View Article PDF

The special article on Core public health functions for New Zealand by Williams and colleagues in this issue of the Journal is a very valuable contribution to public health thinking in this country. The inter-relationships between goals, outcomes sought, core functions and key principles are all well outlined. The valuable illustrative examples in their Table 2 indicate the depth of experience and thinking by the authors. It seems likely that there would be widespread acceptance by health workers for the content of this article, and indeed by the public as well. Even so, in an ideal democratic society attitudes of the public to the principles could be subjected to further evaluation of acceptability eg, with surveys or citizen juries.1Some areas for possible further workThe authors had space restrictions to elaborate on particular issues, but future work could be done on areas where there might be differing perspectives within the New Zealand health sector and society. For example:The stated goal includes New Zealanders living longer lives but is this really what most people want? Perhaps a majority might prefer the health sector to focus more attention on the quality component of life with greater effort directed at major causes of disability. Indeed, there are various potential complex advantages and disadvantages of having an increasingly older population (as discussed elsewhere by New Zealand authors2,3). The ranked list of causes of disability for New Zealand was documented in a recent Lancet article: back pain (largest burden); major depressive disorder; neck pain; anxiety; other musculoskeletal disorders ; asthma; chronic obstructive pulmonary disease (COPD); hearing loss; diabetes and migraine (tenth in burden).4 Of course, preventing some of these conditions (eg, COPD and diabetes) will both reduce disability and result in longer lives, as will progress with tobacco and alcohol control. But the scope for extending life expectancy might soon start to face diminishing marginal returns.Does public health action around reducing health disparities include addressing lower male life expectancy? Indeed, some causes of the gap are readily achievable such as preventing cardiovascular disease in men.5Should evidence for public health practice include both evidence of intervention effectiveness , but also cost-effectiveness to ensure the best value for money? The authors thoughtfully discuss cost-effectiveness in the Background section, but this does not end up in any of the principles.Should there be a principle of the health system striving to be more environmentally sustainable with ongoing reductions in its carbon footprint? Such approaches have been adopted by the National Health Service in the UK and in various other jurisdictions.6,7 Indeed, the Lancet has recently described tackling climate change as the greatest opportunity for advancing global health.8Should there also be a principle of the health system striving to maximise co-benefits for all sectors of society? This might mean, for example, that alcohol control gets special attention given that there are major health benefits but also very wide societal benefits (relating to reduced crime, violence and lost productivity).The critical importance of prevention in public healthThe authors appropriately detail preventive interventions as one of the five core public health functions. But this category may deserve even more emphasis since it generally stands out in terms of value-for-money and the size of the health gain achievable. For example, preventive interventions to reduce alcohol-related harm are likely to be cost-saving to society.9,10 Modelling work for the New Zealand setting also indicates that a range of interventions to prevent high dietary salt intake will also be net cost-saving to the health system.11 Likewise for raising tobacco taxes to prevent tobacco-related disease, again with net cost-savings even though people will incur extra health costs by living longer.12Some preventive interventions will even raise extra tax revenue for the New Zealand Government which can then be used to improve health in other areas, or to fund other public sectors, such as improving education. Examples are traditional taxes on alcohol and tobacco,13 but potentially new taxes such as those on junk food and sugar-sweetened beverages (as per New Zealand modelling work14,15), and also a salt tax.11 Indeed, the World Health Organization has recently stated that increasing tobacco tax is the most cost-effective way to reduce tobacco use and prevent youth uptake of smoking.16 Nevertheless, some preventive interventions might not be worthwhile as per our work on the cost-effectiveness of HPV vaccination for boys in New Zealand at current vaccine prices17 (in contrast to improving HPV vaccination for girls18).Another notable feature of some of these preventive measures that change the environment is that they can also reduce disparities. For example, greater health gain for Mori is suggested by modelling work on raising tobacco taxes,12 for multiple interventions to reduce dietary salt intake,11 and in the domain of food taxes/subsidies.15The particular importance of law as a public health interventionWilliams et al appropriately mention public health laws and regulations in their article, yet this is another area that may deserve a special emphasis. This is because there is now a strong scientific basis for the use of the law as a public health instrument, as shown by one review which identified 65 systematic reviews of studies on the effectiveness of 52 public health laws.19 Most of these laws were found to be effective in achieving their health objectives, and they encompassed: injury prevention; housing; tobacco; vaccination; violence; and food safety. In addition, a review of the ten great public health achievements in the US last century (up to the year 1999) found that all ten were supported by laws at each level of government.20 Laws that benefit public health are relatively low-cost to pass (estimated at $3.7 million for New Zealand21) and can have high levels of effectiveness for multiple decades. For example, the smokefree law banning smoking in pubs and restaurants in New Zealand has been very effective22 and only a few court cases were required in its wake.23 New laws are probably needed in New Zealand to raise taxes on hazardous products (as detailed above), but also to improve food labelling, to control marketing of alcohol and junk food, and to accelerate the tobacco endgame (eg, via retail outlet reduction24). But some existing laws might also cause net public health harm and may need to be reviewed. For example, are the countrys cycle helmet laws fully fit for purpose if these are potentially making it harder to establish cycle sharing schemes in cities? Such schemes are good for public health and are increasingly common internationally (at over 700 cities globally).SummaryThis special article by Williams et al is clearly a valuable contribution to public health thinking in this country. Yet future work could expand on some of the details and give more emphasis to those core functions which have more potential importance than others.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

