IN THE SOUTH ISLAND

3

The Health Status of

Children and Young People

in the

South Island

This report was prepared for the South Island Alliance Programme by Elizabeth Craig, Judith Adams, Glenda Oben, Anne Reddington, Andrew

Wicken and Jean Simpson on behalf of the NZ Child and Youth Epidemiology Service, November 2011

This report was produced as the result of a contract between the Canterbury DHB (on behalf of the South Island Alliance Programme) and the University of Otago (on behalf of the NZ Child and Youth Epidemiology Service (NZCYES). The NZCYES is located in the Department of Women’s and Children’s Health at the University of Otago’s Dunedin School of Medicine. While every endeavour has been made to use accurate data in this report, there are currently variations in the way data are collected from DHBs and other agencies that may result in errors, omissions or inaccuracies in the information in this report. The NZCYES does not accept liability for any inaccuracies arising from the use of these data in the production of these reports, or for any losses arising as a consequence thereof.

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Cover Artwork: Pepe Para Riki - Common Copper Butterfly by John Gillespie

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TABLE OF CONTENTS

Table of Contents ............................................................................................................ 5

List of Figures .................................................................................................................. 7

List of Tables ................................................................................................................. 16

INTRODUCTION AND OVERVIEW.................................................................................. 27

Introduction and Overview ............................................................................................. 29

THE HEALTH STATUS OF CHILDREN AND YOUNG PEOPLE ...................................... 45

ISSUES MORE COMMON IN INFANCY .......................................................................... 47

Regional Births .............................................................................................................. 49

Fetal Deaths .................................................................................................................. 54

Preterm Birth ................................................................................................................. 73

Infant Mortality and Sudden Unexpected Death in Infancy ............................................. 83

Total Infant, Neonatal and Post Neonatal Mortality .................................................... 83

Sudden Unexpected Death in Infancy (SUDI) ............................................................ 92

Breastfeeding .............................................................................................................. 100

ISSUES MORE COMMON IN CHILDREN, OR CHILDREN AND YOUNG PEOPLE ...... 113

TOTAL AVOIDABLE MORBIDITY AND MORTALITY .................................................... 115

In-Depth Topic: Models of Primary Care for Children ................................................... 117

Most Frequent Causes of Hospital Admission and Mortality in Children ....................... 135

Ambulatory Sensitive Hospitalisations ......................................................................... 146

INFECTIOUS AND RESPIRATORY DISEASES ............................................................ 163

Introduction to Infectious and Respiratory Diseases Section ........................................ 165

UPPER RESPIRATORY TRACT CONDITIONS ............................................................. 173

Acute Upper Respiratory Infections and Tonsillectomy in Children .............................. 175

Acute Upper Respiratory Tract Infections ................................................................ 176

Tonsillectomy .......................................................................................................... 184

Middle Ear Conditions: Otitis Media and Grommets ..................................................... 197

LOWER RESPIRATORY TRACT CONDITIONS ............................................................ 215

Bronchiolitis ................................................................................................................. 217

Pneumonia .................................................................................................................. 227

Asthma ........................................................................................................................ 242

Bronchiectasis ............................................................................................................. 255

INFECTIOUS DISEASES ............................................................................................... 265

Pertussis ...................................................................................................................... 267

Meningococcal Disease ............................................................................................... 275

Tuberculosis ................................................................................................................ 284

Rheumatic Fever and Heart Disease ........................................................................... 292

Serious Skin Infections ................................................................................................ 302

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Gastroenteritis ............................................................................................................. 321

OTHER ISSUES ............................................................................................................. 335

Injuries in Children ....................................................................................................... 337

Oral Health: School Dental Service Data and Dental Caries Admissions ..................... 363

School Dental Service Data ..................................................................................... 363

Hospital Admissions for Dental Caries ..................................................................... 371

Permanent Hearing Loss ............................................................................................. 392

Deafness Notification Database .............................................................................. 392

Newborn Hearing Screening ................................................................................... 396

ISSUES MORE COMMON IN YOUNG PEOPLE ............................................................ 405

In Depth Topic: Models of Primary Health Care Delivery for Young People ................. 407

Most Frequent Causes of Hospital Admission and Mortality in Young People .............. 426

Injuries in Young People .............................................................................................. 438

Teenage Pregnancy .................................................................................................... 461

Terminations of Pregnancy .......................................................................................... 472

THE CHILDREN’S SOCIAL HEALTH MONITOR: INTRODUCTION .............................. 483

Introduction to the Children’s Social Health Monitor ..................................................... 485

THE CHILDREN’S SOCIAL HEALTH MONITOR: ECONOMIC INDICATORS ............... 487

Gross Domestic Product (GDP) ................................................................................... 489

Income Inequality ......................................................................................................... 491

Child Poverty and Living Standards ............................................................................. 494

Unemployment Rates .................................................................................................. 503

Children Reliant on Benefit Recipients ......................................................................... 510

THE CHILDREN’S SOCIAL HEALTH MONITOR: HEALTH AND WELLBEING INDICATORS ................................................................................................................. 517

Hospital Admissions and Mortality with a Social Gradient in Children .......................... 519

Injuries Arising from the Assault, Neglect or Maltreatment of Children ......................... 541

APPENDICES AND REFERENCES ............................................................................... 549

Appendix 1: Search Methods for Policy Documents and Evidence-Based Reviews ..... 551

Appendix 2: Statistical Significance Testing and its use in this Report ......................... 553

Appendix 3: the National Minimum Dataset ................................................................. 555

Appendix 4: The Birth Registration Dataset ................................................................. 559

Appendix 5: National Mortality Collection ..................................................................... 560

Appendix 6: Measurement of Ethnicity ......................................................................... 561

Appendix 7: NZ Deprivation Index................................................................................ 565

