8 minute read
Keeping well over winter
Advertisement
Healthisattheforefrontofeveryone’s mindswithanoverhaulofthepublic health system,the Covid-19pandemicand,of course,themyriadofother winter illnesses that aremakingtheir rounds. ryone’s ublichealth and,of ter illnesses
Writes Ruby Harfield
On July1 ThePae Ora(HealthyFutures) Act tookeffect,establishingfournew entitities: • AnewPublicHealthAgency withintheMinistry toleadandstrengthenpublichealth. • Te WhatuOra - HealthNewZealandasthe nationalorganisationtoleadandcoordinate delivery of healthservicesacrossthecountry. • Te AkaWhaiOra - theMāoriHealthAuthority asanindependentstatutory authoritytodrive improvementinHauora Māori. • AnewMinistry forDisabledPeopletoprovidea widerlensondisabilityacrossGovernment and drivetransformationofthedisabilitysupport system.
Thecountry’s 20 District HealthBoardshave beendisestablished.
HealthMinister AndrewLittlesaidthehealth system hadbecomecomplex andfragmented.
“Twentydifferentdistrict healthboardsmeant thehealthcare yougot dependedonwhere you lived.
Theoverhaulwas initiated aftera Government commissionedHealthandDisabilitySystem Review in2018foundthere were 20 disconnected health systemsinNewZealandthat didn’tputpatients at theheartofhealthcare.
Covid-19hasalsobeenputtinga strainonthe healthsystem as wellasonindividuals.
Researchhasfoundthat mentalwellbeinghas becomea topten concernfor NewZealanders.
TheMentalHealthFoundationofNewZealand chiefexecutive ShaunRobinsonsaidaftertwo years of pandemicstress,thisisnosurprise.
“There’s beena dramaticincreaseinthenumber ofNewZealanderswithpoormentalwellbeing; from27percentstrugglinginFebruary 2021to36 percentinFebruary 2022.
Thecompoundingeffectsofthepandemic, economicpressuresandextendedperiodsof isolationishavinga profoundinfluence on mental health,hesaid.
Theincreaseinpoormentalwellbeingledthe MentalHealthFoundationandMinistry of Health todeveloptheAllSorts campaignandwebsite toassist peoplewiththeirmentalwellbeingin themidst of apandemic.
Thegoal of AllSorts is to providetoolsand tipstoreassure peoplethat whatevertheyare feelingisnormal,andgivethemstrategiesto buildtheirresilience.
“Ourresearchshowsthat thisisworking.
“Thegoodnewsis,weknow there arethingseveryonecan do toimprovetheirwellbeing,even duringthetoughest of times.
“In2021,ourresearchtesteda range of dailybehavioursthat are proven to supportresilience and wellbeing.
Theeffect was cumulative– themore thingsanindividual did,thehighertheir wellbeing.
These includestaying connected, movement, isationthatwe cannotreturn to es. ” npoormentalwellbeingledthe undationandMinistryofHealth lSortscampaignandwebsite withtheirmentalwellbeingin ndemic. Sortsistoprovidetoolsand eoplethatwhatevertheyare ,andgivethemstrategiesto nce. showsthatthisisworking. eoplehavefoundthat tobethereforothers connectionandbetter etyofsupportavailable urneed,Robinson wsis,weknow everyonecando wellbeing,even estoftimes. esearchtesteda havio oursthatare rtresilience eand ad justoneof sintheirdaily rcenthigher ng strong g.” s more ual eir nd Honorary Associate Professor at Auckland University and author Dr Giresh Kanji. Photo/Supplied
Mental Health Foundation of New Zealand chief executive Shaun Robinson. Photo/Supplied
breathing, havinga routine and takinga break.
Movementisgreatfor wellbeing; this does not needtobea HIIT workout– it could just be walking outside and down thestreetand back. It could be lying down and stretching or dancingtoa song.
Set small and manageabletasks for each day. Havea shower, eator drink something nourishing
There arealso many helpline services available right now in New Zealand that offer support and information.
Robinson saidtalkingtoa trusted person isstill the number one thing todo whenfeeling down (92 percent of people do this).
“Connecting withothers, with nature, your culture oryour community helps when you’re feeling low.
“Do just one thingeach dayto foster thisconnection– text one friend orfamily member, say hello or kia ora to one person when you are outwalking.”
Covid has impacted many aspects of life including the loss loved ones, getting sick, ongoing health issues, isolating,a lack of social interactions and the financial burden on businesses.
Honorary AssociateProfessor atAuckland University and author Dr Giresh Kanji said Covid has also affected mental wellbeing by creating a fear of connecting with others.
“We now think twice about events or socialgatherings, the very things that help our mental health and improveourhappiness.
“As we workincreasingly from home, social isolation increases.”
Many people are experiencing financial burdens as their businesses havefailed,othersfacedifficulty findingstaff, he said.
“The burden on hard working hospitality andtourism workers has reached new levels over thepastfew years.”
People have lost lovedonesdue tocovid whileothers havepostcovid symptoms plaguing their health, Dr Kanji said.
“We have alsostopped our holiday habits.
“It is importanttoensure some time awaytorefresh, whethertosee family/friends or see the beautiful scenery available in NewZealand.
“Covid is like having the rug pulled under your feet,toleave you standing ina puddle ofcoldwater.”
All of this hasa huge impact on mental wellbeing andstress, he said.
