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Regional Comparison

The Big Cities Project




Desired Outcomes

All people have the opportunity to enjoy long and healthy lives. Avoidable deaths, disease and injuries are prevented. All people have the ability to function, participate and live independently or appropriately supported in society.


Good health is critical to wellbeing. Without good health, people are less able to enjoy their lives to the fullest extent, their options are limited and their general levels of contentment and happiness are likely to be reduced.

Good health has two core dimensions: how long people live and the quality of their lives. The desired outcomes recognise both aspects. As well as enjoying long lives, people want to be free from the pain, suffering and incapacity that injury and illness bring.

The desired outcomes also acknowledge that not all people can live fully independent lives. For some, illness or disability means they need support from families, government agencies or other networks to overcome barriers to their participation in society. Getting this support is an important part of social wellbeing.

People with injuries or illness (both mental and physical) may experience barriers to their participation in education, training and employment, leading to reduced economic standards of living. These barriers can also reduce people’s ability to participate in other areas of life, such as family life, socialising with friends, joining community activities and taking part in recreation and leisure pursuits, which can lead to feelings of frustration and isolation.

A range of factors affect and are affected by health outcomes, including genetic predisposition, behaviour, the physical and social environment and the availability of health services. Increasing attention is being paid to the interaction between socio-economic and health outcomes. People with low incomes, poor housing and few qualifications are likely to have disproportionately poorer health.14


Five indicators are used in this chapter. Taken together, they provide an overall picture of the current state of the nation’s health and the likely trends in the future. They cover both the length and quality of life and include both physical and mental health. The indicators are: health expectancy, life expectancy, suicide, the prevalence of cigarette smoking and obesity.

The first three indicators are relevant to the current state of the nation’s health. Together, they directly measure the desired outcomes relating to long and healthy lives, and people’s ability to participate in society. The last two indicators are strong predictors of future health outcomes.

Health expectancy refers to the number of years a person can expect to live independently, ie free of any functional limitation requiring the assistance of another person or complex assistive device. This is a summary measure of population health integrating both fatal (life expectancy) and non-fatal (disability requiring assistance) health outcomes.

The next indicator, life expectancy, measures the survival experience of the population: how long people live. It is an indicator of fatal health outcomes.

The suicide rate serves as a proxy for the mental health status and social wellbeing of the population. Though the indicator covers the suicide rate for society as a whole, it includes details for subsets of the population. New Zealand 's suicide rates are trending down, but our youth suicide rates remain high compared with other OECD countries.

The last two indicators are strong predictors of future health outcomes. The links between cigarette smoking and poor health are widely recognised. For example, cigarette smoking (active and passive) is a risk factor for many cancers, and respiratory and cardiovascular diseases, and has been linked with low birth weight, Sudden Infant Death Syndrome, and other adverse child health outcomes. Obesity is linked with poor health outcomes, such as an increased risk of heart attacks, strokes, type 2 diabetes and some cancers.15