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.

NZ Health Strategy – are the big prevention programmes really in there? - Public Health Expert

Dec 03, 2015

Prof Tony Blakely, Prof Nick Wilson In this blog we comment for a second time this week on the consultation draft of the NZ Health Strategy, focusing this time on preventive interventions that actually would make a meaningful difference to health in Aotearoa NZ. The draft Strategy has many strong aspects, but by having a ‘people centred’ approach it gravitates to IT system and individual-level actions, and drifts away from population-level prevention activities that would have the biggest health impact (a goal of strategy), reduce health inequalities (another goal of the strategy) and be best value for money (yet another goal of the strategy). We recommend that the word ‘prevention’ needs to be more than a garnish sprinkled through the document, but rather an actual substantive item on the menu of offerings. We conclude by offering up some interventions … Read More

NZ’s draft heath strategy under the spotlight - Public Health Expert

Dec 01, 2015

Prof Nick Wilson, Prof Richard Edwards, Prof Tony Blakely The new draft NZ Health Strategy is strong on strengthening the health care system and has some strong population health aspects, at least rhetorically. It includes phrases like a system moving “from treatment to prevention”. But how does it fare when considering the science around burden of disease and interventions to address the 10 top risk factors for health loss in NZ? Unfortunately not well at all. There are no population health goals and minimal evidence of concrete action to address the major preventable causes of poor health and premature death. In summary, there seems plenty of scope for upgrading the draft Strategy if it is going to enable New Zealanders to “live well, stay well and get well”. The draft NZ Health Strategy (1) has a strong focus on … Read More

Health system costs in NZ: variation by sex, age & proximity to death - Public Health Expert

Nov 16, 2015

Dr Giorgi Kvizhinadze, Prof Tony Blakely, Prof Nick Wilson This blog aims to discuss a study we recently published on NZ health system cost estimates by sex, age and proximity to death. Such work is only possible due to extraordinary richness of routine NZ data. We highlight four findings. First, costs – not surprisingly – vary markedly by age, and also are highly correlated with expected morbidity by age. Second, there is much less variability by age for costs in the last year of life – indeed, the ‘costs of dying’ peak at about 60 years of age, then fall dramatically. Put another way, we spend more on middle-age people in the last year of life – which seems appropriate. Third, there is concern about ballooning health system expenditure due to population aging – but one needs to factor in … Read More

Red Meat & Processed Meat: Summarising the Public Health Issues - Unsorted

Nov 05, 2015

Dr Cristina Cleghorn, Associate Professor Nick Wilson, Professor Tony Blakely This blog was triggered by the recent highly publicised review on the cancer risk from processed meat and red meat. Here we briefly look at this topic and also take a wider perspective on other aspects of meat consumption on human health and the environment, and risk communication.   The cancer agency of the World Health Organization, the International Agency for Research on Cancer (IARC), has recently evaluated the carcinogenicity of consuming red and processed meat (1). Over 400 different epidemiological studies on cancer in humans provided data on processed meat and over 700 provided data on red meat. Processed meat Processed meat refers to meat that has been transformed through salting, curing, fermentation, smoking, or other processes to enhance flavour or improve preservation. Most processed meats contain pork … Read More

Taxing tobacco in NZ: What we know and what could be next - Public Health Expert

Oct 27, 2015

By members of the BODE3 and ASPIRE 2025 Teams, University of Otago* A series of seven annual tobacco tax increases, typically at the 10% level, will end in January 2016 unless it is extended by the NZ Government. In this blog we take a timely look at what is known about tobacco tax increases in this country, what remains unknown, and what might be needed for the next phase of tobacco taxation related policy and research. Recent trends The recent pattern of annual tobacco tax increases in NZ has been associated with a 23% reduction in tobacco consumption per adult (for the period 2010 to 2014) (1). Smoking prevalence has also continued to decline for all major population groups (as per census data for 2013). Youth smoking in particular has continued to decline steeply (see the … Read More

