Story: Public health

Public health initiatives have been at the forefront of improving health and life expectancy since the 19th century. The focus has shifted from quarantine and sewerage systems to vaccination against infectious diseases, screening programmes and policy interventions to prevent chronic diseases, but the aim is still to prevent disease before it takes hold and improve the health of disadvantaged populations.

Story by Kerryn Pollock
Main image: Microbiologist Nick Waipara with a culture of Stachybotrys chartarum, a toxic fungus

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Public health professionals work to prevent disease and promote good health in the community and eliminate inequalities in health. Much of the improvement in health since the 1800s has been because of public health work.

The Ministry of Health plays the lead role in public health, but many other organisations such as local councils and Plunket also do significant public health work.

Environmental health

In the 1800s public health focused on controlling infectious diseases by:

  • quarantining (isolating) people coming into New Zealand with diseases
  • improving sewerage systems.

Later, drinking water was treated, but not until the 1950s for most communities.

Poor housing and overcrowding can cause illness, which is one reason the government began to build state houses in 1906. In the 2000s the government ran a scheme to encourage people to insulate their homes.

Laws were introduced to reduce air pollution, which can cause respiratory diseases, but it was still a problem in the 21st century.

From the 1950s there were campaigns and laws to discourage smoking, which causes diseases including cancer.

Healthy bodies

From the mid-1800s vaccines were developed to prevent infectious diseases. In the 2010s children have free access to vaccinations that provide protection against 13 different infectious diseases. Public health actions have also included broad population level approaches to address non-infectious causes of disease.

Examples include:

  • providing free milk for schoolchildren from 1937 to 1967
  • reducing tooth decay by adding fluoride to drinking water
  • increases in tobacco excise tax and laws introducing smoke-free public places and workplaces 
  • legislation and public education campaigns discouraging drink-driving
  • screening at-risk women for cervical cancer or breast cancer.

Mental health

Around 47% of New Zealanders experience some form of mental illness at some time in their life. From the 1970s there was a new focus on programmes that promoted mental wellness, rather than just treating illness. Because Māori and Pacific Island people have higher rates of mental illness, programmes and services have been developed to support these groups.

Each year, more people die from suicide than from car crashes. Suicide prevention is a major current public health concern.

Social and ethnic factors

Māori, Pacific Island people and those on low incomes are likely to have poorer health than others. Encouraged by public health practitioners and others, governments have developed policies and programmes to reduce or eliminate these health inequalities.

How to cite this page:

Kerryn Pollock, 'Public health', Te Ara - the Encyclopedia of New Zealand, http://www.TeAra.govt.nz/en/public-health (accessed 24 July 2019)

Story by Kerryn Pollock, published 5 May 2011, reviewed & revised 7 Jul 2019 with assistance from Richard Edwards