Healthy Families NZ is a prevention initiative that takes a systems approach to improve the health and wellbeing of whole populations within localities in order to prevent the rise of chronic disease.
Each Healthy Families NZ locality is different; the people, environment, strengths and challenges are all specific to their context. Healthy Families NZ is designed to embrace the unique needs and aspriations of localities, using sytems thinking and social innovation to create sustainable change. The workforce and lead provider in each locality have been chosen because they are best placed to create impact in their locality. What brings the locality teams together is a common approach and principles which creates our movement. We see and feel this movement in action, but it is hard to describe (especially simply) to those that haven’t experienced it yet. We want to inspire others to join the movement and not being able to describe it well is a barrier.
The word prevention can mean different things to different people. We see prevention as a spectrum; just like care and treatment in the health system is a spectrum. We all see and can understand the difference between primary care in the community and highly specialised treatment in tertiary hospitals. We can also easily understand that both are important and needed.
The end of the prevention spectrum that is easiest for most people to picture is the step right before primary care. It tends to be at an individual or household level and the direct link to an improvement in health and wellbeing is fairly obvious. For example, someone joins a local exercise group to help them be active more often. This is prevention!
The other end of the prevention spectrum is less obvious. This is the end that Healthy Families NZ focuses on. We look at the underlying conditions that make it easier or harder to live healthier lives in order to prevent the rise of chronic disease. These conditions don’t just affect one person or whānau but whole communities or populations. To make sustainable change at this end of the prevention spectrum requires looking at the bigger system and understanding the conditions that holds problems in place. For example we know many of our whānau feel time poor, fitting in time for physical activity is seen as a challenge. A whole of population, systems level solution could be influencing Councils to invest in more walking and cycling paths. By making it easier and natural for more people to get where they need to go actively we’re making physical activity part of our everyday lives rather than another thing we need to fit into our day. This is also prevention!
These examples highlight how prevention at each end of the spectrum looks and feels very different, yet we use the same word to describe it.
Prevention is synonymous with a Māori world view. The Māori prevention system can be described through tikanga. Tā Mason Durie states that tikanga pre 1840 was “pragmatic, open-ended and lacked rule-like definitions. This allowed tikanga to be flexible and adaptable to fit new circumstances or the needs of the community at a particular time or situation”(Durie, Mason, Whaiora: Māori Health Development, 1994). Tikanga are put in place as a means to keep Māori safe, healthy, and connected to the environment. Tikanga such as kaitiakitanga are a form of prevention and guardianship over the taiao (nature), tāngata (people), mātauranga (knowledge), and all other elements of te ao Māori.
The word prevention can also feel a bit limiting. Prevention puts the focus and energy into preventing something we don’t want to happen rather than putting all that focus and energy into advancing something we do want to happen. It is not often used alongside actions that enhance, transform or regenerate wellbeing.
The Healthy Families NZ kaupapa is a strengths based and innovative approach to disease prevention. We work to understand the lived experiences of people in our localities in order to create the social and physical environments that enable them to thrive. This means we more often talk about what we’re doing to advance wellbeing rather than prevent chronic disease, making the line of sight less visible to those outside of the movement.
Building the movement for the Healthy Families NZ approach of prevention is critical to creating the impact our communities need to be healthy and well. We know that to change our social and physical environments takes action across sectors, organisations and communities. By building a prevention movement with leaders and organisations from across our society we can create collective impact.
So how might we make it easier for people to see the role they can play in preventing the rise of chronic disease and inspire them to join the movement?