Public health organisation leads charge to turn tide of obesity in Auckland Wednesday, 6 May 2015

Source: NZ Doctor

Two-thirds of Auckland adults and a third of children are overweight or obese and almost half of the city's residents are not physically active enough to be healthy.

Those are just two statistics which clinical director of the Auckland Regional Public Health Service, Julia Peters, is hoping to turn around via a major collaborative plan for the country's biggest city, entitled Healthy Auckland Together.

The initiative involves a large number of organisations, including DHBs, PHOs, the Ministry of Health, local body authorities such as Auckland Transport and Auckland Council and various NGOs.

Primary care and general practice must be involved

Dr Peters says it's the first time such an inter-sectoral approach has been employed to try to reduce obesity, increase physical activity and improve nutrition in Auckland. ARPHS is leading the project and aims to have a plan ready by June, and Dr Peters wants to get primary care and general practice on board.

"We need to start to walk the talk," she says. "It's important that in a primary care setting we are not blaming the victim. GPs and practice nurses remain a very trusted point of contact. They need to be having those courageous conversations about sedentary lifestyles and obesity."

She says GPs can also contribute by doing regular checks on the BMI of patients, including children. "It's really important. Children need to be a big focus."

The problems are most pronounced in areas such as Counties Manukau which has some of the city's lowest socio-economic neighbourhoods, and which are also the areas where primary care practitioners are most stretched, she says.

Building up problems for future

Dr Peters acknowledges healthy eating initiatives have been tried in the past, but the problems of obesity and diabetes have continued to grow.

"This is a problem which will require an inter-sectoral approach. It's not going to be solved by the health sector alone."

Early work on the plan has identified numerous action points, some of which are quite radical. 

They include:

  • implementing healthy food policies within organisations and requiring similar policies for contractors and within vendor agreements 
  • mapping the density and location of fast food outlets and submitting on the Resource Management Act review to provide councils with the ability to zone for these outlets
  • advocating for legislative changes to limit food advertising to children and reviewing advertising on member organisations' assets
  • advocating for supermarkets to have at least one aisle free of energy-dense food and developing a healthy supermarket accord.

Focusing on the 'doable'

Dr Peters admits not all the recommendations will make it into the final plan. ARPHS will focus on "things we believe are doable in our sphere of influence, that make a difference in reducing inequalities".

"Obviously some, like advertising, require action at a national level. Maybe they are things we can discuss with the ministry. Rather than wringing our hands and saying it's all too difficult, we will put the evidence forward for what changes will need to happen at a national level.

"We are going to see how we get on in the next three to five years. We're not pretending this is easy, and just as tobacco has taken a long time and we are not there yet, we are not expecting this to change overnight."