2017 HCHB_digital

Preventive Health
There are certain lifestyle choices people can make to increase their chances of
living a long and healthy life. Most are simple and readily available. A summary of
key preventive health topics is given below. For more information about staying
well, see the New Zealand Ministry of Health’s website for New Zealanders,
HealthEd (www.healthed.govt.nz).
Immunisation
Immunisation is one of the most cost-effective ways to prevent disease. It stimulates
the body’s natural immune system to build resistance to specific infections. The
National Immunisation Schedule of New Zealand is the series of vaccines that are
offered free to babies, children, adolescents and adults. For more information on
vaccination and the diseases vaccinated against, see Childhood Diseases and
Immunisations. While many of these diseases are no longer prevalent in New
Zealand, some are endemic overseas and people travelling should ensure their
full childhood course of immunisations has been completed.
Eating and Activity Guidelines
The weight of New Zealanders continues to increase with nearly 32% of adults
reported as obese in the 2015/2016 New Zealand Health Survey, and a further
35% reported as overweight (but not obese). Maori and Pacific adults have
comparatively high rates of obesity (47% and 67% respectively). Obesity rates
in children have remained relatively stable at 11% of children aged two to 14
years; however, Pacific children were more than three times as likely to be obese
as non-Pacific children.
The New Zealand Eating and Activity guidelines recommend to:
• eat a variety of nutritious foods everyday including plenty of vegetables and
fruit; grain foods (mostly wholegrain and high in fibre); some milk and milk
products (mostly low and reduced fat); some legumes, nuts, seeds, fish and
other seafood; poultry and some red meat (with the fat removed)
• choose foods that contain unsaturated fat (rather than saturated fat), that are
low in sodium (salt), with little or no added sugar, that are mostly whole and
less processed
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Use salt sparingly and choose iodised salt over uniodised salt.
• make plain water your preferred drink
• keep alcohol intake low if you choose to drink alcohol; avoid alcohol during
pregnancy or when trying to get pregnant
• partake in at least 150 minutes of moderate or 75 minutes of vigorous intensity
physical activity spread throughout the week. Do muscle strengthening exercises
on at least two days per week. Break up long periods of sitting with activity.
Funded screening programmes
Screening aims to identify the presence or risk of a disease before it has fully
developed or become harmful and there is a range of screening activities open to
a person throughout their lifecourse. Not all are government funded and several
lack evidence that screening is in fact beneficial. Five screening programmes and
one quality improvement programme are currently coordinated by the National
Screening Unit of New Zealand. These are:
• Breastscreen Aotearoa: screens women for breast cancer
• National Cervical Screening Programme: screens women for abnormal
changes to cells on the cervix
• Newborn Metabolic Screening Programme: screens newborns for certain
metabolic disorders
• Antenatal HIV Screening Programme: screens pregnant women for HIV to
reduce mother-to-child transmission
• Universal Newborn Hearing Screening Programme: screens newborn babies
for hearing loss
• Antenatal screening for Down syndrome and other conditions (quality
improvement for screening).
See the table next page for further information about some of these
government-funded screening programmes and others.
Eye health
Glaucoma affects 2% of the population over 40 years and is largely symptomless.
Glaucoma NZ recommends all adults have an eye examination for glaucoma by
the time they are 45 and then every five years thereafter if the examination is
normal. In addition, macular degeneration – a condition that affects almost one
in seven older New Zealanders and is the leading cause of blindness – should be
screened for in those over the age of 50.
Maintaining good oral health
Good oral health is essential to overall health, and oral health services are free
for all New Zealanders until their 18th birthday. Despite this, the prevalence and
severity of child dental decay In New Zealand is higher than that seen in the
United States, Australia, or the United Kingdom. Significant differences exist in
the number of children who are dental caries-free by age five associated with
ethnicity, region and water fluoridation status, and these inequalities, particularly
between Maori and non-Maori, are worsening. In some areas of New Zealand
the severity of dental decay in children is at the level of developing Eastern
European countries.
Pharmacy staff are in an ideal position to educate their customers about
good oral hygiene and free dental healthcare for their children (see www.
healthysmiles.org.nz or ask at the child’s school). For more information see
Oral Health or Toothache.
Sexual and reproductive health
Sexually transmitted infections (STIs) are common in New Zealand particularly
in adolescents and adults aged 15–25 years. Chlamydia is New Zealand’s most
commonly diagnosed STI and if left untreated (70% of people who have it have
no symptoms), can lead to pelvic inflammatory disease, ectopic pregnancy,
urethritis and infertility. The New Zealand Ministry of Health recommends
chlamydia testing be considered in all sexually active people under the age of 25.
Although not as prevalent as chlamydia, the number of people diagnosed with
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Page 124 HEALTHCARE HANDBOOK 2017-2018 Common Disorders