title: Tackling 'wicked' health promotion problems: a New Zealand case study.
abstract: This paper reports on a complex environmental approach to addressing 'wicked' health promotion problems devised to inform policy for enhancing food security and physical activity among Māori, Pacific and low-income people in New Zealand. This multi-phase research utilized literature reviews, focus groups, stakeholder workshops and key informant interviews. Participants included members of affected communities, policy-makers and academics. Results suggest that food security and physical activity 'emerge' from complex systems. Key areas for intervention include availability of money within households; the cost of food; improvements in urban design and culturally specific physical activity programmes. Seventeen prioritized intervention areas were explored in-depth and recommendations for action identified. These include healthy food subsidies, increasing the statutory minimum wage rate and enhancing open space and connectivity in communities. This approach has moved away from seeking individual solutions to complex social problems. In doing so, it has enabled the mapping of the relevant systems and the identification of a range of interventions while taking account of the views of affected communities and the concerns of policy-makers. The complex environmental approach used in this research provides a method to identify how to intervene in complex systems that may be relevant to other 'wicked' health promotion problems.
authors.affiliation: Health Promotion and Policy Research Unit, PO Box 7343, Wellington South, Wellington 6121, New Zealand. louise.signal@otago.ac.nz
authors.forename: Louise N
authors.initials: LN
authors.lastname: Signal
authors.forename: Mat D
authors.initials: MD
authors.lastname: Walton
authors.forename: Cliona
authors.initials: C
authors.lastname: Ni Mhurchu
authors.forename: Ralph
authors.initials: R
authors.lastname: Maddison
authors.forename: Sharron G
authors.initials: SG
authors.lastname: Bowers
authors.forename: Kristie N
authors.initials: KN
authors.lastname: Carter
authors.forename: Delvina
authors.initials: D
authors.lastname: Gorton
authors.forename: Craig
authors.initials: C
authors.lastname: Heta
authors.forename: Tolotea S
authors.initials: TS
authors.lastname: Lanumata
authors.forename: Christina W
authors.initials: CW
authors.lastname: McKerchar
authors.forename: Des
authors.initials: D
authors.lastname: O'Dea
authors.forename: Jamie
authors.initials: J
authors.lastname: Pearce
mesh_terms: D005523:Food Supply; D006291:Health Policy; D006292:Health Priorities; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009043:Motor Activity; D009520:New Zealand; D019982:Organizational Case Studies