Appendix 8: Ambulatory Sensitive Hospital Admissions ............................................... 566

Appendix 9: Methods Used to Develop the Children’s Social Health Monitor ............... 569

References .................................................................................................................. 572

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LIST OF FIGURES

Figure 1. Intermediate and Late Fetal Deaths, New Zealand 2000–2008 ....................... 58

Figure 2. Fetal Deaths by Gestational Age and Main Fetal Cause of Death, New Zealand 2004–2008 ....................................................................................................... 58

Figure 3. Intermediate and Late Fetal Deaths and Unspecified Deaths by Ethnicity, New Zealand 2000–2008 ............................................................................................... 59

Figure 4. Intermediate and Late Fetal Deaths, South Island DHBs vs. New Zealand 2000−2008..................................................................................................................... 62

Figure 5. Preterm Birth Rates in Singleton Live Born Babies by Ethnicity, New Zealand 2000−2010 ....................................................................................................... 75

Figure 6. Preterm Birth Rates in Singleton Live Born Babies, South Island DHBs vs. New Zealand 2000−2010 ......................................................................................... 76

Figure 7. Preterm Birth Rates in Singleton Live Born Babies by Ethnicity, South Island DHBs vs. New Zealand 2000−2010 ..................................................................... 77

Figure 8. Total Infant, Neonatal and Post Neonatal Mortality, New Zealand 1990−2008..................................................................................................................... 84

Figure 9. Total Infant, Neonatal and Post Neonatal Mortality by Ethnicity, New Zealand 1996−2008 ....................................................................................................... 84

Figure 10. Total Infant Mortality, South Island DHBs vs. New Zealand 1990−2008 ........ 87

Figure 11. Neonatal and Post Neonatal Mortality, South Island DHBs vs. New Zealand 1990−2008 ....................................................................................................... 88

Figure 12. Sudden Unexpected Death in Infancy by Type, New Zealand 1996−2008..................................................................................................................... 92

Figure 13. Sudden Unexpected Death in Infancy by Type and Age in Weeks, New Zealand 2004−2008 ....................................................................................................... 93

Figure 14. Sudden Unexpected Death in Infancy by Ethnicity, New Zealand 1996−2008..................................................................................................................... 94

Figure 15. Sudden Unexpected Death in Infancy by Type and Month, New Zealand 2004−2008..................................................................................................................... 94

Figure 16. Sudden Unexpected Death in Infancy, South Island DHBs vs. New Zealand, 1996−2008 ...................................................................................................... 96

Figure 17. Proportion of Plunket Babies who were Exclusively or Fully Breastfed by Age, New Zealand, Years Ending June 2004−2011 ..................................................... 101

Figure 18. Proportion of Plunket Babies who were Exclusively or Fully Breastfed by Age and Ethnicity, New Zealand, Years Ending June 2004−2011 ................................ 101

Figure 19. Proportion of Plunket Babies who were Exclusively or Fully Breastfed by Age and NZ Deprivation Index Decile, New Zealand, Year Ending June 2011 ............. 102

Figure 20. Proportion of Plunket Babies who were Exclusively or Fully Breastfed by Age, South Island DHBs vs. New Zealand, Years Ending June 2004−2011 ................ 103

Figure 21. Proportion of Plunket Babies who were Exclusively or Fully Breastfed by Age and NZ Deprivation Index Decile, South Island DHBs, Year Ending June 2011 .... 104

Figure 22. Proportion of Plunket Babies who were Exclusively or Fully Breastfed at Less Than 6 Weeks by Ethnicity, South Island DHBs vs. New Zealand, Years Ending June 2004−2011 .............................................................................................. 105

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Figure 23. Proportion of Plunket Babies who were Exclusively or Fully Breastfed at 3 Months and 6 Months by Ethnicity, South Island DHBs vs. New Zealand, Years Ending June 2004−2011 .............................................................................................. 106

Figure 24. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years, New Zealand 2000–2010 ..................................................................................................... 149

Figure 25. Ambulatory Sensitive Hospitalisations in Children Aged 0–14 Years by Age, New Zealand 2006–2010 ..................................................................................... 149

Figure 26. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years by Ethnicity, New Zealand 2000–2010 .............................................................................. 151

Figure 27. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years, South Island DHBs vs. New Zealand 2000–2010 ......................................................... 158

Figure 28. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years by Ethnicity, South Island DHBs vs. New Zealand 2000–2010 ......................................... 159

Figure 29. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years by Month, the South Island DHBs 2006–2010 .................................................................. 160

Figure 30. Acute and Arranged Hospital Admissions for Acute URTIs in Children 0−14 Years by Age, New Zealand 2006−2010 ............................................................. 177

Figure 31.Acute and Arranged Hospital Admissions for Acute URTIs in Children Aged 0–14 Years by Ethnicity, New Zealand 2000–2010 ............................................. 178

Figure 32. Acute and Arranged Hospital Admissions for Acute URTI in Children Aged 0−14 Years, South Island DHBs vs. New Zealand 2000−2010 ........................... 181

Figure 33. Acute and Arranged Hospital Admissions for Acute URTI in Children Aged 0−14 Years by Ethnicity, South Island DHBs vs. New Zealand 2000−2010 ........ 182

Figure 34. Average Number of Acute and Arranged Hospital Admissions for Acute URTI in Children Aged 0−14 Years by Month, the South Island DHBs 2006−2010 ...... 183

Figure 35. Arranged/Waiting List Admissions for Tonsillectomy +/− Adenoidectomy in Children Aged 0−14 Years, New Zealand 2000−2010 .............................................. 185

Figure 36. Arranged/Waiting List Admissions for Tonsillectomy +/− Adenoidectomy in Children 0−14 Years by Age and Ethnicity, New Zealand 2006−2010 ...................... 185