- Nick Wilson, Department of Public Health, University of Otago, Wellington-

Acknowledgements

Correspondence

Nick Wilson, Department of Public Health, University of Otago, Wellington, PO Box 7343, Wellington South, New Zealand.

Correspondence Email

nick.wilson@otago.ac.nz

Competing Interests

- - Street J, Duszynski K, Krawczyk S, et al. The use of citizens juries in health policy decision-making: a systematic review. Soc Sci Med. 2014;109:1-9. Woodward A, Blakely T. Could we all live to 100? Should we? Aust N Z J Public Health. 2015;39:3-4. Woodward A, Blakely T. The healthy country? A history of life and death in New Zealand. Auckland: Auckland University Press, 2014. Global Burden of Disease Study Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;(E-publication 5 June). Wilson N. Should NZ spend relatively more health resources on improving mens health? Public Health Expert [Blog]. https://blogs.otago.ac.nz/pubhealthexpert/2014/03/13/should-nz-spend-relatively-more-health-resources-on-improving-mens-health/. 2014. Jamieson M, Wicks A, Boulding T. Becoming environmentally sustainable in healthcare: an overview. Aust Health Rev. 2015;(E-publication 20 April). Pencheon D, Rissel CE, Hadfield G, et al. Health sector leadership in mitigating climate change: experience from the UK and NSW. N S W Public Health Bull. 2009;20:173-6. Wang H, Horton R. Tackling climate change: the greatest opportunity for global health. Lancet. 2015;(E-publication 19 June). Cobiac L, Vos T, Doran C, et al. Cost-effectiveness of interventions to prevent alcohol-related disease and injury in Australia. Addiction. 2009;104:1646-55. Chisholm D, Rehm J, Van Ommeren M, et al. Reducing the global burden of hazardous alcohol use: a comparative cost-effectiveness analysis. J Stud Alcohol. 2004;65:782-93. Nghiem N, Blakely T, Cobiac LJ, et al. Health and economic impacts of eight different dietary salt reduction interventions. PLoS One. 2015;10:e0123915. Blakely T, Cobiac L, Cleghorn C, et al. Health, health inequality and cost impacts of annual increases in tobacco tax: Multistate lifetable modeling in New Zealand. PLoS Med. 2015 (in press). Cobiac LJ, Ikeda T, Nghiem N, et al. Modelling the implications of regular increases in tobacco taxation in the tobacco endgame. Tob Control. 2015;24:e154-60. Ni Mhurchu C, Eyles H, Genc M, et al. Twenty percent tax on fizzy drinks could save lives and generate millions in revenue for health programmes in New Zealand. N Z Med J. 2014;127:92-5. Ni Mhurchu C, Eyles H, Genc M, et al. Effects of health-related food taxes and subsidies on mortality from diet-related disease in New Zealand: An econometric-epidemiologic modelling study. PLoS One. 2015;10:e0128477. World Health Organization. WHO report on teh global tobacco epidemic 2015: Raising taxes on tobacco. Geneva: WHO, 2015. Pearson AL, Kvizhinadze G, Wilson N, et al. Is expanding HPV vaccination programs to include school-aged boys likely to be value-for-money: a cost-utility analysis in a country with an existing school-girl program. BMC Infect Dis. 2014;14:351. Blakely T, Kvizhinadze G, Karvonen T, et al. Cost-effectiveness and equity impacts of three HPV vaccination programmes for school-aged girls in New Zealand. Vaccine. 2014;32:2645-56. Moulton AD, Mercer SL, Popovic T, et al. The scientific basis for law as a public health tool. Am J Public Health. 2009;99:17-24. Goodman RA, Moulton A, Matthews G, et al. Law and public health at CDC. MMWR Morb Mortal Wkly Rep. 2006;55 Suppl 2:29-33. Wilson N, Nghiem N, Foster R, et al. Estimating the cost of new public health legislation. Bull World Health Organ. 2012;90:532-539. Edwards R, Thomson G, Wilson N, et al. After the smoke has cleared: evaluation of the impact of a new national smoke-free law in New Zealand. Tob Control. 2008;17:e2. Wilson N, Edwards R, Parry R. A persisting secondhand smoke hazard in urban public places: results from fine particulate (PM2.5) air sampling. N Z Med J. 2011;124(1330):34-47. Pearson AL, van der Deen FS, Wilson N, et al. Theoretical impacts of a range of major tobacco retail outlet reduction interventions: modelling results in a country with a smoke-free nation goal. Tob Control. 2014;24:e32-e38.- -

