being forwarded to theMinistry of Social Development without the child’s or parent’s permission. Regardless ofwhether they were from a period where a young person was troubled, this information wouldpermanently stay on their record, potentially preventing them from ever making a fresh start.New Zealand and Finland are countries with similar problems of youth suicide, but very differentapproaches to taxation, wellbeing, and strategies for youth unemployment. Youth suicide in Finland isdeclining, but continuing to rise in New Zealand.Bronwyn Hayward, University of Canterbury, (Christchurch Breakfast)New Zealand has the highest youth unemployment rates inthe OECD at 45 percent. This, along with poorchild outcomes as measured by UNICEF and the OECD, reflects a growing intergenerational inequality.We’ve cut off options for them to stay in tertiary training after four years, we have no new schemesfor senior secondary public education despite having the worst record in the OECD at keeping highschoolteens in education, and now we’re making incremental cuts to primary education and effectivelyprivatising early childhood education. So what do we expect our young people to do?Now, greater burdens are being shifted onto our youth while the wealthy get tax breaks.Susan St John, University of Auckland, (Auckland Breakfast)This Budget does not mention the plight of many children and families. Unlike the AustralianBudget, which acknowledged the financial pressures families face, there were no words ofempathy for struggling families.New Zealand is already seriously indebted, and the current account deficit is only projectedto get worse. However, the Finance Minister’s optimistic forecasts of growth do not stack upagainst figures which show that the 2012 budget will slow down the economy, and will continueto do so for the next four years as population ageing begins in earnest.Overall, inequality and poverty will continue to increase, with all the associated misery and injustice.Jonathan Boston, Victoria University(Auckland Breakfast)This Budget has no reference to childpoverty, and no concerns for theneeds of an ageing population. In theUK they have the Child Poverty Act of2010 which has set a target of halvingchild poverty by 2020. The Act issupported by the three main political parties andhas also established a commission that monitorsits progress and requires councils to developlocal strategies.This is exactly what New Zealand needs.Dr Fiona Cram, Ngāti Pahauwera and founderof Katoa Ltd (Auckland Breakfast)There is a stark contrast in NewZealand between the demographicprofiles of Māori children and Pakeha.Dominant populations seem to enjoyinvisible privileges, while minoritygroups, such as Māori and theirPacific cousins, though in the same environment,battle constant headwinds.These micro-assaults cause glaring differentialsin life chances between Māori and Pakeha,something this Budget has neglected to address.Vol XV No 2 PHA News11

Conference 2012The Wellington branch is pleased to announce thatthe 2012 Public Health Association Conference isshaping up to be another fantastic three days! It’s thepublic health event of the year, and not somethingyou want to miss.ThemesThe theme of the conference is “Equity from the start –valuing our children”. The focus will be on children and thesocial determinants of their wellbeing, as well as on ourresponsibility to provide equal opportunities for every child,regardless of their parents’ income, education or ethnicity.Many children in our country are not getting a good startin life. High rates of preventable diseases, the emergenceof skin conditions as a child health issue, high rates offoetal alcohol syndrome, high profile child abuse casesand deaths, children going to school without breakfast andhaving no lunch – these are all indicators that things arenot good for our nation’s children.And these burdens of poverty, stress, racism and poorhousing are being disproportionally borne by Maori andPacific children.Five sub-themes have influenced the planning of theconference programme:• Looking back to look forward – identifying whathas already been achieved to improve child healthand improve equity and what challenges lie ahead• Values to achieve equity – investigating theapproaches needed to achieve equity and whichhighlight the values behind these approaches• Children’s voices – projects or activities that bringchildren’s voices into decision-making processesand seek active participation from children• What can we agree on? – activities or approachesthat help us to develop a consensus and moveforward• Taking action – success stories, evaluation ofapproaches, identifying actions where there isevidence of effectiveness.ProgrammeA draft programme has been made available on theconference website. It contains a conference scheduleand information about the keynote presentations. Theprogramme will be updated as details are confirmed.Gateway and associated eventsPrior to the start of the conference, a series of Gatewayand associated events will be held in the Wellingtonarea. Some of these events will be focused around theconference theme and others involve gatherings of interestgroups or caucuses within the Public Health Association.These events include an analysis of manifestations ofracism within the public sector, a workshop on ideas forCONFERENCE 2012moving towards a smokefree Aotearoa by 2025 and adiscussion forum on what communities can do to influencegovernment policy discussions.More information about the Gateway and associatedevents Equity is available on from the conference the website, start includingwhen, where and how much each event will cost. You canstill register to book your place at one of these events evenif-youvaluinghave already registeredourfor theChildrenconference.Carbon offsetting policyThis year the PHA Conference will continue with thesuccessful approachPipiteataken inCampus2011 to offset conferencerelated carbon emissions.The PHA carbon Victoria offsetting policy University is available on theconference website. This year a sum of $15 per delegatewill be used towards WELLINGTONfunding NGO advocacy (outside ofthe PHA) on climate change issues.Facebook3 - 5 September 2012Gateway sessions3rd September 2012PHA Conference 2012 is now on Facebook! You can findthe page at www.facebook.com/PHAconference2012.We’ll be updating the page regularly with conference newsand information,www.pha.org.nzso make sure you visit the page often tolearn more about the conference, post queries etc.Please add the page to your list of “Likes” and encourageyour friends and colleagues to do the same!We look forward to seeing you at the conference!Nau mai, haere mai, whakatau mai!Noho ora mai ra, na,Michelle MakoConference Co-Convener12PHA News August 2012