Figure 37. Arranged/Waiting List Admissions for Tonsillectomy +/− Adenoidectomy in Children Aged 0−14 Years by Ethnicity, New Zealand 2000−2010 ........................... 186

Figure 38. Arranged/Waiting List Admissions for Tonsillectomy +/− Adenoidectomy in Children Aged 0−14 Years, South Island DHBs vs. New Zealand 2000−2010 ......... 189

Figure 39. Arranged/Waiting List Admissions for Tonsillectomy +/− Adenoidectomy in Children Aged 0−14 Years by Ethnicity, South Island DHBs vs. New Zealand 2000−2010................................................................................................................... 190

Figure 40. Average Number of Arranged/Waiting List Admissions for Tonsillectomy +/− Adenoidectomy in Children 0−14 Years by Month, South Island DHBs 2006−2010................................................................................................................... 191

Figure 41. Acute Hospital Admissions for Otitis Media and Arranged/Waiting List Admissions for Grommets in Children Aged 0–14 Years, New Zealand 2000–2010 .... 200

Figure 42. Acute Hospital Admissions for Otitis Media and Arranged/Waiting List Admissions for Grommets in Children Aged 0–14 Years by Age and Ethnicity, New Zealand 2006–2010 ..................................................................................................... 200

Figure 43. Acute Hospital Admissions for Otitis Media in Children Aged 0−14 Years by Ethnicity, New Zealand 2000−2010 ......................................................................... 201

Figure 44. Arranged/Waiting List Hospital Admissions for Grommets in Children Aged 0−14 Years by Ethnicity, New Zealand 2000−2010 ............................................ 202

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Figure 45. Acute Hospital Admissions for Otitis Media and Arranged/Waiting List Admissions for Grommets in Children Aged 0−14 Years, South Island DHBs vs. New Zealand 2000−2010 ............................................................................................. 206

Figure 46. Arranged/Waiting List Hospital Admissions for Grommets in Children Aged 0−14 Years by Ethnicity, South Island DHBs vs. New Zealand 2000−2010 ........ 207

Figure 47. Average Number of Acute Hospital Admissions for Otitis Media and Arranged/ Waiting List Admissions for Grommets in Children Aged 0−14 Years by Month, the South Island DHBs 2006−2010 .................................................................. 208

Figure 48. Acute and Semi-Acute Hospital Admissions (2000–2010) and Deaths (2000–2008) from Bronchiolitis in New Zealand Infants <1 Year .................................. 218

Figure 49. Acute and Semi-Acute Hospital Admissions (2006–2010) and Deaths (2004–2008) from Bronchiolitis in New Zealand Children by Age ................................. 219

Figure 50. Acute and Semi-Acute Hospital Admissions for Bronchiolitis in Infants <1 Year by Ethnicity, New Zealand 2000–2010 ........................................................... 219

Figure 51. Acute and Semi-Acute Hospital Admissions for Bronchiolitis in Infants <1 Year, South Island DHBs vs. New Zealand 2000−2010 .......................................... 221

Figure 52. Acute and Semi-Acute Hospital Admissions for Bronchiolitis in Infants <1 Year by Ethnicity, South Island DHBs vs. New Zealand 2000−2010 ....................... 222

Figure 53. Average Number of Acute and Semi-Acute Hospital Admissions for Bronchiolitis in Infants <1 Year by Month, the South Island DHBs 2006−2010 ............. 223

Figure 54. Acute and Semi-Acute Hospital Admissions (2000–2010) and Deaths (2000−2008) from Bacterial/Non-Viral/Unspecified Pneumonia in New Zealand Children and Young People Aged 0−24 Years ............................................................. 229

Figure 55. Acute and Semi-Acute Hospital Admissions (2000−2010) and Deaths (2000–2008) from Viral Pneumonia in New Zealand Children and Young People Aged 0–24 Years ......................................................................................................... 229

Figure 56. Acute and Semi-Acute Hospital Admissions (2006–2010) and Deaths (2004−2008) from Pneumonia in New Zealand Children and Young People by Age .... 230

Figure 57. Acute and Semi-Acute Hospital Admissions for Pneumonia in Children and Young People Aged 0–24 Years by Ethnicity, New Zealand 2000–2010 ............... 230

Figure 58. Acute and Semi-Acute Hospital Admissions for Bacterial/Non-Viral/Unspecified Pneumonia in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2000−2010 ........................................................ 234

Figure 59. Acute and Semi-Acute Hospital Admissions for Viral Pneumonia in Children Aged 0−14 Years, South Island DHBs vs. New Zealand 2000−2010 ............. 235

Figure 60. Acute and Semi-Acute Hospital Admissions for Bacterial/Non-Viral/Unspecified Pneumonia in Children and Young People Aged 0−24 Years by Ethnicity, South Island DHBs vs. New Zealand 2000−2010 ......................................... 236

Figure 61. Average Number of Acute and Semi-Acute Hospital Admissions for Pneumonia in Children and Young People Aged 0−24 Years by Month, the South Island DHBs 2006−2010 .............................................................................................. 237

Figure 62. Acute and Semi-Acute Hospital Admissions (2000−2010) and Deaths (2000−2008) from Asthma in New Zealand Children and Young People Aged 0−24 Years ........................................................................................................................... 243

Figure 63. Acute and Semi-Acute Hospital Admissions (2006−2010) and Deaths (2004−2008) from Asthma in New Zealand Children and Young People by Age .......... 244

Figure 64. Acute and Semi-Acute Hospital Admissions for Asthma in Children and Young People Aged 0−24 Years by Ethnicity, New Zealand 2000−2010 ..................... 244

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Figure 65. Acute and Semi-Acute Hospital Admissions for Asthma in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2000−2010 .... 247

