Quantifying alcohol-attributable disability-adjusted life years to others than the drinker in Aotearoa/New Zealand: A modelling study based on administrative data.

BACKGROUND AND AIMS: Quantifying the health burden of alcohol has largely focused upon harm to drinkers, which is an underestimate. There is a growing literature on alcohol's harm to others (HTO), but it lacks the systematic transfer of HTO into a comparative risk assessment framework. This study calculated disability-adjusted life years (DALYs) for fetal alcohol spectrum disorder (FASD), interpersonal violence and traffic injury due to another's drinking. DESIGN: This study is a disease burden analysis, using modelling of DALYs for New Zealand in 2018. SETTING AND PARTICIPANTS: The study took place among the Aotearoa/New Zealand population in 2018. MEASUREMENTS: The involvement of others' drinking was obtained from prevalence, alcohol-attributable fraction studies and administrative data. Disability weights (DW) for FASD were adapted from fetal alcohol syndrome (FAS) weights using a Beta-Pert probability distribution; for interpersonal injury, DWs used hospital events linked with injury compensation; for traffic injury, DWs used hospital events. Populations were stratified by ethnicity, age group and gender. A descriptive comparison was made with a previous estimate of DALYs for drinkers. FINDINGS: In 2018, 78 277 healthy life years were lost in Aotearoa/New Zealand due to alcohol's HTO. The main contributor (90.3%) was FASD, then traffic crashes (6.3%) and interpersonal violence (3.4%). The indigenous population, Maori, was impacted at a higher rate (DALYs among Maori were 25 per 1000 population; among non-Maori 15 per 1000 population). The burden of HTO was greater than that to drinkers (DALYs HTO = 78 277; DALYs drinkers = 60 174). CONCLUSIONS: Disability from fetal alcohol spectrum disorder (FASD) appears to be a major contributor to alcohol's harm to others in Aotearoa/New Zealand. Taking FASD into account, the health burden of harm to others is larger than harm to the drinker in Aotearoa/New Zealand, and ethnicity differences show inequity in harm to others. Quantification of the burden of harm informs the value of implementing effective alcohol policies and should include the full range of harms.

Noho Taiao: reclaiming Maori science with young people.

Connections and belonging to ancestral lands are strongly and consistently argued as fundamental to Maori education, health and wellbeing. When our connections with and access to health-promoting places of belonging are damaged, we lose more than component parts of wellbeing. An entire cultural infrastructure integral to identity, community, spirituality, sustainability and even material sustenance is eroded, compromising health, wellbeing and vitality. Young people in rural areas are often seen as missing out on the amenities and attractions available in cities, but are assumed to have compensatory access to and positive relationships with 'nature'. For multiple reasons, many arising from colonial legacies, this is often not so for young Maori and there are initiatives underway that seek to reconnect them with customary environments. Place-based learning approaches that use local environments and ecosystems as living laboratories, reimagining the way students engage with knowledge, science and understandings of the natural world can be valuable in this respect. Te Rarawa Noho Taiao projects in the Far North of Aotearoa have been operating for nearly a decade, using indigenous pedagogy that promotes Maori science, science leadership, and learning, applying them in ways that produce a range of health and wellbeing benefits. These include enhanced educational engagement, strengthened capabilities, increased participation/belonging, stronger connections, constructive peer processes and positive intergenerational interactions, all based in Maori values and praxis. Such elements are widely recognised in health-promoting frameworks as highly implicated in the creation and maintenance of health and wellbeing for individuals, communities and populations. In this paper, we use interviews with organisers and teachers of these Noho Taiao and a survey of student participants, to explore the educational and health promotion effects.

Ko Tangonge Te Wai: Indigenous and Technical Data Come Together in Restoration Efforts.

In Aotearoa New Zealand, Maori aspirations around land and water conflict with settler interests. As indigenous people, Maori struggle to enact agency over resources, despite Treaty (Treaty of Waitangi/Te Tiriti o Waitangi is an 1840 agreement between Maori and the crown) settlement processes returning some lands. Returns are complex since changes wrought by dispossession may be extreme, requiring multiple stakeholder engagements. Tangonge, a heavily modified wetland, in northern Aotearoa New Zealand has been the subject of iwi (tribe or tribes) claims since the 1890s. Reparation processes have returned significant areas surrounding Tangonge to key iwi, Te Rarawa and Ngai Takoto, who formed the Tangonge Restoration Group to plan management and restoration. The vision of the iwi is to restore Tangonge as a wetland to rekindle usage by manawhenua (people with demonstrated authority and tribal links to the area in question) and local communities. However, perceived Maori privilege, distrust in Maori praxis and fear of alienation of stakeholders mean the situation presents challenges as well as opportunities. Understanding that various parties view knowledge in particular ways, the Restoration Group sought to juxtapose technical data and manawhenua knowledge about Tangonge. Hydrology findings and local aspirations were aligned to produce ideas for actions that encompassed the broad concerns. This integration of knowledge provides strategic steps for working with administrative authorities who have historical and ongoing interests.

Neighbourhoods for Active Kids: study protocol for a cross-sectional examination of neighbourhood features and children's physical activity, active travel, independent mobility and body size.

INTRODUCTION: New Zealand children's physical activity, including independent mobility and active travel, has declined markedly over recent decades. The Neighbourhoods for Active Kids (NfAK) study examines how neighbourhood built environments are associated with the independent mobility, active travel, physical activity and neighbourhood experiences of children aged 9-12 years in primary and intermediate schools across Auckland, New Zealand's largest city. METHODS AND ANALYSIS: Child-specific indices of walkability, destination accessibility and traffic exposure will be constructed to measure the built environment in 8 neighbourhoods in Auckland. Interactive online-mapping software will be used to measure children's independent mobility and transport mode to destinations and to derive measures of neighbourhood use and perceptions. Physical activity will be measured using 7-day accelerometry. Height, weight and waist circumference will be objectively measured. Parent telephone interviews will collect sociodemographic information and parent neighbourhood perceptions. Interviews with school representative will capture supports and barriers for healthy activity and nutrition behaviours at the school level. Multilevel modelling approaches will be used to understand how differing built environment variables are associated with activity, neighbourhood experiences and health outcomes. DISCUSSION: We anticipate that children who reside in neighbourhoods considered highly walkable will be more physically active, accumulate more independent mobility and active travel, and be more likely to have a healthy body size. This research is timely as cities throughout New Zealand develop and implement plans to improve the liveability of intensifying urban neighbourhoods. Results will be disseminated to participants, local government agencies and through conventional academic avenues.