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Changing Lives

Sir Graeme Avery has the bit in his teeth. Again.

Tom Belford29 March 2017

Just as when he set out decades ago to build a world-class medical publishing business.

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Just as when he launched Sileni Estate in 1998, sending winemaker Grant Edmonds a cheque book with the instructions: “I want to see the first vineyard purchased and planted as soon as you can possibly do it.” Not quite 20 years later, Sileni sells wine to over 80 countries, with Graeme as the roving ambassador.

Just as when he initiated the Hastings Farmers’ Market and the “Wine Country” branding for Hawke’s Bay.

Just as when he launched a world-class athletic, fi tness and sport science centre in Auckland, the AUT Millenium.

And now, as he sets out to change lives in Hawke’s Bay by capitalising on the experience and success of AUT Millenium to bring new energy, capacity and collaboration to tackling our region’s fitness, nutrition and sport development challenges.

His new project: The Hawke’s Bay Community Health and Sports Centre.

Avery’s vision is to combine the magnet of a fi rst-rate community fi tness facility (the $15 million ‘bricks and mortar’ centre, to be located at the Hawke’s Bay Sports Park) with a concerted, grassroots-based programme delivering evidence-based nutrition and fitness education and services to the community … with a special focus on children. So what’s new or unique about this?

The problem

NZ has an obesity epidemic.

In a country with the third-highest obesity rate in the OECD, Hawke’s Bay is one of the worst regions – 33% of HB adults are obese, with Maori at 48% and Pasifi ka people at 64%. Made worse by the fact that 55% of adults in HB do not engage in recommended minimum physical activity levels.

Obese people have many times greater risk of developing diabetes, whose complications a ect their eyes, heart, nerves, feet and kidneys, with a greater chance of premature death. The cumulative health e ects cause lower work productivity and generate enormous costs on the health system … costs that will become unbearable in Hawke’s Bay as elsewhere.

The stakes are huge. The direct and indirect costs of obesity in New Zealand are estimated to be between $1,200 and $3,600 per obese person per year. In Hawke’s Bay alone, the regional cost of obesity is estimated to be between $60 million and $180 million per year … at the lower end, more than $1 billion over the course of a generation.

An investment to address obesity today has the potential to improve thousands of lives directly, greatly reduce health costs for society, and create a generational step- change in the region’s wellbeing.

Seems like a no-brainer. So what’s the investment strategy?

Invest in children

Of course, increased physical activity and healthier eating can improve lives at any age.

However, the evidence shows that people develop a propensity towards obesity from their earliest years (even the nutrition of pregnant mothers has a bearing), particularly in lower socio-economic families and communities.

The bottom line: there’s far greater ‘bang for the buck’ in attempting to improve the nutrition and physical activity habits of children (up to ages 8-10) than trying to persuade any obese readers of this article to change their ways (sorry, to those readers).

Topping off the direct health benefi t, more physical activity and better nutrition have been shown to improve learning ability and educational attainment in children.

So the goal – and challenge – is to change the activity and eating behaviour of children. And that’s what the Centre and its partners and programmes will chiefly set out to do. And the icing on the cake … a better pathway for progressing our most talented young athletes.

As important as these new ‘bricks and mortar’ facilities are in providing a ‘hub’ for community fi tness and sporting excellence, they represent the tip of the iceberg.

And although the focus is heavily on reaching young people, the Centre and its programmes will serve all age groups.

The Centre – bricks and mortar

Avery’s Centre has two incarnations.

First is a set of physical facilities, all located at the Sports Park – a health and fi tness gym, an indoor sports and recreation hall, climbing walls, an eight-lane indoor track, a strength and conditioning gym, an additional hockey pitch, a fi tness trail with workout stations, an athletic throws training area, a health science lab, and more. Even a 43-bed, self-catering lodge to accommodate school and sports groups using the other facilities. A Stage II envisions a 55-metre swimming pool, a freshwater pond for canoe polo, clay tennis courts and other facilities.

The purpose of these facilities is to cater to a wide range of fi tness needs and aspirations for community users of all ages.

Having said that, the Centre will also provide in-region coaching and facilities to advance the skills and development of our most talented local young athletes. Avery puts the “sports talent” as about 15% of the users and benefi ciaries of the facilities and associated programmes.

For the region’s aspiring young athletes, the Centre will provide the now-missing training facilities that can further develop their talent with proven coaching programmes, while also exposing them to career opportunities in the sport, fi tness and nutrition sectors.

