Health Promotion Programme In New Zealand: SunSmart Essay For Skin Cancer Prevention.

Campaign Programme and Health Issue Addressed by it

Discuss about the Health Promotion in New Zealand.
 

The assignment is a discussion on health promotion programme in New Zealand. It will evaluate the health issue that the programme is covering and describe risk factors for the disease or health condition. It will focus on the health inequality related to the disease in New Zealand and highlight the determinant of inequality. It will give a brief idea on the fundamental principles of Treaty of Waitangi. The report will also describe how the health promotion programme can reduce inequality and how it will benefit the community.

The campaign selected for this report is SunSmart for skin cancer prevention. It will address the issue of high rate of melanoma cancer in New Zealand. It is the most common cancer diagnosed in New Zealand with about 67,000 cases reported every year. The purpose of the campaign is to reduce the incidence and impact of skin cancer in New Zealand. The Health Promotion Agency in New Zealand have taken the initiative to prevent skin cancer and promotion of sun safety under the SunSmart campaign ("Skin cancer prevention | HPA - Health promotion agency", 2016).

People with family history of skin cancer, history of tanning, light skins color, sensitive skin, etc. are at more risk of skin cancers. Change in diet can benefit the individual who is at more risk of skin cancer. A vegetarian diet with fruits, fresh herbs, olive oil, and fish minimizes the risk of melanoma. The antioxidants in diet protect against cellular damage by exposure to sun's UV rays. Several medical and surgical treatments like excision biopsy, mohs surgery, lymph node surgery, skin grafting and reconstructive surgery, curettage and electrodessication, etc are beneficial for patients, but they also have risk involved in it. Adverse complications of skin surgery include excessive bleeding, blood clotting abnormalities, bacterial wound infection, surgical injury to nerves and salivary glands, etc. Some medications like Vismodegib, sonidegib, etc have a risk of birth defect in pregnant women, and certain therapies may lead to redness, pain, and swelling (Song et al., 2013). 

In New Zealand, health inequalities exist among socioeconomic groups, ethnic groups living in different geographic areas, males, and females. Indigenous people living in New Zealand are victims of health inequalities because of low socio-economic position. They are more exposed to risk factors and have a lack of access to proper health services. Poverty is the primary cause of ill-health among them. The health status of Maoris has deteriorated a lot because of this. Pacific people have poorer health than Pakeha. Gender and geographical inequalities also exist in New Zealand. The difference in the health status of the indigenous group has occurred because of inequality in income, employment, and housing. Significant impact on health status and mortality occurs because of differential access to health care services and the manner in which care is delivered to these groups (Devaux, 2015).

Type of Health Inequality in New Zealand and Reason for it

This state has been maintained or created due to institutional racism among the Maoris and because of the effect of colonization and land confiscations. They have been forced to live their permanent dwellings and move to new area. This had eroded their economic stability and reduced their influence in the new settlement. Therefore, racism is the reason for less favorable access to health care, social and economic condition. It has also lead to psychosocial stress (Harris et al., 2012).

The most advantaged group in New Zealand according to health inequality are the indigenous groups like Maoris and the Pacific people. The health outcome for Maori and Pacific people is worse than non-indigenous groups of New Zealand even after controlling deprivation. Their life expectancy at birth is also lesser than non-indigenous population. Evidence have also shown that these people live in socially disadvantaged areas which make them unhealthy. Geographical differences in health occur because district with lower income group showed a higher rate of premature mortality and hospitalizations (Bécares et al., 2013).  

Determinants of health inequalities include gender and culture of particular geographical locations, living and working conditions, socioeconomic and environmental conditions, social and community influences, individual lifestyle factors, age, sex and hereditary factors. People have no control over age, sex and hereditary factors, but other factors are under their control. Lifestyle factors like level of exercise, diet, smoking habits have impact on health. Social and community influence is also a major factor for health inequality which is evident from the poor political influence of Maoris. Indigenous groups had a low standard of living due to poverty which also leads to inequality of health. Ethnicity and gender are also a determinant as women, Maoris and Pacific people are not equal salary. Socioeconomic factors also have impact on access to proper health services (Präg et al., 2014).

The primary purpose of New Zealand Public Health and Disability Act 2000 is to provide public funding for public health, personal health, and disability support services and establish new public health organisation to promote better health for New Zealanders. It has implemented the Treaty of Waitangi in 1840 which seeks to improve the health outcome of Maoris. It is an agreement which guaranteed the protection of Maori interest, and it was signed by British Crown and Maori chief. It deals with the methods that will ensure that the Maoris also contribute to decision making, and they also take part in the delivery of health services (Johnston, 2013).

Advantaged Group

The principles of the Treaty of Waitangi looked after the cultural aspects norms and values of surrounding women health among an ethnic group of New Zealand. It promoted inclusion and participation in society and giving the best support to needy persons. Its objective was to reduce health disparities associated with health outcome of Maoris. Women's health is not given priority in ethnic groups. The treaty objective was to remove these norms by proper dissemination of information to deliver timely health services for the protection of disadvantaged groups. The principle of equality addressed the issue (Mokuau & Mataira, 2016). 

