Intouch Public Health

Luke Garland and Cadence Kaumoana

The Public Health Association of New Zealand (PHANZ) has released four policy position statements, reaffirming our commitment to a fairer, healthier Aotearoa New Zealand. These statements reflect PHANZ’s vision of Hauora mō te katoa – oranga mō te ao (“Good health for all – health equity in Aotearoa”) and provide clear guidance on how public policy can better support health, wellbeing, and equity. The association recognises Te Tiriti o Waitangi as Aotearoa New Zealand’s founding document, defining respectful relationships between tāngata whenua (Māori) and tāngata Tiriti (non-Māori).

Each statement has been developed through a collaborative process led by PHANZ staff and the PHANZ Policy Subcommittee, with input and feedback from members and key sector experts and partners.

These position statements have been developed and published during a period of considerable policy and legislative change in Aotearoa New Zealand. Some of these changes carry the potential to significantly influence health outcomes and may contribute to widening existing inequities across Aotearoa New Zealand. In this context, PHANZ is committed to maintaining a strong, independent public health voice. Our voice is grounded in evidence, committed to Te Tiriti, and focused on equity, to constructively inform and engage with political decision-making processes that affect the wellbeing of our communities.

Read the full policy statements at: www.phanz.org.nz/policy

1. Freshwater and Health

The PHANZ is calling for urgent action to protect Aotearoa’s freshwater.

Safe, clean water is essential to human health. Yet intensified agriculture, ageing infrastructure, and climate change are placing freshwater ecosystems under increasing pressure. The public health risks from groundwater contamination and rising nitrate levels are serious and growing.

The  Freshwater and Health statement highlights how declining water quality and proposed changes to environmental legislation and protections put public health at risk, especially in rural and disadvantaged communities. The PHANZ emphasises the need for a strong health and equity-focused approach to freshwater policy and management that upholds Te Tiriti o Waitangi, and strengthens environmental protections.

The PHANZ strongly supports the Te Mana o Te Wai framework, which is the current decision-making framework for freshwater management in Aotearoa New Zealand. Te Mana o te Wai safeguards the health of freshwater ecosystems, and explicitly requires access to safe, good quality drinking water.

Our freshwater statement comes as the Government is proposing changes to Aotearoa New Zealand’s Freshwater National Direction, including the removal of the Te Mana o te Wai framework. While the proposed changes focus on “cutting red tape” for commercial entities, experts note that it will mean more pollution in the places we swim and fish, and in communities’ drinking water sources.

In advocating for the good health of all, the PHANZ believes the Government must adopt a public health approach to freshwater policy. That approach prioritises the health and wellbeing of all people, protects drinking water sources from degradation, and restores the mauri (life force) of water for current and future generations.

2. Community Water Fluoridation

The PHANZ reaffirms its strong support for community water fluoridation as a proven, safe, and equitable public health measure.

Tooth decay remains one of the leading causes of preventable hospital admissions for children in Aotearoa. Māori, Pacific, and disabled communities experience higher rates of dental disease, reflecting broader systemic inequities.

Releasing its new policy position statement on Community Water Fluoridation, the PHANZ emphasises the strong body of international and national evidence supporting community water fluoridation as a safe and effective public health measure for preventing tooth decay in both children and adults.

PHANZ supports the Government’s continued role in ensuring equitable access to fluoridated water and highlights the need for wider oral health reform, including improved access to care, and action on the social determinants of oral health.

3. Climate Change and Health

The PHANZ is calling for urgent, coordinated climate action that places health, equity, and justice at its core.

Climate change is already impacting health globally, and in Aotearoa New Zealand, through heatwaves, extreme weather, air pollution, food insecurity, and housing instability. Communities already experiencing social and economic disadvantage are hit hardest.

The PHANZ’s new policy position statement on Climate Change and Health highlights both the serious health risks posed by climate change, and the opportunity to improve health outcomes and reduce inequities through bold and just climate action.

The statement highlights a growing body of evidence that shows how climate change is exacerbating existing health inequities, highlighting the critical need to prioritise health equity in the development of climate change policies, including both mitigation and adaptation strategies.

Importantly, climate action also presents a major opportunity to improve health. Actions such as promoting active transport, reducing emissions, and improving housing quality can lead to better mental and physical health.

PHANZ calls on the Government and all sectors to recognise that climate action is health action, and to prioritise solutions that deliver for both people and the planet.

 

4. School-age Nutrition and Ka Ora, Ka Ako

Good nutrition in childhood supports learning, development, and lifelong wellbeing. Yet too many children in Aotearoa New Zealand face food insecurity and go to school hungry. Ka Ora, Ka Ako is an existing government-funded school lunches programme that helps address these inequities by providing consistent access to nutritious meals in schools.

Ka Ora, Ka Ako was introduced in 2020 and targets schools with the highest concentration of learners that face socioeconomic barriers. The programme provided healthy and nutritious meals, and used a universal delivery model, providing lunch free of charge to all students within selected schools, to reduce the stigma associated with ‘needing food’ and to encourage uptake.

An evaluation in 2022 found Ka Ora, Ka Ako delivered significant benefits for children and young people, including better mental wellbeing; improved energy levels and being able to undertake physical activity; improvement in school achievement; improved emotional and social wellbeing; and overall better quality of life.

However, recent government cuts and changes to the Ka Ora, Ka Ako programme have diminished meal quality and nutritional value. These changes are not evidence-based and may affect student attendance and achievement, particularly for children experiencing financial hardship and food insecurity.

The PHANZ’s new policy position statement calls for Ka Ora, Ka Ako to be made permanent, expanded to reach more children, and embedded within a broader strategy for food policy, food security, and health equity. The statement also highlights the importance of culturally appropriate, locally sourced food, and partnership with whānau (families) and communities in programme delivery.

 

Luke Garland is Senior Policy Advisor, and Dr Cadence Kaumoana is CEO, at the Public Health Association of Aotearoa New Zealand

Image: Wanaka tree, Aotearoa New Zealand, by Pedro Szekely/Flickr