People ask me, what do most people come into the Emergency Department for?

My usual response refers to what really breaks my heart (pun intended) – what’s really affecting us, particularly men, and shouldn’t be coming in at all – HEART DISEASE.

The consequences are often catastrophic, the heart attack may be large enough to lead to sudden death, and for those that make it to hospital, if the blood supply is not restored in a timely fashion, a scar replaces the once beating heart muscle and the heart is often irreversibly damaged.

The 40’s – A decade we saw one of the Great Wars of the last century nearly destroy and reshape humanity, claiming over 60 million human lives. The 40’s – A decade of life we’re currently seeing an eerily increasing number of men having heart attacks. Every 90 minutes a heart attack claims a kiwi bloke’s life. This is the war of our generation; a war against obesity, smoking, and general excess.

So, how are we fighting back?

There appears to be enough education, enough evidence that smoking is bad for our hearts – yet people continue to smoke. We all know being overweight and eating too much fried and salty foods are risk factors for having a heart attack, yet over 70% of men in NZ are overweight. What can we do when people know what they are doing is unhealthy, but continue to do it?

The Ministry of Health decide annually what health targets to set all of their ‘employees’ for the year – the DHBs, the Hospitals, the local doctors clinics – that they believe will make the most difference to the health of our nation. Big job. To set these targets, they look at ‘determinants of health’ – why are people overweight and still smoking cigarettes?

Of the 2015/2016 health targets, if we can achieve two of the seven targets it will immediately reduce the number of men (and women) we see come into the emergency department at the hospital with heart attacks. It will save hundreds of lives every year.

The first target is ‘Better help for smokers to quit’.

The MOH believe most smokers want to quit, but it’s never the right time, it’s a habit, and many smokers have become physically addicted to nicotine. What it means for Jo Citizen, is that every time we go to see a doctor or nurse, we will likely be asked if we smoke, how many a day, and if we want to quit. If so, we will be given information about what help is available that might work for us.

The second target is ‘More heart and diabetes checks’.

The goal is that 90% of the population at risk will have had a blood test to check their heart health in the past five years. If people know being overweight leads to diabetes and health attacks yet do nothing to change their habits, hopefully being ‘diagnosed’ with heart disease or pre-diabetes in early stages will be a wake up call that changes need to be made to eat better, exercise more and lose weight.

I know what you’re thinking, riveting party chat, is this guy available for functions? Yes, yes I am. I am also a trustee at the Men’s Health Trust NZ and do workplace health talks. I know there is a lot more work to be done to tip the balance in this war against poor health choices and apathy to change, but we’re getting there.

Health education at the grass roots I continue to believe is the key to making an impact. Taking the time to explain what causes heart attacks; what cholesterol is; how smoking hardens the arteries; how they can cause blockages. For the youth, it’s about inspiring them to want to live healthier, to hit them with health education from the time they start forming their daily habits in and away from the family home.


Dr Abhi Charukonda
Men’s Health Trust NZ
15 Oct 2015


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