Public Health Expert

Professor Tony Blakely is an epidemiologist at the University of Otago, Wellington. He has an extensive portfolio of research. Tony initiated and implemented the New Zealand Census-Mortality Study (NZCMS) in the late 1990s, a pioneering study linking the national censuses with mortality data to allow monitoring and research on ethnic and socio-economic inequalities and the contribution of smoking to mortality (the NZ census periodically includes smoking). He has also led the parallel study, CancerTrends, that links census and cancer registration data to allow cancer incidence and survival studies.

Walking and cycling for transport is good for physical activity levels in Kiwis! - Public Health Expert

Oct 31, 2017

By Dr Caroline Shaw, University of Otago.  Physical activity is good for health. Higher levels of physical activity are associated with reduced rates of breast and colon cancer, better mental health, lower obesity rates, lower heart disease, stroke (the list goes on). This blog looks at a new study we just published that found that New Zealanders who walk or cycle to their main activity each day have a 76% higher chance of achieving the Ministry of Health physical activity guidelines than those who drive cars. Despite the overwhelming evidence of the benefits of physical activity, less than half of New Zealanders now meet the Ministry of Health physical activity guidelines, which should really be considered a bare minimum for health (see Figure 1). In addition, an alarming 1 in 6 of us do less than 30 minutes physical … Read More

Home Modification to reduce falls – appears cost-effective in NZ - Public Health Expert

Oct 10, 2017

Prof Nick Wilson, Dr Giorgi Kvizhinadze, Dr Nisha Nair, Prof Tony Blakely We have just published a modelling study on a home safety and modification programme to prevent falls in older people. This work suggests that this intervention could produce considerable health gain and be cost-effective at a health district level in New Zealand. But in this blog we discuss possible implementation options and the desirability of also considering group exercise programmes, which have additional advantages. New Zealand has made good progress on reducing falls in the hospital sector as per work led by the Health Quality & Safety Commission [1] (see also this HQSC online guidance to health workers on preventing falls in multiple different settings). Nevertheless, for falls prevention in older people in the community there are still some knowledge gaps – including about the cost-effectiveness … Read More

“Achieving Smokefree Aotearoa by 2025”: a response to critiques - Public Health Expert

Oct 06, 2017

Prof Richard Edwards, Prof Tony Blakely, Prof Chris Cunningham, Frederieke Sanne van der Deen, Stephanie Erick, Zoe Hawke, Prof Janet Hoek, A/Prof George Thomson, Louise Thornley, Anaru Waa, Prof Nick Wilson The “Achieving Smokefree Aotearoa by 2025” Action Plan was launched at Parliament on 2 August. A previous blog described its key features and a rationale for the recommended measures. This blog addresses critiques of the Plan; it discusses the potential role e-cigarettes could play in achieving the Smokefree 2025 goal and examines how measures in the Action Plan will support people who smoke to either quit or to transition fully from smoking to vaping. Smoke-free Aotearoa 2025 is a world-leading tobacco-control goal with origins in the vision of Māori leaders for a Tupeka Kore (tobacco-free) Aotearoa, freed from the tobacco products introduced to Māori through colonisation. This goal … Read More

“Achieving Smokefree Aotearoa by 2025”: a new Action Plan to achieve our smokefree goal - Public Health Expert

Sep 07, 2017

Richard Edwards, Tony Blakely, Chris Cunningham, Frederieke Sanne van der Deen, Zoe Hawke, Janet Hoek, Shayne Nahu, George Thomson, Louise Thornley, Anaru Waa, Nick Wilson A new Action Plan was launched by one of New Zealand’s great tobacco control champions – Dame Tariana Turia – at Parliament on August 2. This blog describes the Plan’s key features and the rationale for the proposed measures. Smokefree Aotearoa 2025 is a world-leading tobacco-control goal with origins in the vision of Māori leaders for Tupeka Kore (tobacco free) Aotearoa. A team led by researchers from ASPIRE 2025, supported by leading tobacco control researchers and practitioners, has prepared an Action Plan – “Achieving Smokefree Aotearoa by 2025”. An accompanying progress review found that the goal will not be achieved on current trends, and will be missed by a wide margin for Māori and … Read More

Prevention versus treatment, voluntary versus mandatory, targeted versus untargeted – can we generalize? - Public Health Expert

Sep 05, 2017

Professor Tony Blakely, Dr Giorgi Kvizhinadze, Dr Linda Cobiac and Professor Nick Wilson. In this fourth blog that features the BODE3 Interactive League Table, we look at substantive findings across the interventions (so far) in the league table.  We use graphs from the league table to cautiously explore (for fear of over-generalizing) what approaches might typically generate the most health gain and be best value-for-money. In two of the previous blogs in this series we have overviewed the concept of league tables to compare health sector interventions, and provided a ‘mini-user guide’ for the BODE3 Interactive League Table. Another blog has considered the tobacco control interventions in the BODE3 Interactive League Table. In this blog, we tease out some themes using graphs generated from the BODE3Interactive League Table. Prevention versus treatment The figure below shows … Read More