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

The special article on Core public health functions for New Zealand by Williams and colleagues in this issue of the Journal is a very valuable contribution to public health thinking in this country. The inter-relationships between goals, outcomes sought, core functions and key principles are all well outlined. The valuable illustrative examples in their Table 2 indicate the depth of experience and thinking by the authors. It seems likely that there would be widespread acceptance by health workers for the content of this article, and indeed by the public as well. Even so, in an ideal democratic society attitudes of the public to the principles could be subjected to further evaluation of acceptability eg, with surveys or citizen juries.1Some areas for possible further workThe authors had space restrictions to elaborate on particular issues, but future work could be done on areas where there might be differing perspectives within the New Zealand health sector and society. For example:The stated goal includes New Zealanders living longer lives but is this really what most people want? Perhaps a majority might prefer the health sector to focus more attention on the quality component of life with greater effort directed at major causes of disability. Indeed, there are various potential complex advantages and disadvantages of having an increasingly older population (as discussed elsewhere by New Zealand authors2,3). The ranked list of causes of disability for New Zealand was documented in a recent Lancet article: back pain (largest burden); major depressive disorder; neck pain; anxiety; other musculoskeletal disorders ; asthma; chronic obstructive pulmonary disease (COPD); hearing loss; diabetes and migraine (tenth in burden).4 Of course, preventing some of these conditions (eg, COPD and diabetes) will both reduce disability and result in longer lives, as will progress with tobacco and alcohol control. But the scope for extending life expectancy might soon start to face diminishing marginal returns.Does public health action around reducing health disparities include addressing lower male life expectancy? Indeed, some causes of the gap are readily achievable such as preventing cardiovascular disease in men.5Should evidence for public health practice include both evidence of intervention effectiveness , but also cost-effectiveness to ensure the best value for money? The authors thoughtfully discuss cost-effectiveness in the Background section, but this does not end up in any of the principles.Should there be a principle of the health system striving to be more environmentally sustainable with ongoing reductions in its carbon footprint? Such approaches have been adopted by the National Health Service in the UK and in various other jurisdictions.6,7 Indeed, the Lancet has recently described tackling climate change as the greatest opportunity for advancing global health.8Should there also be a principle of the health system striving to maximise co-benefits for all sectors of society? This might mean, for example, that alcohol control gets special attention given that there are major health benefits but also very wide societal benefits (relating to reduced crime, violence and lost productivity).The critical importance of prevention in public healthThe authors appropriately detail preventive interventions as one of the five core public health functions. But this category may deserve even more emphasis since it generally stands out in terms of value-for-money and the size of the health gain achievable. For example, preventive interventions to reduce alcohol-related harm are likely to be cost-saving to society.9,10 Modelling work for the New Zealand setting also indicates that a range of interventions to prevent high dietary salt intake will also be net cost-saving to the health system.11 Likewise for raising tobacco taxes to prevent tobacco-related disease, again with net cost-savings even though people will incur extra health costs by living longer.12Some preventive interventions will even raise extra tax revenue for the New Zealand Government which can then be used to improve health in other areas, or to fund other public sectors, such as improving education. Examples are traditional taxes on alcohol and tobacco,13 but potentially new taxes such as those on junk food and sugar-sweetened beverages (as per New Zealand modelling work14,15), and also a salt tax.11 Indeed, the World Health Organization has recently stated that increasing tobacco tax is the most cost-effective way to reduce tobacco use and prevent youth uptake of smoking.16 Nevertheless, some preventive interventions might not be worthwhile as per our work on the cost-effectiveness of HPV vaccination for boys in New Zealand at current vaccine prices17 (in contrast to improving HPV vaccination for girls18).Another notable feature of some of these preventive measures that change the environment is that they can also reduce disparities. For example, greater health gain for Mori is suggested by modelling work on raising tobacco taxes,12 for multiple interventions to reduce dietary salt intake,11 and in the domain of food taxes/subsidies.15The particular importance of law as a public health interventionWilliams et al appropriately mention public health laws and regulations in their article, yet this is another area that may deserve a special emphasis. This is because there is now a strong scientific basis for the use of the law as a public health instrument, as shown by one review which identified 65 systematic reviews of studies on the effectiveness of 52 public health laws.19 Most of these laws were found to be effective in achieving their health objectives, and they encompassed: injury prevention; housing; tobacco; vaccination; violence; and food safety. In addition, a review of the ten great public health achievements in the US last century (up to the year 1999) found that all ten were supported by laws at each level of government.20 Laws that benefit public health are relatively low-cost to pass (estimated at $3.7 million for New Zealand21) and can have high levels of effectiveness for multiple decades. For example, the smokefree law banning smoking in pubs and restaurants in New Zealand has been very effective22 and only a few court cases were required in its wake.23 New laws are probably needed in New Zealand to raise taxes on hazardous products (as detailed above), but also to improve food labelling, to control marketing of alcohol and junk food, and to accelerate the tobacco endgame (eg, via retail outlet reduction24). But some existing laws might also cause net public health harm and may need to be reviewed. For example, are the countrys cycle helmet laws fully fit for purpose if these are potentially making it harder to establish cycle sharing schemes in cities? Such schemes are good for public health and are increasingly common internationally (at over 700 cities globally).SummaryThis special article by Williams et al is clearly a valuable contribution to public health thinking in this country. Yet future work could expand on some of the details and give more emphasis to those core functions which have more potential importance than others.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

