Determinants of health
Good health is not just a matter of biology and genes. The time, place and conditions people live in, and their life experiences and choices, all help determine their health status. In New Zealand, people’s health may be affected by household income, employment status, working conditions, education, diet, housing, environment, family and cultural networks, and tobacco smoking, as well as age, gender and hereditary factors. Socio-economic and ethnic inequalities are closely related to health.
Illness and wellbeing
Traditionally, good health was viewed as the absence of illness. In the 1940s the World Health Organization defined health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’.1 This definition was still used in New Zealand in the 21st century.
Quality of life
Life expectancy and mortality trends are key measures of health status in the 21st century. However, increasing emphasis is placed on quality of life. Independent life expectancy indicators measure how many years people can expect to live free of limitations on daily activities, and without needing assistance. In 2013 the average independent life expectancy at birth was 65.2 years (compared to 79.5 years of total life expectancy) for New Zealand men, and 66.5 years (compared to 83.2 years of life expectancy) for New Zealand women.
In the 21st century doctors sometimes write out ‘green prescriptions’, which advise patients to be physically active. Research has found that green prescriptions are a cheap way of increasing activity and exercise levels and improving quality of life.
Changes in health
Though lack of illness is only one way of defining health, changes in the types of disease that cause illness and death remain an important way of understanding changes in the health profile of New Zealanders. Infectious disease as a cause of death declined from the late 19th century. This was associated with decreasing child death rates in that period. Deaths from non-communicable diseases such as cancer increased as the population aged and lifestyles changed. For Māori these changes occurred decades later.