What could we do, and what should we not do, to improve public health? This Blog has postings from public health experts on issues such as efficiency, equity, interventions, politics, cost effectiveness and much more.
Monday, July 14th, 2014 | Kate Sloane | No Comments
Associate Professor Nick Wilson, Megan Smith (UNSW Australia), Professor Tony Blakely
This blog looks at a study we just published on a cost-utility analysis around extending HPV vaccination to boys in NZ. In a nutshell, it is not currently cost-effective for boys. Here we put these results into a wider context of vaccination – which is often, but not always, a good use of limited health sector resources.
Thursday, July 3rd, 2014 | Kate Sloane | 2 Comments
Professor Cliona Ni Mhurchu
Editor note: This blog was prepared by Prof Cliona Ni Mhurchu whilst she was visiting her home-country, Ireland. Cliona sent an email to myself and other Kiwis during that time outlining the strong actions that the Irish Government is planning on obesity and food – a far cry from the state of play in New Zealand. Which has led to this blog, in which Cliona makes the head-to-head comparison on food and obesity policy (in)activity between Ireland and New Zealand. Tony Blakely.
In the last couple of years the Irish rugby team gave the All Blacks cause to sit up and take notice not just once but twice. The first occasion was during the 2nd test match in 2012 where the ABs narrowly won with a drop kick minutes before the end, and the second was late last year in Dublin when the ABs won by a margin of just 2 points. Optimistic Irish rugby fans are increasingly convinced that the day will come when Ireland will beat New Zealand at its own game.
Tuesday, July 1st, 2014 | Kate Sloane | 11 Comments
Professor Richard Edwards
Every now and then when discussing New Zealand’s Smokefree 2025 goal, plain packaging or some other policy measure, the question will come up – ‘well why don’t you just ban it?’ Indeed, Hone Harawira drafted a Private Members Bill proposing exactly that back in 2006.
Why not just ban the sale of tobacco?
This blog considers some arguments for and against a ban on the production (other than tobacco grown for personal use), importation and sale of tobacco products, whilst not criminalising the use of tobacco. The purpose of such a measure would be to ensure, hasten and sustain the achievement of the goal of close to zero smoking prevalence by 2025. The blog comes down on the side of intensifying other tobacco control approaches initially but also encouraging a public debate about setting a ‘national quit date’ in a few years time when the tobacco industry would be stopped from selling its lethal and addictive tobacco products.
Thursday, June 26th, 2014 | Kate Sloane | 5 Comments
Editor note: This is Part 2 of a two-part blog by Dr Caroline Shaw and Associate Professor Diana Sarfati on breast cancer screening. In Part 1 they looked at the contested research around breast cancer screening. In today’s Part 2 they explore the implications for New Zealand. As Editor’s, we agree with Shaw and Sarfati that screening beneath the age of 50 should stop and the quality and honesty of communication to women must improve. We would also go one step further and argue that the cost-effectiveness of breast cancer screening should be re-evaluated, for optimistic and pessimistic scenarios. A media release also accompanies this blog.
Dr Caroline Shaw and Associate Professor Diana Sarfati
What do we do with the conflicting information on breast cancer screening?
Assoc Prof Diana Sarfati and Dr Caroline Shaw
Sorting through the information about breast cancer screening is difficult. There are highly experienced and knowledgeable screening experts on both sides of the debate and both sides make some cogent arguments. There is disagreement about the validity of evidence from the individual randomised controlled trials (RCTs), about whether improvements in treatment have had an impact on screening effectiveness and about the level of over-diagnosis from screening. In some cases researchers are looking at the same screening studies and concluding very different things. In others, they disagree about the best methods and data to use to examine an issue. Polarisation of views is pretty typical in screening; however it does make it difficult to know where the truth lies as positions become entrenched.
Monday, June 23rd, 2014 | Kate Sloane | 1 Comment
Editor note: This week Dr Caroline Shaw and Associate Professor Diana Sarfati consider the pros and cons of breast cancer screening, in light of the growing controversy (mostly in the northern hemisphere) about the possibility that the benefits of breast cancer screening are (much) less than previously thought due to over-detection and other issues. In today’s Part 1 blog, Caroline and Diana outline the issues. In the Part 2 blog (appearing on Thursday), they aim for more specific recommendations.
Dr Caroline Shaw and Associate Professor Diana Sarfati
Population screening attracts controversy. For breast cancer screening there is an ongoing controversy being played out in the international literature related to the absolute fundamental rationale of screening; should we be screening for breast cancer at all? This is a big deal, given that most developed countries have invested hundreds of millions of dollars in the human and technical infrastructure for screening in the last few decades. BreastScreen Aoteroa, for example, costs over $50 million annually. Continue reading