|Health promotion opportunities: Smokefree signage at sports facilities and racecourses with outdoor stands
Assoc Prof George Thomson1, Prof Nick Wilson1
1University of Otago, Wellington, New Zealand
Outdoor sports and racecourse facilities are a potential priority area for being covered by smokefree regulations. This is because there are often large numbers of people in relatively close proximity to each other and so many can be exposed to secondhand smoke and the normalising impact of smoking. We aimed to conduct field surveys of these facilities with outdoor stands across New Zealand to inform progress towards the Government's Smokefree 2025 goal.
Methods: We identified lists of sports stadiums and horse racecourses in New Zealand from website listings.1, 2 Additional sports facilities with outdoor stands for spectators were identified from examining green spaces on Google Maps, and using Google Street View to identify the presence of stands. Convenience sampling enabled 25 sports facilities and 25 racecourses to be visited during April 2016 – April 2017. Any smokefree signage within 10 metres of all pedestrian or vehicle entrances was photographed.
Results: The field work identified that 40% (10/25) of the sports facilities had smokefree signage for outdoor areas at their main entrances with only 24% (6/25) having some additional smokefree signage at other entrances. Only four of these sports facilities were smokefree throughout (ie, both grounds and stands). In one setting the only smoking restriction was for people who were on the artificial turf – to protect the turf from damage. None of the racecourses (0/25) had any outdoor-place smokefree signage at any entrances.
Discussion: The results highlight the scope for improvements in designating smokefree areas eg, by those local governments which own sports facilities. There are opportunities for health promoters and the wider health sector to work with race clubs on smokefree policies. But it may be more efficient to amend the national smokefree environments law to prohibit smoking in all sports grounds and outdoor public venues with seating.
Residents' perspectives of the impact of housing on their health and wellbeing
Mrs Lindsay Lowe 1, Mr James Scarfe 2, Dr Jim Miller 3, Mr Nik Gregg 4
1Toi Te Ora - Public Health Sevice, Tauranga, 2Toi Te Ora - Public Health Sevice, Tauranga, 3Toi Te Ora - Public Health Sevice, Tauranga, 4Sustainability Options, Tauranga
Housing is a key determinant of health and a significant influencing factor in health inequalities and poverty. The aim of this qualitative research was to explore residents' perceptions of the impact of housing on their health and wellbeing. Information was also gathered about the differing housing conditions that people living in the Bay of Plenty and Lakes districts experience. This included connection to place (neighbourhood and community) and environment (location and physical quality of the house). Data was collected from in-depth interviews with people from a range of backgrounds and housing circumstances. The data analysis identified key themes and categories and highlighted issues which clearly impact on health. These include cold, damp and overcrowded housing. Fuel poverty was also a recurring theme in low income households. On a positive note, good quality housing was found to have a protective effect on health and wellbeing. This research will be used to inform the Toi Te Ora housing strategy and to support advocacy for better housing and health outcomes.
? The research provides a deeper understanding of residents' personal experiences of housing.
? The circumstances described by those living in fuel poverty were concerning. This warrants further investigation to determine the extent of the problem.
? Dampness and/or mould were issues identified by many residents.
? Home ownership was a significant goal for many participants interviewed in this study.
? Security of tenure was a recurrent theme and impacts on health and wellbeing.
? The quality of neighbourhood relationships and overall community connectivity played an important role in the health and wellbeing of the residents.
? Undertake further investigation regarding the extent of fuel poverty in the Bay of Plenty and Lakes districts.
? Use the knowledge and insights gained by this research to develop a healthy housing communications strategy.
? Provide culturally appropriate information to empower whanau to keep their homes warmer and drier and mitigate the harmful health impacts of crowding.
? Advocate for improved health outcomes through improving housing quality.
Mapihi Raharuhi 1, Debbie-Jane Valiamu 2
1Healthy Families Rotorua, 2Healthy Families Wanganui
Ka Whanake! - Enabling iwi leadership and advocacy using an indigenous systems approach to lead change.
The focus of this approach to change are kaupapa (indigenous aspects) of wai and kai. Kai (food) and wai (water) are deliberately positioned as prime levers for change within a Maori system and context to ultimately address chronic illnesses. Kai is a leading driver of bringing communities together – being connected, giving, and receiving hospitality, building resilience through a sense of belonging and hope. Wai is primarily the value of water to our health and wellbeing and the importance of caring for the source, Papatuanuku (the environment/mother nature).
