The effect of policy on health
The introduction of market rents, lowering tariffs
on imported cars, and lowering the drinking age may have damaged
the health of New Zealanders.
But because the health implications were never assessed, we may never know the
extent of the damage, says Professor Neil Pearce, director of the Centre for
Public Health Research.
He says Health Impact Assessment (HIA) guidelines recently launched by the Public
Health Advisory Committee offer a way to assess the health impacts of policy
Most factors affecting health lie outside the health system,” Professor
Pearce says. “We know the major determinants of health are social, economic
and environmental factors – like housing, nutrition, and occupational exposures.
We need to address this big picture.”
New Zealand is the first country in the world to institutionalise Health Impact
Assessment guidelines, launched by Health Minister Annette King who says use
of the guidelines will lead to more robust policies and better health outcomes.
Market rents for state houses introduced during the 1990s fostered overcrowding
and were linked to the spread of infections like meningococcal disease. High
rents left little money for food, leading to poor nutrition, Professor Pearce
If the health impacts of the introduction of market rent had been assessed when
the policy was being developed, it may have prompted a reconsideration of the
Lowering the drinking age from 20 to 18, work-testing parents on the domestic
purposes benefit and removing tariffs on second hand cars were also examples
of policies that failed to consider the potential ill-effects on people’s
HIA can contribute to improving the overall health of the population by ensuring
that policies, at the very least, do not produce serious adverse effects on health.
It can also play a part in reducing inequalities in health, by ensuring that
policies do not exacerbate or continue existing inequalities.”
Professor Pearce says it is hoped that over time, policy makers across all government
sectors will carry out an HIA for all significant policies. HIA is new to policy-making
in New Zealand but internationally governments and organisations are showing
an increasing commitment to it.
The guidelines are not mandatory nor retrospective, but may become compulsory
in future, he says. Professor Pearce says he hopes over time policy makers across
all government sectors will assess the health impact of all significant policies.