Canterbury HiAP Newsletter - Special environment edition
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HiAP and the environment

Dear <<First Name>>
As we were considering the content of this Canterbury Health in All Policies (HiAP) newsletter, an obvious theme emerged. 

Among the determinants of health, the big picture environment sometimes seem quite remote.  But increasingly environmental issues are coming to the forefront and compelling action.  The positive outcome of the United Nations climate conference in Paris sets a platform for change, in which a Health in All Policies approach can come into its own.
Bringing the global down to the local level, this newsletter introduces the sustainability work being done at the Canterbury DHB, and the innovative approach to refreshing an urban development strategy. To ensure your perspective on environmental issues and health outcomes is embedded in the Greater Canterbury Urban Design Strategy get involved in the discussion by booking a tour of the Canterbury Health System Design Lab before Christmas.  In the new year, there will be further opportunities to provide your input, including workshops in February and March - more information on these is provided below. 
Let's make 2016 the year we all consider how we can make a difference to health by improving the health of our environment! 
Please get in touch if you have any questions or comments.
Kind regards,
Evon Currie
Community and Public Health

It's complicated

The complexity of climate change is illustrated in the Environmental Protection Agency and Centres for Disease Control and Prevention graphics below...  
United States Environmental Protection Agency
CDC Climate and Health Program

COP - What’s it all about?

The international political response to climate change began at the Rio Earth Summit in 1992, where the ‘Rio Convention’ included the adoption of the UN Framework on Climate Change (UNFCCC). This convention set out a framework for action aimed at stabilising atmospheric concentrations of greenhouse gases (GHGs) to avoid “dangerous anthropogenic interference with the climate system.” The UNFCCC which entered into force on 21 March 1994, now has a near-universal membership of 195 parties.

The main objective of the annual Conference of Parties (COP) is to review the Convention’s implementation.  The first COP took place in Berlin in 1995 and significant meetings since then have included COP3 where the Kyoto Protocol was adopted, COP11 where the Montreal Action Plan was produced, COP15 in Copenhagen where an agreement to success Kyoto Protocol was unfortunately not realised and COP17 in Durban where the Green Climate Fund was created.

In 2015 COP21, also known as the 2015 Paris Climate Conference, aimed, for the first time in over 20 years of UN negotiations, to achieve a legally binding and universal agreement on climate, with the aim of keeping global warming below 2.0°C.  In an major achievement, the negotiations achieved a commitment to a higher goal of 1.5°C.

The conference was attended by close to 50,000 participants including 25,000 official delegates from government, intergovernmental organisations, UN agencies, NGOs and civil society.

To visit the official COP21 website for more information, click here.
An oldie but a goodie- created at the Copenhagen COP

NZ at COP21

Dr Alex Macmillan, co-convenor of OraTaiao, the New Zealand Climate and Health Council, attended the climate and health summit. You can see Alex’s blog here.

Dr Macmillan attended with Hon. Jone Usamate and Hon. Satini Tulaga Manuealla, Ministers of Health of Fiji and Tuvalu. Alex says the Ministers of Health of Fiji and Tuvalu spoke strongly about the climate changes issues facing both of their countries.

"They pulled no punches as they described the impacts that sea level rise and more frequent storms are already having on their over-stretched health systems and infrastructure."

The people marched...

At more than 35 events in New Zealand and over 2000 sites worldwide.

Health Professionals gathered at Victoria Park in Christchurch along with approximately 8000 others to call for action at COP21. 

Check out TV One's coverage of the peoples climate march here.

HiAP and climate change

The Public Health Institute’s Center for Climate Change, based in California, recently published a wide-ranging report on health, equity and climate change.  

Their framework tells a persuasive story about health and climate change. Click on it to view a larger version (it's on page 4). 

According to the Public Health Institute’s Center for Climate Change report...

"Climate change and health inequities are the greatest global health threats of the 21st century.  In this report, we explore the many ways in which climate change, health, and equity are connected.  With input from more than a hundred public health professionals and community health, equity, and environmental justice advocates and support from The Kresge Foundation, we developed a conceptual framework to help us see how these issues are linked, and to identify opportunities and recommendations for action.
Interventions that impact those upstream root causes thus have the most potential to simultaneously promote health, equity, and sustainability.  These upstream interventions must be an important focus for the work of government and governance, because they are likely to have the greatest and broadest impact for healthy people, healthy places, and a healthy planet.  These strategies should be incorporated at all stages of strategy and project planning, development, implementation, and evaluation to increase the effectiveness across the spectrum of both health and climate interventions.
The report examines the framework below, considering the component parts and how the model works as a whole.  Highly recommended. 

