Advisory Committee Urges Bold Actions To Improve Health For All New Zealanders By 2040

Today the Public Health Advisory Committee (PHAC) has released its 2025 report: “Determining our Future.” This report looks forward to 2040 and asks: how can we make sure everyone in Aotearoa New Zealand lives a healthy, fulfilling life?

The PHAC is an independent advisory committee established in July 2022 under the Pae Ora Act. It looks at the long-term health challenges facing New Zealand, providing evidence-based public health advice directly to the Minister of Health and central government health agencies.

As Kevin Hague, the chair of PHAC notes, it is over 25 years since the last major report on social, economic, and cultural determinants of health in Aotearoa New Zealand.

“We have known for decades that most of the building blocks of our health and wellbeing come from outside health care itself: where we live, learn, what we earn, our housing and our social connections,” Mr Hague says.

This new report examines trends in these determinants of health (such as income, housing, cultural identity and social cohesion) and in health outcomes since 2000. The report finds that New Zealanders are living longer, and many health and wellbeing outcomes have improved over the last 25 years, but these gains remain unequally shared.

Despite a narrowing of the gap between Māori and Pakeha life expectancy since 2000 overall, there are regional differences. A Pākehā baby boy born in Waikato today can expect to live eight years longer than his Māori neighbour. Pākehā children can expect to live to 84 years in the northern region, seven years longer than Pacific peoples’ children. This gap has increased since 2000.

At the same time, almost two in five people in Aotearoa New Zealand today find it hard to meet every-day costs. Two-thirds of New Zealanders do not feel ‘well off’, and one in four sometimes do not have enough to eat. There are significant pressures on our health system, and we can expect these to increase as our population grows and ages, and as more of us have long-term health problems, such as diabetes.

The report explores why the determinants of health are unevenly distributed in our society and some of the mechanisms through which they affect our health.

The report then looks forward to 2040 and assesses some more recently recognised challenges to health equity and wellbeing. Mr Hague says “We face big challenges, such as the climate crisis and advances in AI and technology - which will affect all aspects of our lives.”

The PHAC report assesses evidence and research from within New Zealand and internationally to understand what works to improve health and wellbeing outcomes and health equity. The report also draws on the perspectives and experience of young people, community, iwi and public service leaders.

The PHAC report identifies that improving health and wellbeing is shaped by the building blocks of wellbeing outside the health sector and requires collaboration between government agencies. But government intentions to do this are often undermined by agencies continuing to pursue objectives in their own silos. This must be addressed by a clear requirement to collaborate around long term wellbeing goals, agreed at Cabinet level.

The PHAC recommends actions to the Minister of Health and Government around three key themes.

• Firstly, good health and wellbeing are rooted in the strengths, mana and aspirations of whānau and communities. The government and public services must work collectively and more effectively to resource and support communities to achieve their own solutions.
• Secondly, we need to get the fundamentals right. The big challenges ahead require courageous leadership, a greater sense of urgency, and shared long-term goals.
• Thirdly, PHAC sees many opportunities that are “win-win” solutions to the big challenges ahead, such as the climate crisis. For example, we can:
  • Intervene early, and better support our families with young children, especially those with complex needs. This has benefits not just for their health but for many other social goals, including education outcomes and reduced crime.
  • Build healthy, affordable homes that offer whānau security, help keep children in school and people out of hospital - but also help reduce carbon emissions.
  • Design our infrastructure and cities to support physical activity, public transport and connection with our environment, which is good for the health of people and will help us reach our climate goals.

As the PHAC report points out, there are some things that only the government can do. It needs to provide an enabling framework – promoting human rights, good governance and honouring Te Tiriti o Waitangi as we move towards 2040. We also need economic, housing and social policies that work for everyone, not just those well off.

Mr Hague says “We have learned much from the gains that have been made, but also from the failures to make progress in many key areas. The unnecessary, costly and preventable differences we see today in the determinants of health, and in health and wellbeing outcomes, are not inevitable or fixed. They can be modified through the policies and actions that we choose to implement.”

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