Figure 66. Acute and Semi-Acute Hospital Admissions for Asthma in Children and Young People 0−24 Years by Ethnicity, South Island DHBs vs. New Zealand 2000−2010................................................................................................................... 248

Figure 67. Average Number of Acute and Semi-Acute Hospital Admissions for Asthma in Children and Young People 0−24 Years by Month, the South Island DHBs 2006−2010 ........................................................................................................ 249

Figure 68. Acute and Semi-Acute Hospital Admissions (2000−2010) and Deaths (2000−2008) for New Zealand Children and Young People Aged 0−24 Years with Bronchiectasis ............................................................................................................. 256

Figure 69. Acute and Semi-Acute Hospital Admissions (2006−2010) and Deaths (2004−2008) for New Zealand Children and Young People with Bronchiectasis by Age .............................................................................................................................. 257

Figure 70. Acute and Semi-Acute Hospital Admissions for Children and Young People Aged 0−24 Years with Bronchiectasis by Ethnicity, New Zealand 2000−2010................................................................................................................... 258

Figure 71. Average Number of Acute and Semi-Acute Hospital Admissions for Children and Young People Aged 0−24 Years with Bronchiectasis by Month, New Zealand 2006−2010 ..................................................................................................... 259

Figure 72. Acute and Semi-Acute Hospital Admissions for Children and Young People Aged 0−24 Years with Bronchiectasis, South Island DHBs vs. New Zealand 2000−2010................................................................................................................... 260

Figure 73. Acute and Semi-Acute Hospital Admissions (2000−2010) and Deaths (2000−2008) from Pertussis in New Zealand Infants <1 Year ...................................... 268

Figure 74. Acute and Semi-Acute Hospital Admissions (2006−2010) and Deaths (2004−2008) from Pertussis in New Zealand Children by Age ..................................... 269

Figure 75. Acute and Semi-Acute Hospital Admissions for Pertussis in Infants <1 Year by Ethnicity, New Zealand 2000−2010 ................................................................ 269

Figure 76. Average Number of Acute and Semi-Acute Hospital Admissions for Pertussis in Infants <1 Year by Month, New Zealand 2006−2010 ................................ 270

Figure 77. Acute and Semi-Acute Hospital Admissions for Pertussis in Infants <1 Year, South Island DHBs vs. New Zealand 2000−2010 ............................................... 272

Figure 78. Acute and Semi-Acute Hospital Admissions (2000−2010) and Deaths (2000−2008) from Meningococcal Disease in New Zealand Children and Young People Aged 0−24 Years ............................................................................................. 276

Figure 79. Acute and Semi-Acute Hospital Admissions (2006−2010) and Deaths (2004−2008) from Meningococcal Disease in New Zealand Children and Young People by Age ............................................................................................................. 277

Figure 80. Acute and Semi-Acute Hospital Admissions for Meningococcal Disease in Children and Young People Aged 0−24 Years by Ethnicity, New Zealand 2000−2010................................................................................................................... 277

Figure 81. Average Number of Acute and Semi-Acute Hospital Admissions for Meningococcal Disease in Children and Young People Aged 0−24 Years by Month, New Zealand 2006−2010 ............................................................................................. 278

Figure 82. Acute and Semi-Acute Hospital Admissions for Meningococcal Disease in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2000−2010 ..................................................................................................... 280

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Figure 83. Acute and Semi-Acute Hospital Admissions (2000−2010) and Deaths (2000−2008) from Tuberculosis in New Zealand Children and Young People Aged 0−24 Years .................................................................................................................. 285

Figure 84. Acute and Semi-Acute Hospital Admissions for Tuberculosis in Children and Young People by Age, New Zealand 2006−2010 .................................................. 286

Figure 85. Acute and Semi-Acute Hospital Admissions for Tuberculosis in Children and Young People Aged 0−24 Years by Ethnicity, New Zealand 2000−2010 .............. 286

Figure 86. Average Number of Acute and Semi-Acute Hospital Admissions for Tuberculosis in Children and Young People Aged 0−24 Years by Month, New Zealand 2006−2010 ..................................................................................................... 287

Figure 87. Acute and Semi-Acute Hospital Admissions for Tuberculosis in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2000−2010................................................................................................................... 289

Figure 88. Acute and Semi-Acute Hospital Admissions (2000−2010) and Deaths (2000−2008) from Acute Rheumatic Fever and Rheumatic Heart Disease in New Zealand Children and Young People Aged 0−24 Years ............................................... 293

Figure 89. Acute and Semi-Acute Hospital Admissions (2006−2010) and Deaths (2004−2008) from Acute Rheumatic Fever and Rheumatic Heart Disease in New Zealand Children and Young People by Age ............................................................... 294

Figure 90. Acute and Semi-Acute Hospital Admissions for Acute Rheumatic Fever and Rheumatic Heart Disease in Children and Young People Aged 0–24 Years by Ethnicity, New Zealand 2000−2010 ............................................................................. 294

Figure 91. Average Number of Acute and Semi-Acute Hospital Admissions for Acute Rheumatic Fever and Rheumatic Heart Disease in Children and Young People Aged 0−24 Years by Month, New Zealand 2006−2010 .................................... 295

Figure 92. Acute and Semi-Acute Hospital Admissions for Acute Rheumatic Fever and Rheumatic Heart Disease in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2000−2010 ........................................................ 297

Figure 93. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years, New Zealand 2000−2010 ................................................... 303

Figure 94. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years by Age and Gender, New Zealand 2006−2010 .................... 305

Figure 95. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years by Ethnicity, New Zealand 2000−2010 ................................ 305

Figure 96. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2000−2010 ............... 314

Figure 97. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years by Ethnicity, South Island DHBs vs. New Zealand 2000−2010................................................................................................................... 315

Figure 98. Average Number of Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years by Month, the South Island DHBs 2006−2010................................................................................................................... 316

