LEADING FOR OUTCOMES: Health system change / Community primary care / Population health / CVD / Diabetes

Improving health and reducing inequalities

Better health, reduced disparities, increased trust and security, and increased participation and independence for people with disabilities are New Zealand's current high level health outcomes. These are addressed in detail in the Ministry of Health's Statement of Intent (SOI). Leading for Outcomes is a programme aimed at encouraging health sector activities that will actually lead us to these outcomes. These include the essential changes in care delivery at the cutting edge of chronic disease management as well as taking a whole of government approach to preventing or postponing the onset of disease.

Working relationships with other programmes and activities both in the health sector and in related sectors such as social welfare, housing, labour and education, will help achieve these high level outcomes. For example, the National Health Committee's document on the Social Cultural and Economic Determinants of Health points to the impact the non-health sector activities have on health outcomes. The Ministry of Health's Improving Quality programme contributes directly to increasing trust and security in the health system. Leading for Outcomes, in taking a whole system view, is able to 'knit' these valuable but often disconnected pieces of work into the larger fabric that will produce the outcomes we seek.

Disproportionately large numbers of Māori and Pacific Islands populations are affected by diabetes and CVD. Success, through carefully targeted activities in reducing the incidence and improving the management of these two long-term conditions can therefore be a marker for success in reducing inequalities of outcome.

In order to achieve such high level societal outcomes as 'better health' and 'reduced inequalities' we need a series of steps to get there. An outcomes hierarchy or series of levels of focus (if moving downward) or generality (if moving upward) provides a systematic way of addressing outcomes. For example, in order to reduce inequalities, it would help greatly to reduce the incidence of long-term conditions and to reduce the impact on the health and well-being of those who develop them. These goals, these lower level outcomes, are the focus of the system changes we seek through Leading for Outcomes.