By NIDHA KHAN and MAY LIN TYE.

In order to have important conversations about health issues affecting society, we need to know what it means to be ‘healthy’. To most the concept appears simple; the absence of disease, eating well, exercising, and being able to mentally function and cope with stress.

However, defining ‘health’ is anything but simple. In fact, the idea of health has continually evolved over time and there is still no single definition of health agreed upon by everyone.

The most commonly used definition is provided by the World Health Organisation; “health is a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity” [1].

At first, this sounds great – who wouldn’t want to be in a complete state of wellbeing? However, once you scratch the surface and delve deeper into this particular definition, problems emerge. For example, it is unrealistic. If being healthy requires a ‘complete’ state of well-being at every second of the day, then very few people would be considered ‘healthy’.

To add further complexity, the concept of health differs across cultures. In Western countries like New Zealand, the root cause of ill health is seen as biological and treated primarily with pharmaceuticals. However, in Pacific Island cultures, biology plays a much smaller role. Ill health is instead seen as a result of disruptions in the balance between spirit, mind, body and environment, or even attributed to supernatural forces like demons and ghosts.

Consequently, treatment is not purely biological and many Pacific Island residents seek help from herbalists, massage therapists and faith healers, rather than doctors. This highlights that ‘health’ is complicated and there will never be a universal definition of health accepted by all cultures. To engage in conversations about health, it is imperative to clearly define how you choose to view health.

 

In our own backyard

NZ is highly diverse, with different subgroups experiencing a variety of health issues. When there are differences in the health status of certain groups, for reasons out of their control, this is health inequity – an issue NZ is overridden with.

One significant characteristic of NZ is our vulnerability to lifestyle diseases: those caused or exacerbated by lifestyle factors, such as lack of physical activity. In general, NZ’s biggest killer is cardiovascular disease – that is, heart, stroke and blood vessel disease, responsible for 30% of deaths per year [2].

Furthermore, as of 2011, NZ was the third most obese country in the OECD – with 28.4% obese [3].  However, there are factors which make these lifestyles more likely for certain groups, for example affordability of unhealthy, processed foods, and density of fast food outlets in poorer neighbourhoods.

This is only one example illustrating NZ’s health landscape: Hugely inequitable with massive room for improvement.

 

And what about us youth?

As young people, our health practices are not always up to par. For example, 15-24 year-olds are the least likely to eat the recommended three servings of vegetables a day [4].

In fact, NZ’s rates of preventable youth health issues, for example youth obesity, is high in comparison to other developed nations. Plus, youth tend to engage in more hazardous behaviours.

Arguably one of the most important issues affecting youth is NZ’s binge drinking culture. As of 2012, 8% of secondary students were drinking alcohol weekly or more frequently, and 23% were binge drinking [5].

Consequently, alcohol use can lead to issues such as unwanted or unsafe sex and drink driving – another leading cause of death in youth.

On top of this, teenage years are difficult to navigate, which is one reason why the mental health of teens is often vulnerable. A survey on secondary students in 2012 showed that 29% female and 18% male students participated in deliberate self harm, and 21% female and 10% male students experienced suicidal thoughts [5].

Sadly, when discussing these statistics, the issue is often framed as ‘youth making bad choices’. This is unhelpful and will not address the problem at hand, as the origins of ill health are shaped by factors besides individual choice.

These are ‘determinants of health’ and can stretch from things like age, sex and genetics, to education level, income, culture and environment, to even wider factors like governmental policies. They all influence our abilities to be healthy – to access health services, to be able to or more likely to live healthy lifestyles, to be in a position where ‘good health’ is possible.

Unfortunately, these determinants affect everyone differently, which means that certain groups, like youth, suffer from poorer health outcomes, an injustice which must be eradicated.

Defining health will continue to be a task fraught with complexities, but clearly NZ’s population suffers from many preventable health issues, often stemming from circumstances they cannot control. To address this as a society, we must avoid blaming population groups for their ill health, raise awareness of these injustices, and advocate for a country which provides every single person with the opportunity to secure a healthier future.

 

[1] World Health Organization. (n.d.) Redefining health.
[2] Heart Foundation. (2015). Statistics: General heart statistics for New Zealand.
[3] Statistics New Zealand. (n.d.). Obesity.
[4] Ministry of Health. (2014). Annual Update of Key Results 2013/14: New Zealand Health Survey. Wellington: Ministry of Health.
[5] Clark, T. C., Fleming, T., Bullen, P., Denny, S., Crengle, S., Dyson, B., Fortune, S., Lucassen, M., Peiris-John, R., Robinson, E., Rossen, F., Sheridan, J., Teevale, T., Utter, J. (2013). Youth’12 Overview: The health and wellbeing of New Zealand secondary school students in 2012. Auckland, New Zealand: The University of Auckland.

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