Can CT screening for lung cancer in New Zealand be cost-effective? - Public Health Expert

Sep 28, 2015

Dr Richard Jaine, Dr Nisha Nair and Professor Tony Blakely There is now strong evidence that screening for lung cancer with low-dose computed tomography (LDCT) scans is effective at reducing lung cancer mortality. So why aren’t countries rushing to introduce a screening programme? Because there is still doubt about its cost-effectiveness. In this blog, we discuss the uncertainties and suggest a way forward for New Zealand.   Lung cancer isn’t the most common cancer in New Zealand – it doesn’t make it into the “top three” cancers in men or women. But it is the most deadly cancer, accounting for almost 20% of all cancer deaths in New Zealand. Lung cancer carries such a high mortality because it is often picked up at a late stage, when the disease is advanced, has spread to other parts of the body, and … Read More

Calculating cardiovascular risk with online calculators – scope for improvement? - Public Health Expert

Sep 21, 2015

Associate Professor Nick Wilson, Dr Nhung Nghiem, Professor Tony Blakely, Professor Rod Jackson It is now possible to readily estimate individual risk of future cardiovascular events with a large number of online calculators – including a NZ-specific calculator that has been available for some years (“Know Your Numbers”). In this blog we consider if such risk calculators could be improved upon. The clear answer being “yes” – and in many ways. There are many ways to prevent cardiovascular disease (CVD) – with public health measures being particularly critical. These include such strategies as enhanced tobacco control (e.g., higher tobacco taxes (1)) and regulations to improve the quality of the food supply (e.g., to limit salt (2)). But individual measures are also important – with health workers providing targeted advice on lifestyle change and the use of medications to … Read More

A co-regulatory approach to protecting children from junk food marketing - Public Health Expert

Sep 09, 2015

Amanda Wood, PhD candidate, University of Auckland The Health Minister is currently deciding how to best address children’s poor health due to diet-related diseases. It is a good time to reflect not only on the content of those approaches, but also the regulatory frameworks for those approaches. This blog explores a co-regulatory approach that could be applied to the strengthening of junk food marketing restrictions to children. “Black and white thinking limits understanding and feedback, two necessary ingredients for successful resolution in creative conflict and successful understanding.” ― David W Earle I’ll admit it, I’m not too sure who David W Earle is, but I do know that I agree with his reflection 100%, and applied to food policy, I agree 200%. Everyone seems to ‘get’ that politics is messy, convoluted and nebulous. Then why do we assume that … Read More

Smartphone apps for weight loss and smoking cessation - Public Health Expert

Sep 07, 2015

Associate Professor Nick Wilson, Dr Christine Cleghorn, William Leung, Dr Osman David Mansoor Are smartphone apps for weight loss and smoking cessation well-designed? We were involved in a study published in last Friday’s NZ Medical Journal that tried to answer that question from a NZ public health perspective. In this blog we discuss what we found and its implications for ‘what next’ for using these new technological tools for health research and promotion in NZ. In NZ, tobacco use and overweight/obesity are the two leading risk factors leading to health loss [1]. The key ways to address these are probably price signals (e.g., tobacco tax increases [2,3]) and a healthier food environment (prices, marketing controls, and healthier food composition). In addition, individuals need support to change. Rapid evolution of Information & Communication Technology (ICT) offers ever more kinds of support, … Read More

Living longer, living healthier? Life expectancy in New Zealand - Public Health Expert

Aug 31, 2015

Professor Tony Blakely and Professor Alistair Woodward In this blog we review the latest update by the Ministry of Health on how much of NZers life expectancy can be expected to be in good health. The good news? We are both living longer, and living longer in good health. The bad news? According to this report, the percentage of our lives with some dependency due to poor health is increasing. And there are marked inequalities in healthy life expectancy. This sort of analysis, as hard as it is to get right, is important – as a society we do not want to just live longer, but live longer in good health. However, we have concerns about the accuracy of this Report, and critique it in this blog. The last two centuries have seen phenomenal increases in life expectancy … Read More