What can we do in ‘Our Place’?

Most of us are all familiar with the usual strategy development process – review the previous document; scope the environment; identify areas for change; draft goals, objective, actions; gain approval by a governance/advisory group to consult; consult; analyse submissions; revise; gain final approval; publish; implement.  It’s a lot of work and some are a bit cynical about the process.
In Canterbury, with all the changes brought about by the 2010/2011 earthquakes, there is a great need for cross-sector collaboration in preparing high quality strategies.  The previous Greater Christchurch Urban Development Strategy was completed in 2006, and requires a refresh.  Many would like to see a greater focus on community health and wellbeing.  The impact of development on the environment is significant and the impact of the environment on health and wellbeing is just as significant.
A key part of the refresh process is the engagement strategy that will involve 300+ people attending workshops in early 2016.  The partner organisations (you can see their logos in the above image) have developed a process that seeks to involve a wide range of communities to co-create a vision for Greater Christchurch.  The partner organisations collectively have a significant influence on the determinants of health, and by working together will maximise their impact.
For the participants, the process starts with a one hour tour at CDHB’s Design Lab, explaining how a participatory design approach can help build the future.  The Design Lab is widely regarded for its role in transforming the Canterbury health system.  Its site and processes have also been used by other organisations to design new ways of working, develop new ideas, etc.

The aim

The promotional material explains the aim is:

A shared collective vision and framework reflecting our common values, principles and direction for how Greater Christchurch will look, feel and function in our future.  A vision that will reflect a connected system of people, communities, services and initiatives which encompass our social, cultural, environmental and economic development and wellbeing. A vision that is our unique collective blueprint for the future – our very own DNA!

We believe Greater Christchurch will be the best region to live, work and play for us and our children after us.

The options and solutions for that to happen reside within our communities and ourselves. But we need to start the conversation.  We want to ensure that there’s enough diversity built into this process from the outset to truly reflect our wider Greater Christchurch community and our aspirations on as wide and deep a level as possible

The December tours are designed to elicit the invitation list for the subsequent workshops – a diverse group of people who are excited about designing a great future for Canterbury.  The February and March workshops will distill ideas to prepare a visual, interactive ‘showcase’ that will be open to the entire community for several months.  There will also be a more formal consultation process for the public to have the opportunity to comment on the draft strategy.

A strategy that delivers wellbeing

The end product of this refresh is an urban development strategy that will deliver against wellbeing outcomes.

Let’s all get involved to make sure the community gets the outcome it deserves. There's still time to go online and book a tour of the design lab before Christmas - this way you can ensure your voice is part of creating the vision for ‘our place’.  After the tours are completed, you can find out about additional ways to provide your input from the Design Lab website.

Infusing sustainability into a large organisation



The Canterbury District Health Board is a high energy user, with over 9000 employees, delivering a full range of health services to its population of 530,000. 

In 2014, the CDHB appointed its first Environmental Sustainability Officer, James Young, to provide a focal point for sustainability initiatives. The CDHB has also signed up to the Certified Emissions Measurement and Reduction Scheme (CEMARS).  This involves measuring their greenhouse gas emissions, putting in place plans to reduce them and having both of these steps independently certified.

Initiatives under way include piloting a ‘Clever Commuters’ programme to promote alternatives to travelling to work by car as sole occupant.  This includes active transport by walking or cycling, or taking the bus or carpooling. 
Clever Commuters are just part of the wider CDHB Zero Hero programme designed to help create a greener, more sustainable organisation, promote positive sustainable behaviours that improve our communities’ health, protect the environment, save us and the health system money, and help to provide a high standard of living for future generations.

CDHB teams can sign up to the Zero Hero programme, which has four stages and two optional projects:
  • The first stage is an assessment of where we are now.
  • The second and third stages are checklists of sustainable actions.
  • There are voluntary actions to support people make changes in their homes so we are warmer, healthier, and cheaper to heat.
  • Participants are encouraged to undertake a sustainability project.
  • The sixth stage is about hitting sustainability targets.
James has developed a range of materials including checklists, commitment cards, posters and graphics to support this work. 

Email James for more information or give him a call on 021 771 612
Nigel Millar - keen cyclist, CDHB chief medical officer, and Zero Hero.