The Stage I facilities will cost $15 million, with about $1 million in annual operating costs when fully in service. Avery says about $12 million of this amount is already committed or in sight. The Avery Foundation, Pak’nSave and Ngati Kahungunu have contributed. The Hastings District Council has committed $2 million from current funds, and is consulting with ratepayers this year to add another $2 million.

A return on investment (ROI) analysis has been completed for the capital project that indicates a social payback of $58.6 million over 25 years, a 4:1 return, with the initial investment recovered in four years. To realize that benefi t, it is assumed that 55,000 individuals would participate in Centre programmes per year, yielding a 10% lifetime reduction in their obesity (and assuming 50% return to unhealthy lifestyles). This analysis is publicly available.

As important as these new ‘bricks and mortar’ facilities are in providing a ‘hub’ for community fi tness and sporting excellence, they represent the tip of the iceberg.

The Centre – in the community

Avery and everyone involved in the current planning actually give more emphasis to the second aspect of the Centre – the hands-on nutrition and fi tness educational programmes that will be delivered both at the hub facilities but well beyond that through pre-schools, schools, sports clubs and community groups, and existing health promotion networks.

As Graeme puts it: “The primary thrust and the predominant programmes will be all about community health and wellness, through highly structured programmes on healthy eating, health cooking, healthy food shopping and active recreation for life.”

According to one presentation: “… the Centre’s true impact will be through professional sta working with preschools, schools and community networks to promote greater knowledge, change attitudes and create new behaviours to achieve healthy lifestyles.”

And: “Community health and fi tness programmes will be professionally developed and delivered based on best evidence from research, and supervised by certifi ed instructors/coaches.”

I interviewed two of the ‘advance troops’ already working to give substance to the Centre’s on-the-ground programme. Both work at the coal face, and are passionate about the broad benefi cial impact they see physical activity programmes have on the children and youth they work with.

Wendy Pirie has 20 years experience in exercise training and health science, and a master’s degree in child development. She currently runs TimberNook, which o ers nature-based child development programmes, and previously was early childhood development o cer at Sport Hawke’s Bay. She knows how to get kids moving!

Wendy’s been tapped to help research existing local and national programmes and educational tools that are working best to foster physical activity and sound nutrition for young children. She notes that roughly 90% of young children nationally are participating in an early learning facility of some sort. “We need to get the best available, evidence-based information into families using all channels, from books to social media.”

Photo: Sarah Cates

“We have some great organisations working alongside young children and their families, whanau in Hawke’s Bay across health, sport and social welfare. We’re identifying what’s in place and what we will need to provide … and we’ll pull together all the agencies doing this work into one united group … this hasn’t been done before.”

As Wendy sees it, the pathway – a broad “physical literacy” programme – extends from in-utero support to developing elite sport talent, with the ‘bricks and mortar’ Centre o ering every child in Hawke’s Bay access to facilities to achieve their fullest potential without needing to leave the region – “the opportunity to aspire”.

Wendy is in the ‘inventorying’ stage of her work, but plans are to have the Centre’s fi rst pilot programmes – both physical activity and nutrition-based – into place by year’s end, working with selected early childhood centres and primary schools.

“We’re identifying what’s in place and what we will need to provide … and we’ll pull together all the agencies doing this work into one united group … this hasn’t been done before.”

WENDY PIRIE, TIMBERNOOK

With Wendy Pirie focused on the early childhood end of the spectrum, Marcus Agnew is focused at the other end – identifying and nurturing the talent of our most promising youth athletes.

Marcus has been a senior tutor in EIT’s Recreation and Sport programme since 2008, and holds a masters in health science. In his role for the Centre, he is building relationships with secondary schools and sport groups who want to ‘up their game’ in terms of physical conditioning programmes and sport training.

Already, schools like Havelock High, CHB College, Taradale, Wairoa College and Lindisfarne are working with Marcus in areas like fundamental movement training, healthy lifestyle and nutrition education, strength and resistance, and athletic development. Hastings Girls, Hastings Boys and Woodford are slated to join in as well. Hawke’s Bay Netball and HB Rowing are involved, as are emerging talented athletes from hockey, BMX, athletics and triathlon.

Photo: Sarah Cates

Marcus sees the Centre as o ering schools throughout the region assistance in bringing best-practice into their own in-school physical activity and sports programmes and improving training regimes and coaching skills in sport groups. “I talk to sports coordinators in schools and they are just swamped with juggling daytoday tasks … they don’t have the specialist training or the time” to be on top of the latest developments in sport science or skill development.

The Centre will come into the schools to identify and work with high potential athletes, as well as provide tailored programmes for them using the Centre’s facilities. Schools will participate on a userpays basis.

