How We Work
“Public health is the ‘art and science of preventing disease, prolonging life and promoting health through the organised efforts of society’ ”
– World Health Organisation, 1988
Public health is about the health of populations rather than medical treatment of individuals, and looks beyond health care services to the aspects of society, environment, culture, economy and community that shape the health status of populations.
Good public health is based on creating conditions that enable people to have the best opportunities for health and wellbeing throughout their life. It also requires the input of and partnership with agencies beyond the health sector.
Learn more about Public Health.
Toi Te Ora Public Health focuses on the achievement of health equity, in particular for Māori.
The Ministry of Health's definition of equity is:
In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust. Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes.
Learn more about health equity.
Determinants of Health
Determinants of health are the circumstances in which people are born, grow up, live, learn, work and age. They are also the wider set of forces and systems affecting these circumstances, for example, economic and development policies, geographic and climatic environments, social norms, social policies and political systems.
A Health Map for the Local Human Habitat, Barton and Grant (2006) based on a public health concept by Dahlgren and Whitehead (1991).
Individually, we have little direct control over many health determinants. For example, the local economy affects employment opportunities, which in turn affects income, which influences the quality of housing and food we can afford. All of these things then affect the health and wellbeing of our whole family.
Income, employment, education and housing have considerable impacts on our health; much more than the delivery of health services. The level of educational achievement directly affects health outcomes. People who are socially and economically advantaged have better health outcomes than those living in poverty. These situations describe health inequity. Inequity is about unfair and avoidable differences between groups.
Health inequities are not about ‘making bad choices’, ‘bad genes’ or not accessing medical care. Health inequities usually stem from avoidable structural problems in our communities.
The challenge for all sectors is to work together to create fair and just policies and systems. Different inputs for different groups may be required in order to achieve equivalent outcomes.
Health in All Policies
The determinants of health illustrate that our health and wellbeing is influenced by much more than access to quality healthcare. The factors that affect our health are often many and complex, and lie outside health services and health policies.
Health in All Policies (HiAP) is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity. It improves accountability of policy makers for health impacts at all levels of policy making. It includes an emphasis on the consequences of public policies on health systems, determinants of health and wellbeing.
A key feature of HiAP is a formal collaborative arrangement for policy making and planning. It acknowledges that the work of many organisations and agencies contribute to community health and wellbeing and the best policy and planning outcomes arise from that collaboration. It is community-centred with a focus on health and wellbeing outcomes.