- Nick Wilson, Department of Public Health, University of Otago, Wellington-

Acknowledgements

Correspondence

Nick Wilson, Department of Public Health, University of Otago, Wellington, PO Box 7343, Wellington South, New Zealand.

Correspondence Email

nick.wilson@otago.ac.nz

Competing Interests

- - Street J, Duszynski K, Krawczyk S, et al. The use of citizens juries in health policy decision-making: a systematic review. Soc Sci Med. 2014;109:1-9. Woodward A, Blakely T. Could we all live to 100? Should we? Aust N Z J Public Health. 2015;39:3-4. Woodward A, Blakely T. The healthy country? A history of life and death in New Zealand. Auckland: Auckland University Press, 2014. Global Burden of Disease Study Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;(E-publication 5 June). Wilson N. Should NZ spend relatively more health resources on improving mens health? Public Health Expert [Blog]. https://blogs.otago.ac.nz/pubhealthexpert/2014/03/13/should-nz-spend-relatively-more-health-resources-on-improving-mens-health/. 2014. Jamieson M, Wicks A, Boulding T. Becoming environmentally sustainable in healthcare: an overview. Aust Health Rev. 2015;(E-publication 20 April). Pencheon D, Rissel CE, Hadfield G, et al. Health sector leadership in mitigating climate change: experience from the UK and NSW. N S W Public Health Bull. 2009;20:173-6. Wang H, Horton R. Tackling climate change: the greatest opportunity for global health. Lancet. 2015;(E-publication 19 June). Cobiac L, Vos T, Doran C, et al. Cost-effectiveness of interventions to prevent alcohol-related disease and injury in Australia. Addiction. 2009;104:1646-55. Chisholm D, Rehm J, Van Ommeren M, et al. Reducing the global burden of hazardous alcohol use: a comparative cost-effectiveness analysis. J Stud Alcohol. 2004;65:782-93. Nghiem N, Blakely T, Cobiac LJ, et al. Health and economic impacts of eight different dietary salt reduction interventions. PLoS One. 2015;10:e0123915. Blakely T, Cobiac L, Cleghorn C, et al. Health, health inequality and cost impacts of annual increases in tobacco tax: Multistate lifetable modeling in New Zealand. PLoS Med. 2015 (in press). Cobiac LJ, Ikeda T, Nghiem N, et al. Modelling the implications of regular increases in tobacco taxation in the tobacco endgame. Tob Control. 2015;24:e154-60. Ni Mhurchu C, Eyles H, Genc M, et al. Twenty percent tax on fizzy drinks could save lives and generate millions in revenue for health programmes in New Zealand. N Z Med J. 2014;127:92-5. Ni Mhurchu C, Eyles H, Genc M, et al. Effects of health-related food taxes and subsidies on mortality from diet-related disease in New Zealand: An econometric-epidemiologic modelling study. PLoS One. 2015;10:e0128477. World Health Organization. WHO report on teh global tobacco epidemic 2015: Raising taxes on tobacco. Geneva: WHO, 2015. Pearson AL, Kvizhinadze G, Wilson N, et al. Is expanding HPV vaccination programs to include school-aged boys likely to be value-for-money: a cost-utility analysis in a country with an existing school-girl program. BMC Infect Dis. 2014;14:351. Blakely T, Kvizhinadze G, Karvonen T, et al. Cost-effectiveness and equity impacts of three HPV vaccination programmes for school-aged girls in New Zealand. Vaccine. 2014;32:2645-56. Moulton AD, Mercer SL, Popovic T, et al. The scientific basis for law as a public health tool. Am J Public Health. 2009;99:17-24. Goodman RA, Moulton A, Matthews G, et al. Law and public health at CDC. MMWR Morb Mortal Wkly Rep. 2006;55 Suppl 2:29-33. Wilson N, Nghiem N, Foster R, et al. Estimating the cost of new public health legislation. Bull World Health Organ. 2012;90:532-539. Edwards R, Thomson G, Wilson N, et al. After the smoke has cleared: evaluation of the impact of a new national smoke-free law in New Zealand. Tob Control. 2008;17:e2. Wilson N, Edwards R, Parry R. A persisting secondhand smoke hazard in urban public places: results from fine particulate (PM2.5) air sampling. N Z Med J. 2011;124(1330):34-47. Pearson AL, van der Deen FS, Wilson N, et al. Theoretical impacts of a range of major tobacco retail outlet reduction interventions: modelling results in a country with a smoke-free nation goal. Tob Control. 2014;24:e32-e38.- -

