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.

Dietary counselling – how effective and cost-effective is it? - Public Health Expert

Mar 20, 2018

Prof Nick Wilson, Dr Cristina Cleghorn, Dr Linda Cobiac, Dr Anja Mizdrak, Prof Cliona Ni Mhurchu, Prof Tony Blakely In this blog we consider recent literature (particularly reviews) on the effectiveness and cost-effectiveness of dietary counselling as a health intervention. Most studies suggest that dietary counselling is effective though the benefits are typically modest and short-term. The literature on cost-effectiveness is mixed, and there is substantial uncertainty about long-run cost-effectiveness given the typically short-term trials involved. Addressing the obesogenic environment will have potentially (much) larger gains, and due to substantial reductions in obesity-related disease it is likely to be cost-saving. However, governments, policy-makers and the public are often interested in counselling interventions, necessitating close attention to cost-effectiveness of these interventions relative to more structural changes to the environment. In NZ, dietary counselling is delivered by dietitians, practice nurses, … Read More

Standardised packaging: A new era in reducing tobacco marketing in NZ - Public Health Expert

Mar 14, 2018

Janet Hoek, Philip Gendall, Richard Edwards, Shayne Nahu, Nick Wilson From today, all tobacco products in New Zealand will start appearing in standardised, or plain, packages. In this blog, we discuss the importance of developing an on-going monitoring and evaluation plan around this intervention. We also explain why communications with smokers – whether on-pack or mass media – must be salient and timely to have strong and continuing impact on supporting quitting. Achieving all these actions should help to accelerate progress towards the NZ Government’s Smokefree 2025 goal. From today, all tobacco products in New Zealand will start appearing in standardised, or plain, packages.  These will feature new, enlarged pictorial warning labels, but none of the brand livery formerly conveyed on tobacco packaging.  For decades, tobacco companies have used brand imagery to create connotations that lure young people to smoke … Read More

Can we manage dual use of smoking and vaping more effectively? - Public Health Expert

Feb 16, 2018

Professor Janet Hoek, Dr Lindsay Robertson, Ms Mei-Ling Blank, Dr Rosalina Richards Although most smokers want to quit, many of those who begin vaping continue to smoke. We recently probed this perplexing ambiguity and explored dual use of cigarettes and electronic nicotine delivery systems (ENDS) [1]. In this blog, we summarise our findings and consider interventions that could encourage smokers to transition completely to vaping. Many smokers report regretting the fact they smoke [2, 3] and each year, around two thirds of New Zealand smokers make at least one quit attempt lasting between 24 hours and one week [4]. The advent of electronic nicotine delivery systems (ENDS), which can closely replicate smoking actions, has fostered hopes that ENDS will facilitate these quit attempts, accelerate smoking cessation, and therefore improve the health of many New Zealanders. It could also … Read More

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