Figure 99. Acute and Semi-Acute Hospital Admissions (2000−2010) and Deaths (2000–2008) from Gastroenteritis in New Zealand Children and Young People Aged 0–24 Years ......................................................................................................... 323

Figure 100. Acute and Semi-Acute Hospital Admissions (2006–2010) and Deaths (2004−2008) from Gastroenteritis in New Zealand Children and Young People by Age .............................................................................................................................. 323

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Figure 101. Acute and Semi-Acute Hospital Admissions for Gastroenteritis in Children and Young People Aged 0−24 Years by Ethnicity, New Zealand 2000−2010................................................................................................................... 324

Figure 102. Acute and Semi-Acute Hospital Admissions for Gastroenteritis in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2000−2010 ..................................................................................................... 326

Figure 103. Acute and Semi-Acute Hospital Admissions for Gastroenteritis in Children and Young People Aged 0−24 Years by Ethnicity, South Island DHBs vs. New Zealand 2000−2010 ............................................................................................. 327

Figure 104. Average Number of Acute and Semi-Acute Hospital Admissions for Gastroenteritis in Children and Young People Aged 0−24 Years by Month, the South Island DHBs 2006−2010 .................................................................................... 328

Figure 105. Mortality from Unintentional Injuries in Children Aged 0−14 Years by Main Underlying Cause of Death, New Zealand 2000−2008 ........................................ 338

Figure 106. Mortality from Land Transport Injuries in Children Aged 0−14 Years by Ethnicity, New Zealand 2000−2008 ............................................................................. 346

Figure 107. Average Number of Hospital Admissions for Land Transport Injuries per Month in Children Aged 0−14 Years, the South Island DHBs 2006−2010 .............. 347

Figure 108. Hospital Admissions (2006−2010) and Deaths (2004−2008) from Land Transport Injuries in New Zealand Children 0–14 Years by Age and Gender ............... 348

Figure 109. Hospital Admissions for Transport Injuries in Children 0–14 Years by Age and Injury Type, New Zealand 2006−2010 ........................................................... 348

Figure 110. Average Number of Hospital Admissions for Unintentional Non-Transport Injuries per Month in Children Aged 0−14 Years, South Island DHBs 2006−2010................................................................................................................... 353

Figure 111. Hospital Admissions (2006−2010) and Deaths (2004−2008) from Unintentional Non-Transport Injuries in New Zealand Children 0–14 Years by Age and Gender .................................................................................................................. 354

Figure 112. Hospital Admissions for Selected Unintentional Non-Transport Injuries in Children 0–14 Years by Age and Injury Type, New Zealand 2006−2010 .................. 354

Figure 113. Hospital Admissions for Falls and Mechanical Force Type Injuries in Children 0–14 Years by Age and Injury Type, New Zealand 2006−2010 ..................... 355

Figure 114. Mortality from Unintentional Non-Transport Injuries in Children Aged 0−14 Years by Ethnicity, New Zealand 2000−2008 ...................................................... 358

Figure 115. Percentage of Children Who Were Caries-Free at 5 Years and Mean DMFT Scores at 12 Years, New Zealand 2000−2010 .................................................. 364

Figure 116. Percentage of Children Who Were Caries-Free at 5 Years by Ethnicity, New Zealand 2003−2010 ............................................................................................. 364

Figure 117. Mean DMFT at 12 Years by Ethnicity, New Zealand 2003−2010 .............. 365

Figure 118. Percentage of Children Who Were Caries-Free at 5 Years, South Island DHBs vs. New Zealand 2002−2010 ................................................................... 366

Figure 119. Mean DMFT at 12 Years, South Island DHBs vs. New Zealand 2002−2009................................................................................................................... 367

Figure 120. Percentage of Children Who Were Caries-Free at 5 Years by Ethnicity, South Island DHBs with Non-Fluoridated Water Supplies vs. New Zealand 2003−2010................................................................................................................... 368

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Figure 121. Percentage of Children Who Were Caries-Free at 5 Years by Ethnicity, South Island DHBs with Fluoridated and Non-Fluoridated Water Supplies vs. New Zealand 2003−2009 ..................................................................................................... 369

Figure 122. Mean DMFT at 12 Years by Ethnicity, South Island DHBs with Non-Fluoridated Water Supplies vs. New Zealand 2003−2010 ............................................ 369

Figure 123. Mean DMFT at 12 Years by Ethnicity, South Island DHBs with Fluoridated and Non-Fluoridated Water Supplies vs. New Zealand 2003−2009 ........... 370

Figure 124. Hospital Admissions for Dental Caries in Children and Young People Aged 0−24 Years, New Zealand 2000−2010 ............................................................... 372

Figure 125. Hospital Admissions for Dental Caries in Children and Young People by Age, New Zealand 2006−2010 ................................................................................ 372

Figure 126. Hospital Admissions for Dental Caries in Children and Young People Aged 0−24 Years by Ethnicity, New Zealand 2000−2010 ............................................ 374

Figure 127. Hospital Admissions for Dental Caries in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2000−2010 ........................... 383

Figure 128. Hospital Admissions for Dental Caries in Children Aged 0−14 Years by Ethnicity, South Island DHBs vs. New Zealand 2000−2010 ......................................... 384

Figure 129. Average Number of Hospital Admissions for Dental Caries in Children and Young People Aged 0−24 Years by Month, the South Island DHBs 2006−2010 ... 385

Figure 130. Average Age of Suspicion and Confirmation of Hearing Losses, New Zealand Deafness Notification Database 2001−2005 and 2010 ................................... 394

Figure 131. Mortality from Unintentional Injuries in Young People Aged 15−24 Years by Main Underlying Cause of Death, New Zealand 2000−2008 ......................... 439