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

The special article on Core public health functions for New Zealand by Williams and colleagues in this issue of the Journal is a very valuable contribution to public health thinking in this country. The inter-relationships between goals, outcomes sought, core functions and key principles are all well outlined. The valuable illustrative examples in their Table 2 indicate the depth of experience and thinking by the authors. It seems likely that there would be widespread acceptance by health workers for the content of this article, and indeed by the public as well. Even so, in an ideal democratic society attitudes of the public to the principles could be subjected to further evaluation of acceptability eg, with surveys or citizen juries.1Some areas for possible further workThe authors had space restrictions to elaborate on particular issues, but future work could be done on areas where there might be differing perspectives within the New Zealand health sector and society. For example:The stated goal includes New Zealanders living longer lives but is this really what most people want? Perhaps a majority might prefer the health sector to focus more attention on the quality component of life with greater effort directed at major causes of disability. Indeed, there are various potential complex advantages and disadvantages of having an increasingly older population (as discussed elsewhere by New Zealand authors2,3). The ranked list of causes of disability for New Zealand was documented in a recent Lancet article: back pain (largest burden); major depressive disorder; neck pain; anxiety; other musculoskeletal disorders ; asthma; chronic obstructive pulmonary disease (COPD); hearing loss; diabetes and migraine (tenth in burden).4 Of course, preventing some of these conditions (eg, COPD and diabetes) will both reduce disability and result in longer lives, as will progress with tobacco and alcohol control. But the scope for extending life expectancy might soon start to face diminishing marginal returns.Does public health action around reducing health disparities include addressing lower male life expectancy? Indeed, some causes of the gap are readily achievable such as preventing cardiovascular disease in men.5Should evidence for public health practice include both evidence of intervention effectiveness , but also cost-effectiveness to ensure the best value for money? The authors thoughtfully discuss cost-effectiveness in the Background section, but this does not end up in any of the principles.Should there be a principle of the health system striving to be more environmentally sustainable with ongoing reductions in its carbon footprint? Such approaches have been adopted by the National Health Service in the UK and in various other jurisdictions.6,7 Indeed, the Lancet has recently described tackling climate change as the greatest opportunity for advancing global health.8Should there also be a principle of the health system striving to maximise co-benefits for all sectors of society? This might mean, for example, that alcohol control gets special attention given that there are major health benefits but also very wide societal benefits (relating to reduced crime, violence and lost productivity).The critical importance of prevention in public healthThe authors appropriately detail preventive interventions as one of the five core public health functions. But this category may deserve even more emphasis since it generally stands out in terms of value-for-money and the size of the health gain achievable. For example, preventive interventions to reduce alcohol-related harm are likely to be cost-saving to society.9,10 Modelling work for the New Zealand setting also indicates that a