BODE3 Interactive League Table – how to use it - Public Health Expert

Aug 23, 2017

Prof Tony Blakely, Prof Nick Wilson, Dr Giorgi Kvizhinadze, Dr Linda Cobiac Last week we introduced the concept of league tables to compare interventions.  This week we provide a brief ‘user guide’ for our just launched BODE3 Interactive League Table.  We walk through how to pull down tables and graphs of health gain (quality-adjusted life-years; QALYs), health system costs and cost effectiveness for 50+ interventions currently in the interactive league table. In our blog last week we introduced the BODE3 Interactive League Table, and focused on how it is important to know what you are comparing – the intervention description, and what it is being compared to.  We argued that policy-making and research prioritisation could be improved with not only stand-alone simulation studies and cost effectiveness analyses of interventions, but also by comparing interventions side-by-side in a league table. Read More

NZ’s Quitline Service is value-for-money: But how does it compare with other tobacco control actions in a league table? - Public Health Expert

Aug 21, 2017

Prof Nick Wilson, Dr Nhung Nghiem, Dr Cristina Cleghorn, Dr Frederieke Sanne van der Deen, Prof Tony Blakely We have just published a journal article on the cost-effectiveness of NZ’s Quitline service (including its associated promotion in the mass media). The study found that this intervention package is likely to be an effective means to generate health gain, address health inequalities and save costs for the NZ health system.  But in this blog we also compare the New Zealand Quitline intervention with other tobacco interventions using our just launched BODE3 Interactive League Table, and find that whilst the Quitline is a good thing to do, much more health gain is possible through other tobacco control interventions. In our just published study in the peer-reviewed journal Tobacco Control, we used an established multi-state life-table model (1-3) to explore … Read More

NZ’s Environmental Protection Authority in a muddle over weed killer - Public Health Expert

Aug 16, 2017

Prof Alistair Woodward*, A/Prof Andrea t’Mannetje**, Dr Dave McLean**, Prof Jeroen Douwes**, Prof John D Potter** (*Auckland and **Massey Universities) Last year the New Zealand Environmental Protection Authority (EPA) chose not to accept the assessment of the International Agency for Research on Cancer (IARC) that the herbicide glyphosate (the active ingredient in “Roundup”) was a “probable carcinogen”. Instead, the EPA commissioned its own report which found that glyphosate is “unlikely to be genotoxic or carcinogenic”, a significant departure from IARC’s conclusion. An investigation by the Green MP Stefan Browning released two weeks ago raises serious questions about the process followed by the EPA. The controversy has been given fresh life by comments made by the Chief Scientist for the Authority, Dr Jacqueline Rowarth. Her attempt to justify what happened gives a muddled account of risk assessment, and misrepresents … Read More

Comparing health interventions in a meaningful way – Introducing the BODE3 Interactive League Table - Public Health Expert

Aug 15, 2017

Prof. Tony Blakely, Prof. Nick Wilson, Dr. Giorgi Kvizhinadze, Dr. Linda Cobiac This blog introduces league tables, and more specifically the NZ-specific BODE3 Interactive League Table, for comparing interventions on health gain, cost and cost-effectiveness – and potentially many other things.  A league table is a useful tool for researchers and policy-makers to get an informed ‘first impression’ of what are the best health interventions to give further consideration to investing in, or disinvesting in. If life and policy were more rational, New Zealand society would do things in the health sector that had the maximum gain in health, and least cost – or which were even cost-saving.  But life is far more complicated than this.  There is a genuine need to balance government intervention with respect for individual autonomy and the benefits of market forces, but there are also problematic … Read More

Nine Things New Zealand Must Do To Tackle The Child Obesity Crisis - Public Health Expert

Jul 25, 2017

Dr Stefanie Vandevijvere, Professor Boyd Swinburn A panel of 71 independent and government experts have undertaken an evaluation of New Zealand Government food environment policies, compared to international best practice.  This is the second such evaluation, the first being in 2014.  In this blog we summarise the findings. There are some areas where New Zealand is at the level of best practice and there are some areas where there is progress compared to 2014. However, there remain major implementation gaps, especially for policies to improve the healthiness of food environments, to catch up with other nations globally in tackling the child obesity crisis. According to a 2017 OCED Report New Zealand is still the third fattest high income country both for children and adults (1), which means no progress since 2014 (2). It is critical that the New Zealand … Read More