Figure 132. Average Number of Hospital Admissions for Land Transport Injuries per Month in Young People Aged 15−24 Years, South Island DHBs 2006−2010 ......... 448

Figure 133. Hospital Admissions (2006−2010) and Deaths (2004−2008) from Land Transport Injuries in New Zealand Children and Young People 0−24 Years by Age and Gender .................................................................................................................. 449

Figure 134. Hospital Admissions for Transport Injuries in Children and Young People Aged 0−24 Years by Age and Injury Type, New Zealand 2006−2010 .............. 449

Figure 135. Mortality from Land Transport Injuries in Young People Aged 15−24 Years by Ethnicity, New Zealand 2000−2008 ............................................................... 452

Figure 136. Average Number of Hospital Admissions for Unintentional Non-Transport Injuries per Month in Young People 15−24 Years, the South Island DHBs 2006−2010................................................................................................................... 454

Figure 137. Hospital Admissions (2006−2010) and Deaths (2004−2008) from Unintentional Non-Transport Injuries in New Zealand Children and Young People Aged 0−24 Years by Age and Gender ......................................................................... 455

Figure 138. Hospital Admissions for Falls and Mechanical Force Type Injuries in Children and Young People Aged 0−24 Years by Age and Injury Type, New Zealand 2006−2010 ..................................................................................................... 455

Figure 139. Mortality from Unintentional Non-Transport Injuries in Young People Aged 15−24 Years by Ethnicity, New Zealand 2000−2008........................................... 458

Figure 140. Teenage Pregnancy Rates, New Zealand 1996−2009 .............................. 462

Figure 141. Teenage Birth Rates by Ethnicity, New Zealand 2000−2010 ..................... 463

Figure 142. Live Birth Rates by Maternal Age and Ethnicity, New Zealand 2006−2010................................................................................................................... 464

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Figure 143. Teenage Birth Rates, South Island DHBs vs. New Zealand 2000−2010 ... 465

Figure 144. Teenage Birth Rates by Ethnicity, South Island DHBs vs. New Zealand 2000−2010................................................................................................................... 466

Figure 145. Terminations of Pregnancy by Age, New Zealand 1980−2010 .................. 473

Figure 146. Terminations of Pregnancy by Age, New Zealand 2010 ............................ 474

Figure 147. Terminations of Pregnancy by Age and Ethnicity, New Zealand 2010 ....... 474

Figure 148. Terminations of Pregnancy by Ethnicity in Young Women <25 Years, New Zealand 2006−2010 ............................................................................................. 475

Figure 149. Proportion of Women Who Had a Termination by Age and Gestation at Termination, New Zealand 2009 .................................................................................. 475

Figure 150. Proportion of Women Who Had a Termination by Age and Number of Previous Terminations, New Zealand 2009 .................................................................. 476

Figure 151. Gross Domestic Product (GDP): Percentage Change from Previous Quarter, New Zealand June Quarter 2007 to June Quarter 2011 ................................. 490

Figure 152. Income Inequality in New Zealand as Assessed by the P80/P20 Ratio for the 1984−2010 HES Years ..................................................................................... 493

Figure 153. Income Inequality in New Zealand as Assessed by the Gini Coefficient for the 1984−2010 HES Years ..................................................................................... 493

Figure 154. Proportion of Dependent Children Aged 0−17 Years Living Below the Income Poverty Threshold Before Housing Costs, New Zealand 1984−2010 HES Years ........................................................................................................................... 496

Figure 155. Proportion of Dependent Children Aged 0−17 Years Living Below the Income Poverty Threshold After Housing Costs, New Zealand 1984−2010 HES Years ........................................................................................................................... 496

Figure 156. Proportion of Dependent Children Living Below the 60% Income Poverty Threshold (1998 and 2007 Median, After Housing Costs) by Age, New Zealand 1984−2010 HES Years .................................................................................. 497

Figure 157. Proportion of Dependent Children Aged 0−17 Years Living Below the 60% Income Poverty Threshold (1998 and 2007 Median, After Housing Costs) by Number of Children in Household, New Zealand 1984−2010 HES Years .................... 498

Figure 158. Proportion of Dependent Children Aged 0−17 Years Living Below the 60% Income Poverty Threshold (1998 and 2007 Median, After Housing Costs) by Household Type, New Zealand 1984−2010 HES Years ............................................... 498

Figure 159. Proportion of Dependent Children Aged 0−17 Years Living Below the 60% Income Poverty Threshold (1998 and 2007 Median, After Housing Costs) by Work Status of Adults in the Household, New Zealand 1984−2010 HES Years ........... 499

Figure 160. Proportion of Children Aged 0–17 Years with Deprivation Scores of Four or More by Ethnicity and Family Income Source, NZ Living Standards Survey 2008 ............................................................................................................................ 502

Figure 161. Seasonally Adjusted Unemployment Rates, New Zealand Quarter 1 (March) 1986 to Quarter 3 (September) 2011 .............................................................. 504

Figure 162. Annual Unemployment Rates by Age (Selected Age Groups), New Zealand September 1987−2011 ................................................................................... 505

Figure 163. Annual Unemployment Rates by Age and Gender in New Zealand Young People Aged 15−24 Years, September 1987−2011 .......................................... 505

Figure 164. Quarterly Unemployment Rates by Total Response Ethnicity, New Zealand Quarter 4 (December) 2007 to Quarter 3 (September) 2011 .......................... 506

15

Figure 165. Annual Unemployment Rates by Qualification, New Zealand September 1987−2011 ................................................................................................ 507

Figure 166. Proportion of those Unemployed by Duration of Unemployment, New Zealand September 1987−September 2011 ................................................................ 507

Figure 167. Quarterly Unemployment Rates by Regional Council, South Island Regional Councils vs. New Zealand Quarter 1 (March) 2005 to Quarter 3 (September) 2011 ........................................................................................................ 508