range of interventions to prevent high dietary salt intake will also be net cost-saving to the health system.11 Likewise for raising tobacco taxes to prevent tobacco-related disease, again with net cost-savings even though people will incur extra health costs by living longer.12Some preventive interventions will even raise extra tax revenue for the New Zealand Government which can then be used to improve health in other areas, or to fund other public sectors, such as improving education. Examples are traditional taxes on alcohol and tobacco,13 but potentially new taxes such as those on junk food and sugar-sweetened beverages (as per New Zealand modelling work14,15), and also a salt tax.11 Indeed, the World Health Organization has recently stated that increasing tobacco tax is the most cost-effective way to reduce tobacco use and prevent youth uptake of smoking.16 Nevertheless, some preventive interventions might not be worthwhile as per our work on the cost-effectiveness of HPV vaccination for boys in New Zealand at current vaccine prices17 (in contrast to improving HPV vaccination for girls18).Another notable feature of some of these preventive measures that change the environment is that they can also reduce disparities. For example, greater health gain for Mori is suggested by modelling work on raising tobacco taxes,12 for multiple interventions to reduce dietary salt intake,11 and in the domain of food taxes/subsidies.15The particular importance of law as a public health interventionWilliams et al appropriately mention public health laws and regulations in their article, yet this is another area that may deserve a special emphasis. This is because there is now a strong scientific basis for the use of the law as a public health instrument, as shown by one review which identified 65 systematic reviews of studies on the effectiveness of 52 public health laws.19 Most of these laws were found to be effective in achieving their health objectives, and they encompassed: injury prevention; housing; tobacco; vaccination; violence; and food safety. In addition, a review of the ten great public health achievements in the US last century (up to the year 1999) found that all ten were supported by laws at each level of government.20 Laws that benefit public health are relatively low-cost to pass (estimated at $3.7 million for New Zealand21) and can have high levels of effectiveness for multiple decades. For example, the smokefree law banning smoking in pubs and restaurants in New Zealand has been very effective22 and only a few court cases were required in its wake.23 New laws are probably needed in New Zealand to raise taxes on hazardous products (as detailed above), but also to improve food labelling, to control marketing of alcohol and junk food, and to accelerate the tobacco endgame (eg, via retail outlet reduction24). But some existing laws might also cause net public health harm and may need to be reviewed. For example, are the countrys cycle helmet laws fully fit for purpose if these are potentially making it harder to establish cycle sharing schemes in cities? Such schemes are good for public health and are increasingly common internationally (at over 700 cities globally).SummaryThis special article by Williams et al is clearly a valuable contribution to public health thinking in this country. Yet future work could expand on some of the details and give more emphasis to those core functions which have more potential importance than others.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

- Nick Wilson, Department of Public Health, University of Otago, Wellington-

Acknowledgements

Correspondence

Nick Wilson, Department of Public Health, University of Otago, Wellington, PO Box 7343, Wellington South, New Zealand.