HiAP core business for Ecan 

Environment Canterbury Chief Executive Bill Bayfield (left) and judge Dr Patrick Harris (right) from the University of Sydney present Christchurch City Council Housing Unit Manager Carolyn Gallagher with the Excellence Award 
One of the most talked about presentations at the May 2015 NZ HiAP Conference was by Bill Bayfield, CEO of Environment Canterbury. 

His full-length presentation notes are available here. Some highlights of the speech are provided below.
The regional council’s work is very much about human health and wellbeing - working to make sure that people throughout Canterbury have a strong and healthy environment and economy, and cultural and social opportunities.
Transport, water management, air quality, waste management, harbour safety…All our work needs to be aligned to people.
A health in all policies approach for us started with relationship building:
  • We are a signatory to the Healthy Christchurch partnership, with Rex Williams as our Commissioner.
  • We have a joint work programme in place approved by our commissioners and is the focus for a biannual governance meeting
  • And we have now undertaken a range of Health Impact Assessments
As this conference is about learning and reflecting upon what health in all policies means, I have looked into what it has meant for us as an organisation and how we see this as a successful initiative.
The theory of health in all policies made sense, but we needed some careful thought put into how our work programmes might recognise and incorporate public health more strongly and how our staff could start to explicitly factor public health outcomes into their work.  We also wanted to normalise the approach, so making this a real part of day to day business was one of our key outcome.
What helped us:
  • ready access to the knowledge within the DHB and health sector when developing our plans and policies
  • taking time to build relationships at each tier of our organisation
  • beginning on common ground – selecting three areas where we had common priorities
  • a joint work programme
  • joint project work on the new Air Plan, which included a Health Impact Assessment - ‘real progress through action’ - ‘little steps at the start’
  • the mutual benefit of learning from each other
A joined up approach to considering health is more than just a planning process, it’s about daily operations, thinking and behaviour.
We’ve been able to , as a result of this work programme, reduce the rework and some of the public tensions of the past and produce a more effective, efficient and productive approach to policy and regulation in Canterbury
Joint agency collaboration is not necessarily easy as we have different aims, resources, time-frames and objectives.

Sometimes trying to agree on these is frustrating.  But we have found that having high-level organisational support as well as a wide variety of practical projects that staff are implementing is a good way to keep on making progress.
The Canterbury Health in All Policies partnership agreement has a number of aims, and I believe we’re really starting to meet some of these now.  We are incorporating health evidence into our policies and plans, we are taking a more participatory and cross-sectoral approach, and we are enabling improvements to policy proposals in ways that might lower their controversy.
We have put health on the map for the regional council, we have improved understanding of the determinants of health for our staff, and more importantly, we’re starting to see our staff explicitly factor these determinants of health into their everyday work.
So to summarise, the regional council:
  • Knows what HiAP stands for
  • We are working to ensure we consider health in all our policies and our work
  • Has committed (at the highest level of our Commissioners) to continue this work and to make sure we have staff who keep an eye on progress, promote health in all policies work within our organisation, and make sure we are meeting our joint goals.
It seems that here in Canterbury we’ve got HiAP rolling and now we’re actively delivering on it.  The next few years will be exciting as we continue this work which really is an obvious part of what a regional council does.

Nice one Tony!! 

A special shout out to our colleague Tony Moore, Principal Advisor, Sustainability at the Christchurch City Council, for being awarded the New Zealander of the Year - Local Hero Award.

Tony was anonymously nominated by the community for efforts to rebuild our city in a more sustainable way, including his involvement in Build Back Smarter, the Canterbury Sustainable Homes Working Party, Housing Matters, Breathe New Urban Village competition, Food Resilience Network, helping to set up and support Gap Filler, Greening the Rubble and Life in Vacant Spaces, and work the NZ Green Building Council, and other projects and policies (city recovery plans, climate change, energy, the list goes on and on!). 

Tony is pictured with Kiwibank CE Paul Brock (far left) and Christchurch Mayor Lianne Dalziel

Extra for experts...

TED Talks


  • OraTaiao: The New Zealand Climate and Health Council comprises health professionals in Aotearoa/New Zealand concerned with:
    • The negative impacts of climate change on health.
    • The health gains that are possible through strong, health-centred climate action.
    • Highlighting the impacts of climate change on those who already experience disadvantage or ill-health (equity impacts).
    • Reducing the health sector's contribution to climate change.

Articles and reports

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