Figure 168. Proportion of All Children Aged 0−18 Years Who Were Reliant on a Benefit or Benefit Recipient by Benefit Type, New Zealand April 2000−2011 ............... 512

Figure 169. Proportion of New Zealand Children Aged 0−18 Years Who Were Reliant on a Benefit or Benefit Recipient by Age and Benefit Type, as at the end of April 2011 .................................................................................................................... 512

Figure 170. Hospital Admissions (2000−2010) and Mortality (2000−2008) from Conditions with a Social Gradient in New Zealand Children Aged 0−14 Years (excluding Neonates) ................................................................................................... 523

Figure 171. Hospital Admissions for Conditions with a Social Gradient in Children Aged 0−14 Years by Ethnicity, New Zealand 2000−2010 ............................................ 524

Figure 172. Mortality from Conditions with a Social Gradient in Children Aged 0−14 Years (excluding Neonates) by Ethnicity, New Zealand 2000−2008 ............................ 524

Figure 173. Hospital Admissions for Conditions with a Social Gradient in Children Aged 0−14 Years by NZ Deprivation Index Decile, New Zealand 2000−2010 .............. 525

Figure 174. Mortality from Conditions with a Social Gradient in Children Aged 0−14 Years (excluding Neonates) by NZ Deprivation Index Decile, New Zealand 2000−2008................................................................................................................... 526

Figure 175. Hospital Admissions for Conditions with a Social Gradient in Children Aged 0–14 Years, South Island DHBs vs. New Zealand 2000–2010 ........................... 537

Figure 176. Hospital Admissions for Medical Conditions with a Social Gradient in Children Aged 0−14 Years by Ethnicity, the South Island DHBs vs. New Zealand 2000−2010................................................................................................................... 538

Figure 177. Hospital Admissions for Injuries with a Social Gradient in Children Aged 0−14 Years by Ethnicity, the South Island DHBs vs. New Zealand 2000−2010................................................................................................................... 539

Figure 178. Hospital Admissions (2000−2010) and Deaths (2000−2008) due to Injuries Arising from the Assault, Neglect or Maltreatment of New Zealand Children 0−14 Years .................................................................................................................. 542

Figure 179. Hospital Admissions (2006−2010) and Deaths (2004−2008) due to Injuries Arising from the Assault, Neglect or Maltreatment of New Zealand Children 0–14 Years by Age and Gender ................................................................................... 542

Figure 180. Hospital Admissions for Injuries Arising from the Assault, Neglect or Maltreatment of Children 0−14 Years by NZ Deprivation Index Decile, New Zealand 2006−2010 ..................................................................................................... 543

Figure 181. Hospital Admissions for Injuries Arising from the Assault, Neglect or Maltreatment of Children 0−14 Years by Ethnicity, New Zealand 2000−2010 .............. 543

Figure 182. Hospital Admissions for Injuries Arising from the Assault, Neglect or Maltreatment of Children Aged 0−14 Years, South Island DHBs vs. New Zealand 2000−2010................................................................................................................... 547

16

LIST OF TABLES

Table 1. Overview of the Health Status of Children and Young People in the South Island DHBs ................................................................................................................... 32

Table 2. Distribution of Live Births by Ethnicity, Nelson Marlborough, South Canterbury, and Canterbury DHBs 2000–2010 .............................................................. 50

Table 3. Distribution of Live Births by Ethnicity, West Coast, Otago and Southland DHBs 2000–2010 .......................................................................................................... 51

Table 4. Distribution of Live Births by Ethnicity, Maternal Age and NZ Deprivation Index Decile, South Island DHBs 2010 .......................................................................... 52

Table 5. Intermediate Fetal Deaths by Cause of Death, New Zealand 2004–2008 ........ 56

Table 6. Late Fetal Deaths by Cause of Death, New Zealand 2004–2008 ..................... 57

Table 7. Intermediate and Late Fetal Deaths and Unspecified Deaths by Ethnicity, NZ Deprivation Index Decile, Maternal Age and Gender, New Zealand 2004–2008 ...... 60

Table 8. Intermediate and Late Fetal Deaths, South Island DHBs vs. New Zealand 2004−2008..................................................................................................................... 61

Table 9. Intermediate and Late Fetal Deaths by Cause, Nelson Marlborough 2004−2008..................................................................................................................... 63

Table 10. Intermediate and Late Fetal Deaths by Cause, South Canterbury 2004−2008..................................................................................................................... 64

Table 11. Intermediate and Late Fetal Deaths by Cause, the West Coast 2004−2008..................................................................................................................... 64

Table 12. Intermediate and Late Fetal Deaths by Cause, Canterbury 2004−2008 ......... 65

Table 13. Intermediate and Late Fetal Deaths by Cause, Otago 2004−2008 ................. 66

Table 14. Intermediate and Late Fetal Deaths by Cause, Southland 2004−2008 ........... 67

Table 15. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention of Fetal Deaths ............................................................................................ 68

Table 16. Preterm Birth Rates in Singleton Live Born Babies, South Island DHBs vs. New Zealand 2006−2010 ......................................................................................... 74

Table 17. Preterm Birth Rates in Singleton Live Born Babies by Ethnicity, NZ Deprivation Index Decile, Gender and Maternal Age, New Zealand 2006–2010 ............ 74

Table 18. Evidence-Based Reviews Relevant to the Prevention of Spontaneous Preterm Birth ................................................................................................................. 78

Table 19. Neonatal and Post Neonatal Mortality by Main Underlying Cause of Death, New Zealand 2004−2008 ................................................................................... 85

Table 20. Risk Factors for Neonatal and Post Neonatal Mortality, New Zealand 2004−2008..................................................................................................................... 86