In working with individual athletes, Marcus sees fi rsthand proof of benefi ts far beyond better sport skills and performance – attitudes change about work ethic, school achievement, sound nutrition … even career aspiration as youth are exposed to possible futures in health science, health promotion, coaching, fi tness and nutrition training. He emphasizes, “I see this work, it’s not conceptual to me.”

He points to his work with rugby athletes from Wairoa College, four-hour sessions held alternately in Wairoa and the HB Sports Park, where a ‘pop-up’ conditioning gym is already in place. “They love to learn about lifting weights and strength movements and that gives us the chance to talk about school work and proper eating.” The idea of busing kids in from Wairoa and CHB to use the Centre’s facilities is baked into the scheme, and is one of the reasons the Centre includes a 43-bed lodge with cooking facilities – proper training and proper eating go together.

Stakeholders on board

Without question, Graeme Avery is the catalyst for and leader of this endeavor. “Sport and health have been my life,” he says. Now he’s sounded the bugle, asking for help.

Says Sport HB chief executive Mark Aspden, “Graeme’s a remarkable combination of skills and experience spanning business, health, sport and philanthropy almost impossible to replicate in one person. Given his proven track record of getting it done in Auckland on a bigger scale, when he comes along and says I’ve done this and I’ll do it in HB, no one can say it can’t be done … Combine that with his passion for wanting to make a di erence, you have someone uniquely able to pull the pieces of the jigsaw puzzle together.”

While Marcus and Wendy represent the ‘grassroots’ side of the Centre team, the Hawke’s Bay DHB, EIT and Sport Hawke’s Bay represent the major local institutional partners, joined by Auckland’s AUT Millennium Institute of Sport and Health, which Avery also co-founded.

Their attitudes – enthusiastic in every case – and collaboration are crucial to the success of the Centre. Chief executives of EIT and Sport HB, Chris Collins and Mark Aspden, sit on the HB Community Fitness Trust that is overseeing the initiative, and the Trust has signed a MOU securing the participation of the DHB.

The DHB presently puts the most resource into health promotion, spending about $500,000 per year on programmes focused on healthy weight in children. These range from nutrition and physical activity advice provided to pregnant women, to nurse checks on kids four years old and under (B4SC), to encouraging water-only schools (i.e, no fi zzies). To deliver these programmes, DHB partners with groups like Sport HB, Plunket and Te Taiwhenua o Heretaunga.

But as DHB chief executive Kevin Snee notes, much of the underpinning for good health in the community involves the broader environment – such as proper housing, safe drinking water, education, income inequity – and the institutions responsible in those areas.

He says: “We’re dealing with complex problems that are di cult to crack, like obesity and poverty, and one of the best ways to help the community is to have the key organisations lined up and working to agreed programmes. Hawke’s Bay over a long time has been bedeviled by not being able to get those organisations working well together … Any opportunity that comes along that provides the focus for collective action should be viewed positively.”

EIT views itself as a “key regional stakeholder” in the initiative. “It will only work if the entire community gets behind it … we need each other,” says Mark Oldershaw, EIT’s deputy chief executive. He emphasizes the hands-on role EIT can play in the long-term research meant to inform community wellness interventions and document outcomes.

EIT can also contribute by training the talent required to meet the specialist needs envisioned by the Centre. Finding the professional talent is critical to Avery. EIT presently graduates about 100 students with certifi cates or degrees in the areas of health science, fi tness, sport and recreation, and nearly another 100 in nursing. It has expertise in high performance athletes. Oldershaw sees “fantastic opportunities” for EIT to work with secondary schools to open students’ eyes to health promotion career options … the Centre, from facilities to research, being a “magnet” for local and international students alike.

Sport Hawke’s Bay brings 60 sta and a $3-4 million budget to the region’s sport and fi tness sector, including some programmes complementary to the Centre’s goals. Mark Aspden is looking forward to the Hawke’s Bay-specifi c research envisioned by the Centre to inform more e ective and bettertailored local interventions. “We need to take each other’s learnings and go from there to develop a unifi ed programme.”

Snee, Oldershaw and Aspden each emphasize that the challenge of lifting health and fi tness outcomes and, in particular, curbing obesity in Hawke’s Bay is both long-term and beyond the capacity of any single organisation. They welcome Avery’s catalytic role, see huge opportunities for their organisations and the community in the proposition, and are eager to play formative roles in developing the detail of what the Centre will offer.

Says Graeme simply: “What we’re doing now is fragmented, not integrated, and it’s not working.”

Too elitist?

Is a Centre aiming – in part – to bring out the best in our top athletes too elitist?