The 2012 PHA Conference in Wellington will be the key New Zealandpublic health event of the year, so make sure you don’t miss out.You can read more about the conference and register athttp://conference.pha.org.nz.SpeakersWe’re pleased to announce our impressive line-up ofinternational and local speakers:Hon Dr Tuitama Leao Talalelei Tuitama:Minister of Health for Samoa. A medicalphysician by profession, he was the Head ofMedical Unit of the Samoa National ReferralHospital in Apia during the 1990s andpracticed as a Private Medical Practitionerbefore endeavouring on a political career. Hon Dr Tuitamahas also represented Samoa on numerous regional andinternational meetings over the last decade.Sir Michael Marmot: Chair of theCommission on Social Determinants ofHealth at the World Health Organization.The review he led for the British Governmenton improving health and improving fairnessin health identified the six most effectivestrategies to addressing inequalities.Please note: unfortunately Sir Michael Marmot is unableto attend the conference in person, but will be presentingvia a pre-recorded video specifically tailored for the PHAconference.Peter Boshier: New Zealand Principal FamilyCourt Judge. Peter has worked extensivelyin the management of the Family Court andjudicial system. In 1993, he completed areview of the Family Court, which resulted inchanges to Court processes.Russell Wills: New Zealand’s Children’sCommissioner. He has had leadershiproles in community paediatrics with thePaediatric Society of New Zealand and theRoyal Australasian College of Physicians,and contributed to national guidelines andprojects on family violence, child abuse and medicalaspects of children in Child, Youth and Family care.Cindy Blackstock: Executive Director, FirstNations Child and Family Caring Societyof Canada. Cindy has worked in the fieldof child and family services for more than20 years. Key interests include exploringstructural drivers of child maltreatment inFirst Nations communities, human rights and the role ofthe voluntary sector in expanding the range of culturallyand community based responses to child maltreatment.Anne Smith: Emeritus Professor fromCollege of Education at Otago University.From 1995 until 2006 she was Director ofthe Children’s Issues Centre, which carriedout research on children’s wellbeing andrights in such areas as family law, earlychildhood education, and the prevention of child abuse.In 2009 she received an award from the United States forher “research and advocacy to ensure that the voices ofchildren are heard”.Cindy Kiro: Head of the School of PublicHealth at Massey University, and previouslyChildren’s Commissioner. Her areas ofresearch expertise are Public Health, MāoriHealth, Children and Young People Policy,and Māori Development.Associate Minister of Health Hon JoGoodhew (with responsibility for publichealth) will be speaking to on 5 September.Two of our Children’s voices keynote speakers areJazmine Heka (a 16-year-old child poverty campaignerfrom Northland) and Veronica Ng Lam (Save the ChildrenFund Youth Advisory Committee Chair). These youngpeople will be presenting about raising the profile ofchildren and young people’s voices.Vol XV No 2 PHA News13

come wrapped in language that people associate withphilosophies or political views they oppose, it mayactually increase their opposition to any action on healthinequalities.The CRG suggests it’s important to frame messages inpolitically-neutral language that won’t alienate a significantportion of your audience.So is there anything we can learn from this aboutexpressing public health messages in New Zealand?Perhaps when we’re writing or speaking for a generalaudience we could piggy-back on the Commission to Builda Healthier America’s effective metaphors and talk aboutour children’s lives in terms of a journey. We could uselanguage that emphasises our unity as a people (‘those onvery low incomes or in inadequate housing are fellow NewZealanders who are suffering’) rather than in ways thatsegregate. We could talk about the costs of ill health interms of using up resources that are valuable to us all. Wecould talk about New Zealand core values, such as ‘givingpeople a fair go.’Should we rely less on facts and statistics and spend moretime telling people’s stories to show how health policychanges could positively affect other people’s journeys?The Quit Group does this effectively by profiling veryreal but very ordinary people whose health has greatlyimproved by becoming smokefree. Perhaps this approachcould be used more widely.The PHA also works hard to avoid politically chargedlanguage wherever possible, so that terminology doesn’tdistract from the real issues. We’ve also picked upthe RWJF’s recommendation of starting written or oralpresentations with acknowledgment of common values,rather than by confronting or challenging the people we’recommunicating to.And lastly, perhaps the public health community shouldn’tbe afraid to acknowledge that New Zealanders do have totake some responsibility for improving their own lives. Byextending that olive branch as a starting point, we mightfind more of the general population still listening when wetalk about how that’s easier to do for some people thanothers because of the particular pathway (journey) they’vebeen dealt.Read about the Robert Wood Johnson Foundation work at www.rwjf.org/pr/product.jsp?id=53235 andwww.rwjf.org/pr/product.jsp?id=66428.Vol XV No 2 PHA News15

“The PHA — leadingthe public healthapproach for healthequity, underpinned byTe Tiriti o Waitangi”