Public awareness and understanding of DOHaD concepts in Aotearoa New Zealand.

Recent reports suggest that New Zealanders underestimate the burden of non-communicable diseases (NCDs) on society, perceiving NCDs as standalone problems to be managed by affected individuals. This belief conflicts with the Developmental Origins of Health and Disease (DOHaD) hypothesis that NCD risk is rooted in early-life environmental exposures. For the research community to contribute towards shifting societal beliefs, we need to know more about NZers' understanding of how NCDs develop and have the potential to track this over time. To address this, we conducted a face-to-face survey of 702 Auckland adults in 2015-16, repeated in 2022-23 with 814 online and 96 face-to-face respondents. An increased recognition of links between mental health and obesity was the only change observed between the earlier and later cohorts. Overall, of the 59% familiar with the term 'non-communicable disease', 73% accurately described NCD characteristics and gave examples. Online, tertiary-educated and non-male respondents were more likely to identify various social determinants of health in addition to individual behaviours as contributors to metabolic disease risk. More than twice as many subjects strongly agreed that preconception health of mothers could affect the health of the child than that of fathers. Maternal nutrition was recognised by most as important for fetal health, but 49% disagreed or did not know if it could affect adult health. These results indicate that regardless of subject sampling or data collection method, adult New Zealanders have little appreciation of the significance of the early-life environment in relation to NCD risk across the lifespan.