Healthy Families New Zealand has a role to ensure leaders and champions of system change are well armed with quality information and evidence to produce positive outcomes for whanau, hapu, iwi and the wider community on complex health and wellbeing issues. Creating a national movement around kai and wai is about uplifting communities – enabling community-led solutions and local leadership, and building community capability and capacity.
The intention to whakamana (prioritise) kai and wai provides a strong foundation from which all Healthy Families New Zealand sites can further engage with iwi leaders. This level of engagement with Maori will directly promote 'for Maori, with Maori, by Maori' approach to health and well-being. This approach is founded on generational narratives and traditional practices passed down to iwi Maori around kai and wai and are intrinsically linked with key principles of whakapapa (connections) and matauranga (knowledge).
Ka Whanake is a wero (call to action) to all leaders to activate their sphere of indigenous influence for systems change or system enhancement. Ultimately change at scale using a lens that is relative to a Maori world view specific to wai and kai. Imagine if….
Christchurch - Our Smokefree City and Moving Towards the Vision
Heather Kimber1, Martin Witt2
1Canterbury District Health Board, 2Cancer Society Canterbury/West Coast Divsion
Objectives: Christchurch has the vision of being a liveable city. With the biggest urban rebuilding programme in the Southern Hemisphere as a result of earthquakes, there has been significant opportunity for public health partnerships to evolve between health and government agencies. This presentation examines how a joined up approach between partners have developed a Health in All Policies approach to a smokefree city and how this is being responded to by policy makers and stakeholders in the rebuild.
Method: Using the Smokefree 2025 goal as a rationale to reduce the visibility of smoking in outdoor public spaces, the Christchurch City Master Plan was assessed for opportunities to engage with decision makers responsible for the development of new public space. Framing advocacy around the public's and health organisations' support for smokefree environments for a liveable city, a practical model was developed illustrating how city design, policy and partnerships can help to denormalise smoking in public spaces.
Results: This presentation will report on how health advocates partnered with the Christchurch Council and other agencies charged with managing the design and rebuild of the city. Examples include how key redevelopment projects triggered conversations with decision makers to adopt and include smokefree policies as part of their footprints and implementation designs.
So what: The concept of a Smokefree Christchurch City is a framework whereby partnerships that offer a Health in All Policies approach can unite with different agencies around the benefits of a public health goal. This approach may assist those working in other areas such as reduction of supply of tobacco, demoralising tobacco and by considering how new smokefree public spaces might look like.
Spatial intersections: Location, obesity, ethnicity, and deprivation in Aotearoa/New Zealand
Ms Alison Watkins1, Dr Melanie Tomintz2, Dr Malcolm Campbell1
1Department of Geography, University Of Canterbury, Christchurch, 2GeoHealth Laboratory, University Of Canterbury, Christchurch
Local and international literature identifies a strong relationship between deprivation, minority ethnicity – Maori and Pacific in New Zealand – and obesity (McLaren, 2007; Ministry of Health, 2016). These comparisons are generally drawn using data covering a large geographic area, such as the national and DHB level analysis provided by the New Zealand Health Survey (Ministry of Health, 2015, 2016). This paper will illustrate the complex and non-stationary nature of the relationship between deprivation, ethnicity, and obesity using small area (neighbourhood) level estimates of obesity from SimAotearoa, a spatial microsimulation model.
Estimating obesity for small areas reveals a substantially uneven distribution of obesity in New Zealand. Estimated rates of obesity for small areas ranged from 15.3% to 67.2%, with areas of high and low obesity rates sometimes in close proximity. Projected models for 2018 and 2023 show limited change in overall obesity rates, though a diverging trend is present with the most obese areas become more obese and the least obese areas become less obese.
The modelled spatial variation in obesity rates suggests a problematic existing and future health inequality, but it also has important implications for policy. Small pockets of obesity were found even within DHBs with otherwise low overall rates, suggesting that the usual administrative boundaries may not be a good indicator for the purposes of targeting and funding anti-obesity policy. Further, some population sub-groups exhibited high obesity rates in otherwise low obesity areas, suggesting that targeting these may be beneficial. Perhaps the most important policy consideration highlighted by the results of SimAotearoa is the fundamental importance of deprivation as a driving force of obesity in New Zealand. To combat this, SimAotearoa provides important fine-scale data for policy makers, either for overall obesity or for obesity in key population sub-groups.