Everybody enjoys a full and healthy life by living well, staying well and getting well. Avoidable deaths, disease and injuries are prevented. Everybody has the ability to function, participate, and live independently or appropriately supported in society.
Good health is critical to wellbeing as it enables people to participate in society and the economy. Without good health, people are less able to enjoy their lives to the fullest extent, and their options may be limited. Good health has two core dimensions: the length of time people live and the quality of their lives. As well as enjoying long lives, people want to be free from the pain, suffering and incapacity from injury or illness. However, not everybody can live a fully independent life.
People with injuries or illness (both mental and physical) may experience barriers to participating in employment, education and training, thus reducing their economic standard of living. People’s inability to participate in other areas of life, such as family life, socialising with friends, joining in community activities and taking part in recreation and leisure pursuits, can lead to feelings of frustration and isolation.
A range of factors affect and are affected by health outcomes, including people’s genetic predisposition; behaviour; physical and social environment; and awareness and availability of health services.
Nine headline indicators are used in this chapter. Together they provide a picture of the current state of the nation’s health and the likely trends in the future. The indicators are: life expectancy; health expectancy; suicide; self-rated health; psychological distress; obesity; cigarette smoking; potentially hazardous drinking; and participation in physical activity.
Some indicators directly measure the desired outcomes relating to long and healthy lives, and people’s ability to participate in society. Others are predictors of future health outcomes.
Life expectancy at birth measures the survival experience of the population: how long people live. It is an indicator of fatal health outcomes.
The second indicator, health expectancy, also known as independent life expectancy, refers to the number of years a person can expect to live independently (ie free of any disability requiring the assistance of another person or complex assistive device). This is a summary measure of a population’s health, combining both fatal (life expectancy) and non-fatal (disability requiring assistance) health outcomes.
The suicide death rate serves as a proxy for the mental health status and social wellbeing of the population. The indicator covers the suicide death rate for society as a whole, and includes details for subsets of the population.
The fourth indicator, self-rated health, is a widely used indicator of health. Being in good health means people rating their health as excellent, very good or good.
Psychological distress refers to the proportion of people with high or very high levels of psychological distress (such as anxiety, confused emotions, depression or rage), which indicates a high probability of an anxiety or depressive disorder.
The sixth indicator, obesity, is linked with poor health outcomes, such as an increased risk of heart attacks, strokes, type 2 diabetes, and some cancers.
The links between cigarette smoking and poor health are widely recognised. For example, cigarette smoking (active and passive) is a risk factor for many cancers and respiratory and cardiovascular diseases, and has been linked with adverse child health outcomes such as low birth weight and Sudden Infant Death Syndrome.
Alcohol is the most commonly used recreational drug in New Zealand. The eighth indicator, potentially hazardous drinking, is an established pattern of alcohol consumption that carries a high risk of future damage to physical or mental health, but may not yet have resulted in significant adverse effects. Alcohol also contributes to death and injury from traffic accidents, drowning, suicide, assaults, and domestic violence.
The final indicator, participation in physical activity, tells us how active New Zealanders are. Moderate physical activity can improve a number of health and other outcomes, and lead to fewer health problems and higher productivity at work, especially when combined with a balanced diet and a healthy lifestyle.
Overall, the Health domain indicators show a mixed picture of improvements.
Life expectancy at birth continues to increase over time, with the gap between male and female life expectancy narrowing, but there are marked ethnic, socio-economic and regional differences. While people are living longer and living longer in “good” health, they are spending proportionally less of their total life in “good” health in 2013 compared with 1996.
The rate for people committing suicide increased in the mid-1980s before returning to pre-1987 levels in the 2000s. When looking at recent-change and medium-term-change, the proportions of people who report experiencing high levels of psychological distress have remained consistent. People rate their own health highly, with improvements in terms of recent-change and medium-term-change, and New Zealand ranked first among the OECD countries.
The rate of cigarette smoking is stable when looking at recent-change but improved for medium-term-change. The potentially hazardous drinking rate has remained steady in terms of both recent-change and medium-term-change, as has the rate of people who met physical activity guidelines. While obesity rates for adults and children are stable when looking at recent-change, the rates have increased since 2006/2007 with New Zealand having one of the highest adult rates in the OECD.