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.

Preventing falls can be very cost-effective in NZ - Public Health Expert

Feb 06, 2018

Prof Nick Wilson, Dr Giorgi Kvizhinadze, Dr Linda Cobiac, Prof Tony Blakely We have just published a modelling study on exercise programmes in NZ to prevent falls in older people. This work suggests that this approach (home-based or group-based exercise) is good value for money for the NZ Government. In this blog we consider these results alongside other fall prevention interventions that policy-makers can consider – which are now all in the BODE3 online interactive league table. Falls among older people are common, with high morbidity and mortality impacts. Yet there are interventions that can reduce the risk of falls. In this blog we examine some programme options. What did our new study find? We found that a home-based exercise programme generated the greatest health gain and cost the least. This programme involves instructions from a nurse … Read More

What public health lessons can NZ still learn from the United States? - Public Health Expert

Jan 30, 2018

Prof Nick Wilson, A/Prof George Thomson The United States has many major health problems – including declining life expectancy and an exorbitantly expensive health care system. However, the large number of state and local governments provide a wealth of potential lessons that NZ could learn from. In this blog we briefly consider some of these, particularly in the domains of support for nutrition and physical activity, tobacco and alcohol control, and pollution control. The US has declining life expectancy – associated with such problems as the epidemic of opioid addiction and overdoses. It also has an extremely expensive health care system by OECD standards, due partly to high administrative costs [1]. There are even the peculiarities of health agencies being “banned” from using certain words [2], lack of adequate gun control and the political constraints on research (eg, federal prohibitions … Read More

The Havelock North drinking water inquiry: A wake-up call to rebuild public health in New Zealand - Public Health Expert

Dec 21, 2017

Prof Michael Baker, Prof Nick Wilson, Prof Alistair Woodward The huge campylobacteriosis outbreak in Havelock North in August 2016 caused by contaminated drinking water was a public health disaster. The second report of the Havelock North Drinking Water Inquiry describes a long list of failings that contributed to the outbreak. In this blog we argue that the failings are much broader than the safety of drinking water supplies and represent a serious erosion and fragmentation of NZ’s national public health institutions. What is needed now is a major stocktake and rebuilding of our country’s national public health capacity. The Havelock North drinking water outbreak and Inquiry Many of the facts of the Havelock North campylobacter outbreak are now common knowledge. The outbreak was recognised on 12 August 2016 and resulted in an estimated 5,500 cases, 45 hospitalisations, and 3 deaths … Read More

Smokefree cars legislation: Should the new government make this a priority? - Public Health Expert

Dec 12, 2017

George Thomson, Richard Edwards, Richard Jaine, Janet Hoek, Jude Ball, Nick Wilson This blog briefly reviews the case for the prioritisation by the new Government of a law for smokefree cars carrying children. This would demonstrate their commitment to children’s health and well-being, respond to public and smoker opinion, follow official and Parliamentary advice, and fit with the research evidence favouring legislation for health reasons. So what’s the situation? The new government has many problems to address. Years of minimal legislation for population health means that the legislative calendar will be packed with efforts to catch up on matters that have been left largely to market forces. There will be bottlenecks in policy expertise, in legal drafting, and in parliamentary time. So why should the government prioritise making cars carrying children smokefree? There is overwhelming evidence that exposure to secondhand … Read More

Patterns of declining smoking in NZ – But more action needed by the new government - Public Health Expert

Nov 21, 2017

By Nick Wilson, Frederieke Sanne van der Deen, Richard Edwards, George Thomson, Anaru Waa, Tony Blakely Just published results from the NZ Health Survey indicate ongoing declines in smoking for Māori and for European New Zealanders. In this blog we comment on the possible reasons for these trends and describe recent work on how progress could be accelerated. The results from the NZ Health Survey indicate recent ongoing declines in smoking, with a graph below of the trends since 2012 (tabulated data in the Appendix). These downward patterns are consistent with long-term trend data from other sources such as the Census [1] and declining cigarette sales data.     We plan to do more detailed analyses of these trends and update our past work [1] when next year’s Census results are available. But in the interim we … Read More

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