The challenge of reducing health inequities

The challenge of reducing health inequities and improving health outcomes in New Zealand

The Healthier Lives – He Oranga Hauora National Science Challenge welcomes the announcement from the Minister of Research, Science and Innovation Hon Megan Woods, which confirms funding for its 2019-2024 research strategy.

Director Professor Jim Mann says the new Healthier Lives five-year strategy puts equitable health outcomes at its very heart.

“We have forged new ground in health research by partnering with the Whānau Ora Iwi Leaders Group, as well as working with a committed group of communities, NGOs and health services who share our vision,” he says.

“New Zealand can be a world leader in our efforts to achieve equitable health outcomes. The group of eminent international scientists who reviewed Healthier Lives earlier this year was impressed by the way in which the Challenge is working effectively to enhance equity, commonly stated as a goal internationally.”

Healthier Lives, which is charged with reducing the burden of major New Zealand health problems, consulted widely to develop an innovative strategy focusing future research into three broad areas:

1. Healthy food and physical activity environments

2. Culturally centred health interventions

3. Precision medicine and personalised prevention.

“Over the next five years, Healthier Lives will consolidate a portfolio of activities within these three themes, guided by an overarching determination to reduce health inequities,” says Professor Mann.

“The new themes acknowledge that to improve health outcomes we need to work at many levels, ranging from systems that affect the health of the whole population, to approaches that are effective for particular communities, as well as interventions that take into account the genetic make-up and life experiences of individuals.”

Although there have been significant health improvements over the last few decades, New Zealand still has very high rates of non-communicable diseases and major inequities in health outcomes, for example:

· heart disease occurs six to eight years earlier in Māori and Pacific populations than in the rest of the population;

· adults living in the most economically deprived areas of New Zealand have obesity rates 1.7 times higher than those in least deprived areas;

· new cancer registration rates are almost a third higher for Māori than non-Māori;

· the prevalence of diabetes in Māori and Pacific populations is around three times higher than among other New Zealanders, and also high among South Asian populations.

Healthier Lives Governance Chair Dr Jenny McMahon is proud of what the Challenge has already achieved: “Healthier Lives has been up and running for just three years, a relatively short time in terms of research results, but is already making significant headway in its mission to turn the tide of non-communicable diseases,” she says.

Notable achievements include:

· An early outcome of Healthier Lives research, jointly supported by the Health Research Council of NZ, Ministry of Health and Heart Foundation, is a new approach to detecting cardivascular disease risk. This will enable protective measures to be recommended earlier than is currently the case and particularly benefit those at high risk of developing the disease.

· Healthier Lives researchers have also shown that a simple blood test to detect circulating tumour DNA (ctDNA) in colorectal cancer and melanoma patients has potential to improve monitoring of these diseases. By reducing the need for frequent hospital scans it promises particular benefit for cancer patients living in rural and isolated parts of the country.

· A mobile phone app aimed at encouraging healthy lifestyle choices, (OL@-OR@) has potential to support prevention of disease from an early age. The app was co-designed by Healthier Lives researchers with several Māori and Pacific communities, and is currently being evaluated.

The Healthier Lives Challenge is hosted by the University of Otago. Deputy Vice Chancellor of Research and Enterprise, Professor Richard Blaikie praised Healthier Lives for its rapid progress and highly collaborative approach to science.

“It has been exciting to see how Healthier Lives has constructively engaged with a wide range of partners to improve the health and wellbeing of New Zealanders. They received high praise from national and international experts for the way in which their highly collaborative approach has become a fulcrum for real change. ”

Sample highlights in Healthier Lives news stories of the past year:

· Detecting CVD risk for NZ’s unique populations

· Reducing inequities for cancer patients in New Zealand

· Empowering youth for a healthier Pasifika generation

· Putting healthcare into patients’ hands

· Empowering people to take charge of diabetes

· Canterbury quake damage increased risk of CVD

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