Should prioritising health interventions be informed by modelling studies? The case of cancer control in Aotearoa New Zealand.

In this viewpoint, we suggest that policymakers should prioritise health interventions by using evidence around health gain, impact on equity, health-system costs and cost-effectiveness. We take the example of the new cancer control agency in New Zealand, Te Aho o Te Kahu, and argue that its decision-making can now be informed by many methodologically compatible epidemiological and health economic analyses. These analyses span primary prevention of cancer (eg, tobacco control, dietary and physical activity interventions and HPV vaccination), cancer screening, cancer treatment and palliative care. The largest health gain and cost-savings from the available modelling work for New Zealand are seen in nutrition and tobacco control interventions in particular. Many of these interventions have potentially greater per capita health gain for Maori than non-Maori and are also found to be cost saving for the health sector. In summary, appropriate prioritisation of interventions can potentially both maximise health benefits as well as making best use of government funding of the health system.

Healthy and Climate-Friendly Eating Patterns in the New Zealand Context.

BACKGROUND: The global food system is driving both the climate crisis and the growing burden of noncommunicable disease. International research has highlighted the climate and health co-benefit opportunity inherent in widespread uptake of plant-based diets. Nevertheless, uncertainty remains as to what constitutes healthy and climate-friendly eating patterns in specific world regions. OBJECTIVES: Using New Zealand as a case study, this research investigates the extent to which potential contextual differences may affect the local applicability of international trends. It further examines the potential for demand-end avenues to support a transition toward a healthier, more climate-friendly food system in New Zealand. METHODS: A New Zealand-specific life-cycle assessment (LCA) database was developed by modifying cradle to point-of-sale reference emissions estimates according to the New Zealand context. This food emissions database, together with a New Zealand-specific multistate life-table model, was then used to estimate climate, health, and health system cost impacts associated with shifting current consumption to align with dietary scenarios that conform to the New Zealand dietary guidelines (NZDGs). RESULTS: Whole plant foods, including vegetables, fruits, legumes, and whole grains were substantially less climate-polluting (1.2-1.8 kgCO2e/kg) than animal-based foods, particularly red and processed meats (12-21 kgCO2e/kg). Shifting population-level consumption to align with the NZDGs would confer diet-related emissions savings of 4-42%, depending on the degree of dietary change and food waste minimization pursued. NZDG-abiding dietary scenarios, when modeled out over the lifetime of the current New Zealand population, would also confer large health gains (1.0-1.5 million quality-adjusted life-years) and health care system cost savings (NZ$14-20 billion). DISCUSSION: Guideline-abiding dietary scenarios, particularly those that prioritize plant-based foods, have the potential to confer substantial climate and health gains. This research shows that major contextual differences specific to New Zealand's food system do not appear to cause notable deviation from global trends, reinforcing recent international research. https://doi.org/10.1289/EHP5996.