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Hauora's four walls

Monday 3rd March 2014

Phoebe Morris

When I first came across the concept of hauora I didn’t immediately understand it. I was a junior reporter covering the health round for The Nelson Mail and the local health board was funding a new initiative to cover all sorts of social support services.

My concept of health was doctors and nurses that were at the hospital as the ambulance at the bottom of the cliff, as health bureaucrats like to say, and doctors and nurses in general practices who were there at the top of the cliff. In-between were specific support services for covering areas such nutirition, exercise and mental health. Everything was separate. If you had a problem you went to a specific service to get the treatment and advice you needed.

As Ati Teepa explains, hauora, in the Te Whare Tapa Wha (four walls of a house) philosophy, takes a holistic view of health. The four walls are mental wellness, spiritual health, physical health and social/family wellness.

This month The Wireless has adopted hauora as its theme and we’ll be exploring a range of health issues - from depression to dieting to prescription drug abuse - in depth.

Every year the Ministry of Health updates its annual survey. The most recent report, published in December last year, says 90 per cent of adults rate their health as good, very good or excellent and 98 per cent of parents consider their children to be in good health.

Reading further, state of the nation’s health doesn’t look as rosy.

Thirty-one per cent of adults are now estimated to be obese, up from 29 per cent in 2011/12. Overall, 1.2 million Kiwis are estimated to be obese.

Smoking rates are dropping overall, but about a third of Maori adults smoke daily. Smoking rates are also higher in deprived areas, with 28 per cent of adults living in the nation’s most deprived areas smoking daily, compared with 9 per cent of adults living in the least deprived areas.

Smoking is just one indicator of the disparity between rich and poor. “Adults living in the most socioeconomically deprived areas have significantly higher levels of all health risks,” the report says. Maori and Pacific Islanders in particular are more likely to suffer from health problems such as diabetes, psychological distress, asthma and heart disease.

Te Whare Tapa Wha recognises is that various facets of health and wellbeing are linked. If one wall crumbles, it can dislodge the bricks of another.

There is no one quick fix for one problem either. Building a strong whare takes time. As the roof begans to lift on one side, it creates room to do a bit more work on the neighbouring walls.

As Sebastian Boyle can attest, fixing one problem doesn’t right everything else. In another of our opening stories for the month, he tells of losing half his weight, going from 140kg to 70kg, over nine months.

“I’d long had issues with depression and anxiety, and I quite reasonably assumed the continuation of these was tied largely to my weight. It was, but it was more complex than that. Changing one thing, even a big thing, may not magically fix everything for you.”

Opening up about health issues isn’t always easy. Sometimes there’s a sense of shame, failure or futility associated with them. But talking about them helps others know that they are not alone, and those that do speak should be given support.

Thank you to everyone who has shared their stories with us this month.

Marcus joined RNZ to set up The Wireless. Before that, he slugged away as the Night Editor for Stuff and booked punk shows.