Wheel
Opportunities in
Health
Dr Harriette Carr
Public Health Medicine Specialist
Ministry of Health
Outline
• Why is the Ministry of Health interested in
Cycling
• Structure of the Health Sector
• Strategic Direction relevant to Cycling
• Cycling fit in the Health picture
• Health fit in the Cycling picture
• Government Walk the Talk – a practical
example
Why is the Ministry
interested in cycling?
Obesity Prevalence in NZ Adults
1977-2003
25
20
15
%
Females
Males
10
5
0
1970
1980
1990
Year
2000
2010
Obesity Prevalence in NZ Children
by ethnic group
(2002, age 5-14)
35
Prevalence of obesity (%)
30
25
20
Boys
Girls
15
10
5
0
NZEO
Maori
Ethnic group
Pacific
Ethnic inequalities in obesity prevalence,
2003
50
Maori
45
Pacific
Asian
40
European
35
30
25
20
15
10
5
0
Males
Females
Boys
Girls
Environmental Determinants
Labour saving
technology
Inactive Leisure Options
Sedentary Work
& Leisure
Unsafe play areas
Longer working hours
Urban Design
Physical
Activity
Obesity &
T2Diabetes
E Dense
Food &
Drink
Unsafe walk & cycle routes
Motorised
Transport
Marketing EDF
Long travel distances
Marketing priority activity
Globalisation & Urbanisation
Price
Availability
of EDF
efficiency food production
Preprepared Foods
Vending mach’s/Takeaways
High sugar
content of food
& drink
Why is the Ministry of Health
Interested in Cycling?
• Increasing physical activity
• Individual health benefits
• Reducing inequalities
• Cycling as a means of transport
• Injury prevention
• Environmental health
Structure and
direction of the
Health Sector
Structure of the Health Sector
• Complex sector
• Realigned towards prevention
• Establishment of District Health Boards (DHBs)
• Devolution of funding to DHBs
• Primary Health Care
• Health promotion & preventive care
Strategic Direction relevant to
Cycling
• New Zealand Health Strategy (2000)
• Healthy Eating Healthy Action (HEHA)
Strategy + Background (2003)
• HEHA Implementation Plan (2004)
Creating Supportive Environments
Strengthening Community Action
• HEHA DHB Project Managers
Cycling fit in Health Picture
Ministry of Health
• Policy
• National collaboration and support
• Monitoring, research and evaluation
• National Funder
• Internal Programmes
Cycling fit in Health Picture
DHBs
• Programmes
• Initiatives
• Interagency collaboration
• District Promotion
• District Funder
• Internal Programmes
Cycling fit in Health Picture
Primary Health Organisations
• Funded to deliver health promotion
programmes to their enrolled populations
• Programmes may include cycling
Non-governmental Organisations
• Programmes
• Initiatives
• Promotion
• Advocacy
Health fit in the Cycling Picture
Ministry of Health
• Steering Committee for Implementing Getting
There: On Foot, By Cycle
• Co-Funder BikeWise
• HEHA Research and Evaluation Database
• HEHA Toolbox
• Govt Walk the Talk
• Health Impact Assessments
Health fit in the Cycling Picture
DHBs
• Planning and funding health services in their
regions
• Accountable for health service delivery in their
region
Public Health Units and PHOs
• Health Promotion Initiatives
Government Walk the Talk
A practical example
• Encourage state sector to make responsible
decisions about work environment and
conditions of employment to promote
healthy nutrition and physical activity
• Making healthy nutrition options available and
making physical activity accessible,
convenient and fun
• Opportunities for supplementary cycling
programmes
• Importance of Active Transport
Environmental Determinants and
Related Solutions
BL
O
PR
S
EM
Sedentary Work
& Leisure
Labour saving
technology
Active
schools,
communities,
workplaces
Inactive Leisure Options
Green Prescriptions
Unsafe play areas
Push Play Campaign
Longer working hours
Other SPARC activities
Unsafe walk & cycle routes
DHB / Community Projects
Long travel distances
Transport Strategy
Urban Design
Physical
Activity
Obesity &
T2Diabetes
E Dense
Food &
Drink
Motorised
Transport
Marketing EDF
Marketing priority activity
Marketing Healthy Foods
Globalisation & Urbanisation
Breast feeding promotion
Price
efficiency food production
Availability
of EDF
Food Industry Accord
Preprepared Foods
Influence price & availability
Vending mach’s/Takeaways
DHB / Community Projects
High sugar
content of food
& drink
Fruit in
Schools &
other school
programmes
SO
LU
TIO
N
S
More Active
Work & Leisure
Environments
supporting PA
Active Transport
Healthy Marketing
& public awareness
Improved food
availability
Env’s supporting
healthy eating
Physical
Activity
‘Normal’
Energy
Intake
Healthy
NZers