Marcus Agnew responds, “We have no supporting dollars in the region to support our best athletes … Why should our best kids have to leave Hawke’s Bay in the fourth form if they want to excel? That’s a blight on our region.” Why wouldn’t we want to produce Olympic qualifi ers on our home ground?

“If we don’t get it right at school academically and with the whole child, these kids will cost the country an absolute fortune. We have multi-million dollar families at this school through health and social welfare costs.” MATT O’DOWDA PRINCIPAL KIMI ORA SCHOOL

But he notes that producing Olympic qualifi ers starts with the community programmes. “The wider the base, the higher the pyramid.”

Moreover, what might be ‘elitist’ is prizing only ‘academics’, to the neglect of healthy bodies and life skills.

Matt O’Dowda would echo that. He has no problem with a Centre that nurtures excellence. He’s principal at Kimi Ora, a Flaxmere decile 1 primary school with an 80% Pasifi ka and 20% Maori (plus 1 Pakeha) student population. Students making massive strides academically under his team.

“Health and wellbeing is massively important,” he says. His school places an extraordinary emphasis on physical activity and sound nutrition. Every child participates in a half-hour of ‘whole school fi tness’ to begin the day, breakfasts and $1 lunches are provided (only 6 kids out of 130 bring their own lunch), and the kids even learn to prepare healthy menus, shop for and prepare healthy meals.

As Matt sees it, as a teacher you’re here to make a di erence. “It’s not a 5-year-old’s fault if he comes to school without eating breakfast or with no lunch … you don’t have a very good mum, tough.” Meeting the most basic physical needs of his students is an absolute prerequisite for progressing them academically. “What kind of academic outcome are you going to get in the afternoon from a kid who just had a packet of biscuits for lunch … kids who are on sugar highs or have no energy at all?”

Moreover he notes, “Learning is about a helluva lot more than reading, writing and maths. For our kids, learning about life and how to look after yourself is way more important … there’s not much point to reading, writing and maths if you’re not alive at 25 because you’ve had a heart attack or you’ve got diabetes and you’re sick.”

“If we don’t get it right at school academically and with the whole child, these kids will cost the country an absolute fortune. We have multi-million dollar families at this school through health and social welfare costs.”

Matt looks to the future benefi ts. “We need to fi x this age group of kids … life skills for these kids is really important … what can you cook for a dollar a day per person that’s healthy? Within ten or fi fteen years, quite a few of the kids from here will be parents and if we can get some good sense into them now, then that kid is going to a ect the next generation. ”

What else needs to be done? Matt notes that most of his kids don’t get driven to Saturday sport or swimming and dancing classes; most of their families can’t provide participation opportunities that require a car or cost money, so it falls to the school to step in. At Kimi Ora, two young multi-lingual teacher aides are on sta to give the kids high quality PE and sport skills. “These kids love playing sports, they’re big and strong, they have great potential and we can provide the groundwork, but what’s the next step?” Matt asks.

He sees the Centre as “the next level, giving our top kids access to the best facilities and coaching … there’s more potential in these kids than there are from lots of the top decile schools”.

“If we don’t have a top facility, then our Flaxmere elite kids are going to miss out on the opportunity to get themselves out of a place like this … that’s a huge life chance our kids will miss out on … it could mean a massive future for those kids.”

What next?

The institutional stakeholders are rallying to Graeme Avery’s bugle call. All give him high marks for his collaborative style, and all are committed to digging in and using their expertise to co-develop programme and research details and implementation plans. Some of the most important planning involves research.

Committed to results, Avery is determined to measure and document the e ectiveness of the Centre at changing lives. The Centre plans two large-scale, longterm research projects, costing $5 million per annum in total and requiring separate funding. One is a longitudinal study to document lifelong benefi ts from healthy eating and activity in HB. The other is a pre-school to intermediate school study to benchmark the relevant behavioural habits of the region’s young students and measure programme impact. EIT, DHB and AUT will be the key players here.

Graeme himself will focus on capital fundraising over the coming months. With $12 million already in the pipeline, he’s pegged construction to start mid-2017, with ‘doors open’ in early 2019. In the meantime, pilot programmes will be trialed with clusters of schools in Flaxmere and Havelock North, as well as Wairoa and CHB.

At its most obvious level, the Centre is about healthy eating and fitness. Worthy enough.
But what really motivates Sir Graeme Avery is the need and opportunity to change lives. He describes a conversation Marcus Agnew had with a ten-year-old already participating in the Centre’s Wairoa programme. He asked the boy what he wanted to be. “President”, the boy replied. “President of what?” Marcus asked. “The Mongrel Mob” said the boy.

Avery and his mob are really out to change that life.

 

Tom Belford29 March 2017

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