Saturday, May 26, 2012
I recently received this media statement from the Kiwi Health Minister, promoting the green prescription program. This can be the most important prescription a doctor writes for their patient...
"Many keen for green prescribing
The benefit to patients from following doctors’ orders for regular exercise is highlighted in a publication launched today by Health Minister Tony Ryall.
“Last year GPs and practice nurses issued 32,028 people with a Green Prescription to become more physically active, an increase of 5,868 people since 2008. Over 80 per cent of GPs in the country have issued Green Prescriptions.
The internationally recognised Green Prescriptions are a health professional’s written advice to encourage and support patients to exercise regularly as part of a total health plan. The main activities prescribed are walking, swimming and gym exercises.
“The top three reasons people are given a Green Prescription are weight problems, high blood pressure and risk of stroke or diabetes.
“A survey this year shows 73 per cent of people noticed improvements in their health six to eight months after receiving their Green Prescription.
“The online publication tells 10 patient stories - each one showing how regular exercise has had significant benefits in the person’s life.
“It also includes a story from our own Olympic great Sir Peter Snell who describes regular physical exercise as the closest we can get to immortality – and after reading the patient stories it’s easy to understand his enthusiasm.
“Since receiving his Green Prescription, Northland man Andrew Riwhi-Moiha has lost 22 kilograms, reduced his blood pressure and no longer needs to take as much diabetes medication.
Health Minister Tony Ryall says the National Government’s Green Prescription initiative is getting more New Zealanders active and significantly improving their health.
The patient stories can be read or watched on the Ministry website.
Wednesday, May 2, 2012
Here in New Zealand, I often reflect on October 2010. You may recall that month; the fall colors were black and orange and the season was flush with fearful beards and late-inning “torture.” During those pennant-winning weeks, the cauldron of Giants baseball fever hovered between bubble and froth and our community had cohesion of purpose unlike I’d seen before.
So why is it that half-a-world away (where virtually no one knows the difference between a slider and a curveball) I’m consistently reminded of the 2010 World Champs? Well, it’s because the fervour of fall ’10 is replicated daily in New Zealand but for a much different sport: rugby.
New Zealand has been a rugby nation since shortly after its incorporation into the Crown territories in the early19th century. The British, you see, were intent on avoiding the opulent mentality that plagued prior empires, and so chose a formidable and stoic sport to promote throughout their colonies. I don’t know how successful this tactic was elsewhere, but in New Zealand the game – and its paradigm – took root.. According to Dr. Robin McConnell, in his profile Inside the All Blacks, rugby “shapes New Zealand social history and everyday life .” Case in point -- it’s been five months since the New Zealand national team won the Rugby World Cup on home turf, yet the All Blacks remain ubiquitous. Flags, some homemade, fly from car antennas and balconies, babies don All Black onesies, and bottles of the nation’s top selling beer (Steinlager) declare “All Blacks…25 Years of Unconditional Support.” Looking for front-page news? Any snippet about a present or former All Blacks player will do. Did you know that the legendary Michael Jones is helping to bring a Carl’s Jr. franchise to New Zealand?
The All Blacks are a national team and rugby a national sport in New Zealand – and we really have nothing comparable in the U.S., especially in terms of unity of loyalty. Given size and diversity differences between the two countries, this may not seem a fair comparison but it nonetheless raises the question of whether this shared passion for, and culture of, rugby pervades Kiwi life beyond the pitch? And in particular, does it help make Kiwis happier and healthier?
If you ask my wife, rugby is defined as a sport played by short men wearing too short shorts around gigantic thighs. But to others, it is defined by discipline, masculinity and stoicism. It is the type of sport in which a player (true story) might insist on playing most of a match with one testicle hanging torn from his scrotum. Stories like this are common and lead one to believe that the stoicism of Kiwis is unparalleled – an observation that finds some support in medical studies on pain tolerance. It could be that rugby plays a role in the Kiwi approach to death and dying [which is?]– one that, anecdotally at least, is more accepting than that of many other countries. Additionally, the national morale may be boosted by shared enthusiasm over rugby, which, in turn, can benefit the collective welfare. Indeed if you were to ask psychologist Jonathan Haidt, author of The Righteous Mind, Kiwi rugby culture might represent a classic case of sacredness of the group - “People who worship the same idol can trust one another, work as a team and prevail over less cohesive groups.”
But some argue that any such benefits are greatly overwhelmed by rugby’s culture of rowdiness, drunkenness and intolerance. In fact, just as there are Kiwis who live for rugby, there are those who detest it. One blogger, in a piece entitled “NZ Rugby Morally Bereft,” writes that rugby “promotes machocism, alcoholism, violence, sexism and colonialism. Rugby has also created a crippling crisis in our health sector.” There is certainly truth to the first statement – the only rugby match I’ve ever attended hosted a highly intoxicated crowd, and I won’t even attempt to describe the experience of visiting a stadium urinal. But while injuries are common, I can’t believe that they are a crippling crisis. Rugby may have a higher injury rate than many other sports, and concussions (especially under-reported concussions) are of particular concern, but the rates of devastating injuries such as spinal cord injury are actually not that high. A review of nationwide injury claims related to rugby from 1999-2007 reports an average of 743 a year, most of them limb and soft-tissue injuries, with a rather (given the nature of health expenses) modest yearly cost of $5.3 million.
One of the few academics that has closely studied and written about the cultural and societal effects of Kiwi rugby is Brendan Hokowhitu, an associate dean at University of Otago. He shares a rather bleak assessment of the health effects of the sport. “I wouldn't say there is anything historically at least positive about New Zealand rugby culture and health,” he wrote. “Rugby was very much part of the establishment and was as such quite oppressive of women and alterity [cultural freedom] in general.”
So the All Blacks culture does have a black side. But, to reiterate, the cohesiveness of the culture certainly has positive effects regarding national identity and group mentality. New Zealanders consistently score highly in international surveys of happiness and a nationwide social survey of 8,000 Kiwis found very high levels of people feeling like they “belong to New Zealand.” Another survey, of about 6,000, conducted by psychologist Marc Wilson of Victoria University of Wellington, found that Kiwi respondents with stronger identification to rugby reported being happier, more optimistic and having higher self-esteem. The beneficial effects of happiness on health are both obvious and well documented, and should not be underestimated. I wonder if the rugby in rugby culture could be replaced with a group activity with fewer downsides? Could a less dangerous and less rambunctious diversion replace rugby? Golf is popular here – so perhaps the All Greens might substitute. When it comes to group identity, however, such a change is much easier to talk about than to make. It’s a bit like asking a Giants fan to take up an L.A. Dodger habit.