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Massey Magazine Issue 13 November 2002

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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 decisions.

“ 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 says.

“ 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 policy.”

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 wellbeing.

“ 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.


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