The intervention will reduce inequality and create better health opportunities for New Zealanders. Successfully meeting the objectives of the Treaty of Waitangi will lead to a fairer society where everyone will have a sense of belonging and everyone’s need would be addressed. It will not just improve the health status of indigenous population but will promote the well-being of the whole population of New Zealand. It will also lead to a stronger economy as better health contributes to richer social and economic life (Drummond et al., 2015). 

The methods to reduce inequalities include:

• Setting framework and principles at national, geographic and local levels by service providers, policy makers, and community groups.
• Addressing social, economic, cultural and historical barriers in society.
• Planning intervention at the structural level to tackle the cause of health inequality.
• Undertaking specific action for implementing health services in socially disadvantaged areas.
• Targeting psychosocial and behavioral factors of individual to change social norms in society.
• Minimising impact of disability among ethnic groups of New Zealand like Maoris and the Pacific people (O'Mara-Eves et al., 2013).

To know whether inequalities has been reduced or not, The Ministry of Health can conduct a regular census of population to get information about health outcomes (such as morbidity, mortality), risk factors in health and level of service utilization such as prevention, treatment and rehabilitation methods. A periodical collection of these data will help in estimating whether inequalities have been reduced or not.

The indigenous population of New Zealand like Maoris, the Pacific, Pakeha and the Asian people will benefit the most from campaigns trying to reduce health inequality. This is because they suffer from maximum health inequality due to lack of access to health service and poor economic conditions. The SunSmart Campaign for skin cancer prevention will help in reducing impact of skin cancer by primary intervention, early detection and diagnosis, rehabilitative support and care, increasing research evaluation and surveillance. Their focus is on reducing exposure to ultraviolet radiation which is the major risk factor for skin cancer. They wanted to change individual behavior so that people are protected from excessive UV exposure and stays in effective sun safe setting. This program will help such population by bringing health service closer to their home. Through various programs, it will also educate the people about the importance of good health and remove social taboos existing in an ethnic population (Jones et al., 2014). 

Determinants of Health Inequality

The unintended consequences might be that it will change the pattern and approach of seeking health care services. Better health service will mean better prosperity and better economic status of the community. The knowledge and attitude of people towards illness will change. It might also be possible that despite several programs, health disparities may increase further because people might still not gain access to health care service. There might also be additional cost involved in implementing guideline rather than what was expected in the beginning. Performance and health improvement measurement might be difficult.

Conclusion

From the whole report, we get information about the role of health promotional campaign in addressing health issues in New Zealand. It highlighted the health inequality in the region and the population mostly affected by it. Through the Treaty of Waitangi, it explained what could be done to reduce health inequality and how the society will benefit from it. 

Reference

Bécares, L., Cormack, D., & Harris, R. (2013). Ethnic density and area deprivation: Neighbourhood effects on Māori health and racial discrimination in Aotearoa/New Zealand. Social Science & Medicine, 88, 76-82.

Devaux, M. (2015). Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries. The European Journal of Health Economics, 16(1), 21-33.

Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015). Methods for the economic evaluation of health care programmes. Oxford university press.

Harris, R., Cormack, D., Tobias, M., Yeh, L. C., Talamaivao, N., Minster, J., & Timutimu, R. (2012). The pervasive effects of racism: experiences of racial discrimination in New Zealand over time and associations with multiple health domains. Social science & medicine, 74(3), 408-415.

Johnston, K. (2013). Treaty of Waitangi. NZ Law Review, 2013, 159-689.

Jones, R., Bennett, H., Keating, G., & Blaiklock, A. (2014). Climate change and the right to health for Māori in Aotearoa/New Zealand. Health and Human Rights Journal, 16, 54-68.

Mokuau, N., & Mataira, P. J. (2016). From Trauma to Triumph: Perspectives for Native Hawaiian and Māori Peoples. Decolonizing Social Work, 145.

O'Mara-Eves, A., Brunton, G., McDaid, G., Oliver, S., Kavanagh, J., Jamal, F., ... & Thomas, J. (2013). Community engagement to reduce inequalities in health: a systematic review, meta-analysis and economic analysis. Public Health Research, 1(4).

Präg, P., Mills, M., & Wittek, R. (2014). Income and income inequality as social determinants of health: do social comparisons play a role?. European sociological review, 30(2), 218-229.

Skin cancer prevention | HPA - Health promotion agency. (2016). Hpa.org.nz. Retrieved 22 July 2016, from https://www.hpa.org.nz/what-we-do/skin-cancer-prevention

Song, F., Qureshi, A. A., Giovannucci, E. L., Fuchs, C. S., Chen, W. Y., Stampfer, M. J., & Han, J. (2013). Risk of a second primary cancer after non-melanoma skin cancer in white men and women: a prospective cohort study. PLoS Med, 10(4), e1001433.