Source: NZ Doctor
Two-thirds of Auckland adults and a third of children are
overweight or obese and almost half of the city's residents are not
physically active enough to be healthy.
Those are just two statistics which clinical director of the
Auckland Regional Public Health Service, Julia Peters, is hoping to
turn around via a major collaborative plan for the country's
biggest city, entitled Healthy Auckland Together.
The initiative involves a large number of organisations, including
DHBs, PHOs, the Ministry of Health, local body authorities such as
Auckland Transport and Auckland Council and various NGOs.
Primary care and general practice must be
Dr Peters says it's the first time such an inter-sectoral approach
has been employed to try to reduce obesity, increase physical
activity and improve nutrition in Auckland. ARPHS is leading the
project and aims to have a plan ready by June, and Dr Peters wants
to get primary care and general practice on board.
"We need to start to walk the talk," she says. "It's important
that in a primary care setting we are not blaming the victim. GPs
and practice nurses remain a very trusted point of contact. They
need to be having those courageous conversations about sedentary
lifestyles and obesity."
She says GPs can also contribute by doing regular checks on the
BMI of patients, including children. "It's really important.
Children need to be a big focus."
The problems are most pronounced in areas such as Counties Manukau
which has some of the city's lowest socio-economic neighbourhoods,
and which are also the areas where primary care practitioners are
most stretched, she says.
Building up problems for future
Dr Peters acknowledges healthy eating initiatives have been tried
in the past, but the problems of obesity and diabetes have
continued to grow.
"This is a problem which will require an inter-sectoral approach.
It's not going to be solved by the health sector alone."
Early work on the plan has identified numerous action points, some
of which are quite radical.
- implementing healthy food policies within organisations and
requiring similar policies for contractors and within vendor
- mapping the density and location of fast food outlets and
submitting on the Resource Management Act review to provide
councils with the ability to zone for these outlets
- advocating for legislative changes to limit food advertising to
children and reviewing advertising on member organisations'
- advocating for supermarkets to have at least one aisle free of
energy-dense food and developing a healthy supermarket accord.
Focusing on the 'doable'
Dr Peters admits not all the recommendations will make it into the
final plan. ARPHS will focus on "things we believe are doable in
our sphere of influence, that make a difference in reducing
"Obviously some, like advertising, require action at a national
level. Maybe they are things we can discuss with the ministry.
Rather than wringing our hands and saying it's all too difficult,
we will put the evidence forward for what changes will need to
happen at a national level.
"We are going to see how we get on in the next three to five
years. We're not pretending this is easy, and just as tobacco has
taken a long time and we are not there yet, we are not expecting
this to change overnight."