Totop it offpeople may befeeling worse in winter because heatreduces the activity of thestress system.
“We arehappier over summer.
“To battle the winter blues more attention needstobe placed on our daily health habits.
“Over thewarmer months weare far more likelytobe out and about, goingfor walks,cycling,relaxing with friends and spending timeatthe beach.”
Habits for life areimportant in maintaining one’smental health, Dr Kanji said.
There arefive things that can reduce the activity of thestress nervous system andbalance a person’smental health.
These are heat(sauna/spa/ bath),exercise,Yoga, Tai Chi and meditation/breathing.
Four timesa week isa good dose.
Heatandexercise for20to 30 minutes andYoga/Tai Chi/ meditation/breathingfor 40 minutes.
“We canrecreatetheheatof summer bygoing into a hotbath, sauna or spa for 20 minutes three or four timesa week.
“If this is out ofreach,I have advisedpatients to jump into an electric blanketheated bed and deep breathe, five seconds in and five seconds outfor 20 to 40 minutes a day.
“The deep breathing and the heat can both combinetoimprove your mental health.”
For exercise, joininga gym over wintercan help as it doesn’t matter if the weatherisbad.
Sleep isa goodbarometer of mental health.
“If you are waking in the middle of the night with difficultygetting backtosleep, this is signaling your balance is tipping.A reminder something hastochange.
“In the busy city with work, commuting and children, time is a significantbarriertomaintaining good health.
“If time is short, getanexercise machineathome,takeregular hot baths, orgoonto YouTubetofind a Pilates/Yoga/Tai Chi video you can follow.”
Itis also importantto balance hard work with enjoyment in life, he said.
“At some point in our lives hard work is important inreaching our goals, howeverI believe moderation andbalance arefar more important.
“I am alwaystellingpatients to play the longgame with moderation andbalance to keepgood health and balance the wealth/health equation.
“As one of mycolleaguesatthe university says we need work/love/ playbalance in our livestoenjoy the journey.”
Havinga healthy body not only helps mental wellbeing but also immunity which isparticularly important during winter.
University of Otago Professor of Microbiology and Immunology RoslynKemp said in winter people are exposedtomore pathogens because they are inside more.
“We areclosetogether inside (often with windows closed) and some of thepathogens also prefer cold weather.”
There aren’t easy tipstoboost immunity buta good immune system ispart ofa healthy body, she said.
“So the normal health advice (don’t smoke, don’t drinktoo much alcohol,eat lots of fruit and veggies, do someexercise, don’t be overweight, getenoughsleep) means that youare overallgoingto be healthy and havea better immune responsetoinfection than if you don’t havea healthy body.
“I don’t think there is a magic pill orfood that,on its own, boosts immunity.”
There is data showing changes in cell types or functions inresponse tovarious nutrients, often in the lab, and also heavily promoted by companies, but none of this is better than the healthadvice above, she said.
Immunity is not just aboutgetting sick yourself, but also about not acting asa host for infections that youcan then spread to other people, DrKemp said.
“If you aren’tgetting infected and if your bodycan fight offpathogens, then that stops thosepathogens spreadingtoothers. So it’s goodfor your own health, butgoodfor the communitytoo.”
The immune system is very complex andinvolves loads of different types ofcells and molecules that cancontrol how werespondto infection as wellashow westay well in between infections.
“In most cases, the immune system is very goodatregulating itself and boosting itself when needed.”
Roslyn Kemp’stop tipsfor boosting immunity andreducing the riskof spreading illness: • The first and best thingtodo is to get vaccinated against winter pathogens, especially flu. That does actually boost your immune system –increasing the number and improving the function of immunecells designedtofight the flu. • The second istorestif you are sick – this meansstaying home from workwherepossible, until you are well. The immune system needs energytowork, so resting allows it todo that.Notethat working from home while sick is not resting. • Staying home and away from others also prevents others from beingexposed. Many people don’t have the abilitytostay away from workfor long periods, and so employerscan do what they can toencourage sick peopletostay home– it pays offin the long run – onesick employee taking5 days offis more efficient than 20 sick employeestaking2 days offeach. • Wearing masks has becomepart of our normal culture now, and it’s a good idea for defending against infection from lotsofpathogens.
It won’t seem so oddtous nowto weara masktothe supermarketor school if we havea cold and it will stop the spread.
He Ara Oranga,the report of the Government Inquiry into Mental Health and Addiction’,recognised that the Mental Health (Compulsory Assessment andTreatment) Act 1992 (the Mental Health Act) has not keptpacewith the shifttowards a recovery andwellbeing approach tocare, and has never been comprehensivelyreviewed. The report made thefollowing recommendation: “Repeal andreplace the Mental Health (Compulsory Assessment and Treatment) Act 1992 so that it reflects a human rights-based approach, promotes supporteddecisionmaking, aligns with therecovery and wellbeing model of mental health, and provides measurestominimise compulsory or coercive treatment.” The Mental HealthFoundation says itstrongly supports this recommendation. They madea submission during publicconsultation which closed in January. The Ministry of Health websitesays all the submissions have been shared with anexternal, independent company. “They willconsolidateand analyse all the responses wereceive to guide usas we develop new mental health legislation.” The Minister of Health is dueto reportbacktoCabinet with policy proposalsfor new legislation by the end of 2022. Once the Government hasagreedto the policy for new legislation,a Bill will be created and willgothrough theParliamentary processes.