Correspondence Email

nick.wilson@otago.ac.nz

Competing Interests

- - Street J, Duszynski K, Krawczyk S, et al. The use of citizens juries in health policy decision-making: a systematic review. Soc Sci Med. 2014;109:1-9. Woodward A, Blakely T. Could we all live to 100? Should we? Aust N Z J Public Health. 2015;39:3-4. Woodward A, Blakely T. The healthy country? A history of life and death in New Zealand. Auckland: Auckland University Press, 2014. Global Burden of Disease Study Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;(E-publication 5 June). Wilson N. Should NZ spend relatively more health resources on improving mens health? Public Health Expert [Blog]. https://blogs.otago.ac.nz/pubhealthexpert/2014/03/13/should-nz-spend-relatively-more-health-resources-on-improving-mens-health/. 2014. Jamieson M, Wicks A, Boulding T. Becoming environmentally sustainable in healthcare: an overview. Aust Health Rev. 2015;(E-publication 20 April). Pencheon D, Rissel CE, Hadfield G, et al. Health sector leadership in mitigating climate change: experience from the UK and NSW. N S W Public Health Bull. 2009;20:173-6. Wang H, Horton R. Tackling climate change: the greatest opportunity for global health. Lancet. 2015;(E-publication 19 June). Cobiac L, Vos T, Doran C, et al. Cost-effectiveness of interventions to prevent alcohol-related disease and injury in Australia. Addiction. 2009;104:1646-55. Chisholm D, Rehm J, Van Ommeren M, et al. Reducing the global burden of hazardous alcohol use: a comparative cost-effectiveness analysis. J Stud Alcohol. 2004;65:782-93. Nghiem N, Blakely T, Cobiac LJ, et al. Health and economic impacts of eight different dietary salt reduction interventions. PLoS One. 2015;10:e0123915. Blakely T, Cobiac L, Cleghorn C, et al. Health, health inequality and cost impacts of annual increases in tobacco tax: Multistate lifetable modeling in New Zealand. PLoS Med. 2015 (in press). Cobiac LJ, Ikeda T, Nghiem N, et al. Modelling the implications of regular increases in tobacco taxation in the tobacco endgame. Tob Control. 2015;24:e154-60. Ni Mhurchu C, Eyles H, Genc M, et al. Twenty percent tax on fizzy drinks could save lives and generate millions in revenue for health programmes in New Zealand. N Z Med J. 2014;127:92-5. Ni Mhurchu C, Eyles H, Genc M, et al. Effects of health-related food taxes and subsidies on mortality from diet-related disease in New Zealand: An econometric-epidemiologic modelling study. PLoS One. 2015;10:e0128477. World Health Organization. WHO report on teh global tobacco epidemic 2015: Raising taxes on tobacco. Geneva: WHO, 2015. Pearson AL, Kvizhinadze G, Wilson N, et al. Is expanding HPV vaccination programs to include school-aged boys likely to be value-for-money: a cost-utility analysis in a country with an existing school-girl program. BMC Infect Dis. 2014;14:351. Blakely T, Kvizhinadze G, Karvonen T, et al. Cost-effectiveness and equity impacts of three HPV vaccination programmes for school-aged girls in New Zealand. Vaccine. 2014;32:2645-56. Moulton AD, Mercer SL, Popovic T, et al. The scientific basis for law as a public health tool. Am J Public Health. 2009;99:17-24. Goodman RA, Moulton A, Matthews G, et al. Law and public health at CDC. MMWR Morb Mortal Wkly Rep. 2006;55 Suppl 2:29-33. Wilson N, Nghiem N, Foster R, et al. Estimating the cost of new public health legislation. Bull World Health Organ. 2012;90:532-539. Edwards R, Thomson G, Wilson N, et al. After the smoke has cleared: evaluation of the impact of a new national smoke-free law in New Zealand. Tob Control. 2008;17:e2. Wilson N, Edwards R, Parry R. A persisting secondhand smoke hazard in urban public places: results from fine particulate (PM2.5) air sampling. N Z Med J. 2011;124(1330):34-47. Pearson AL, van der Deen FS, Wilson N, et al. Theoretical impacts of a range of major tobacco retail outlet reduction interventions: modelling results in a country with a smoke-free nation goal. Tob Control. 2014;24:e32-e38.- -

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