Table 21. Neonatal and Post Neonatal Mortality, South Island DHBs vs. New Zealand 2004−2008 ....................................................................................................... 89

Table 22. Neonatal and Post Neonatal Mortality by Main Underlying Cause of Death, Nelson Marlborough, South Canterbury and Canterbury 2004−2008.................. 90

Table 23. Neonatal and Post Neonatal Mortality by Main Underlying Cause of Death, the West Coast, Otago and Southland 2004−2008 ............................................. 91

Table 24. Risk Factors for Sudden Unexpected Death in Infancy (SUDI), New Zealand 2004−2008 ....................................................................................................... 93

17

Table 25. Sudden Unexpected Death in Infancy, South Island DHBs vs. New Zealand 2004–2008 ....................................................................................................... 95

Table 26. Local Policy Documents and Evidence-Based Reviews Relevant to SUDI Prevention ..................................................................................................................... 98

Table 27. Local Policy Documents and Evidence-Based Reviews Relevant to the Promotion or Support of Breastfeeding ........................................................................ 107

Table 28. Most Frequent Reasons for Hospital Admission in Children Aged 0–14 Years (Neonates Excluded) by Admission Type, New Zealand 2006–2010 ................. 136

Table 29. Most Frequent Causes of Mortality in Children Aged 1–14 Years by Main Underlying Cause of Death, New Zealand 2004–2008 ................................................. 137

Table 30. Most Frequent Reasons for Hospital Admission in Children Aged 0–14 Years (Neonates Excluded) by Admission Type, Nelson Marlborough 2006–2010 ...... 138

Table 31. Most Frequent Reasons for Hospital Admission in Children Aged 0–14 Years (Neonates Excluded) by Admission Type, South Canterbury 2006–2010 .......... 139

Table 32. Most Frequent Reasons for Hospital Admission in Children Aged 0–14 Years (Neonates Excluded) by Admission Type, Canterbury 2006–2010 .................... 140

Table 33. Most Frequent Reasons for Hospital Admission in Children Aged 0–14 Years (Neonates Excluded) by Admission Type, the West Coast 2006–2010 .............. 141

Table 34. Most Frequent Reasons for Hospital Admission in Children Aged 0–14 Years (Neonates Excluded) by Admission Type, Otago 2006–2010 ............................ 142

Table 35. Most Frequent Reasons for Hospital Admission in Children Aged 0–14 Years (Neonates Excluded) by Admission Type, Southland 2006–2010 ...................... 143

Table 36. Most Frequent Causes of Mortality in Children Aged 1–14 Years by Main Underlying Cause of Death, South Island DHBs 2004–2008 ........................................ 144

Table 37. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years by Primary Diagnosis, New Zealand 2006–2010 .............................................................. 148

Table 38. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006–2010 ............ 150

Table 39. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years, South Island DHBs vs. New Zealand 2006–2010 ................................................................... 151

Table 40. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years by Primary Diagnosis, Nelson Marlborough 2006–2010 ................................................... 152

Table 41. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years by Primary Diagnosis, South Canterbury 2006–2010 ....................................................... 153

Table 42. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years by Primary Diagnosis, Canterbury 2006–2010 .................................................................. 154

Table 43. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years by Primary Diagnosis, the West Coast 2006–2010 ........................................................... 155

Table 44. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years by Primary Diagnosis, Otago 2006–2010 ......................................................................... 156

Table 45. Ambulatory Sensitive Hospitalisations in Children Aged 0–4 Years by Primary Diagnosis, Southland 2006–2010 ................................................................... 157

Table 46. Local Policy Documents and Evidence-Based Reviews Which Consider Generic Approaches to Infectious and Respiratory Diseases ....................................... 166

Table 47. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention of Second Hand Cigarette Smoke Exposure .............................................. 168

18

Table 48. Local Policy Documents and Evidence-Based Reviews Relevant to Housing ....................................................................................................................... 170

Table 49. Acute and Arranged Hospital Admissions for Acute URTIs in Children Aged 0–14 Years by Primary Diagnosis, New Zealand 2006–2010 ............................. 177

Table 50. Acute and Arranged Hospital Admissions for Acute URTIs in Children Aged 0–14 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006–2010 ..................................................................................................... 178

Table 51. Acute and Arranged Hospital Admissions for Acute URTI in Children Aged 0–14 Years by Primary Diagnosis, Nelson Marlborough, South Canterbury, Canterbury and the West Coast 2006–2010 ................................................................ 179

Table 52. Acute and Arranged Hospital Admissions for Acute URTI in Children Aged 0–14 Years by Primary Diagnosis, Otago and Southland 2006–2010 ................. 180

Table 53. Acute and Arranged Hospital Admissions for Acute URTI in Children Aged 0–14 Years, South Island DHBs vs. New Zealand 2006–2010 ........................... 180

Table 54. Arranged/Waiting List Admissions for Tonsillectomy +/− Adenoidectomy in Children Aged 0−14 Years by Primary Diagnosis, New Zealand 2006−2010 ........... 184

Table 55. Arranged/Waiting List Admissions for Tonsillectomy +/− Adenoidectomy in Children Aged 0−14 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010 ............................................................................... 186

Table 56. Arranged/Waiting List Admissions for Tonsillectomy +/− Adenoidectomy in Children Aged 0−14 Years, South Island DHBs vs. New Zealand 2006−2010 ......... 187

Table 57. Arranged/Waiting List Admissions for Tonsillectomy +/− Adenoidectomy in Children Aged 0−14 Years by Primary Diagnosis, South Island DHBs 2006−2010 .. 188

Table 58. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention and Management of Upper Respiratory Tract Infections and Tonsillectomy ............................................................................................................... 193

Table 59. Acute Hospital Admissions for Conditions of the Middle Ear and Mastoid in Children Aged 0–14 Years by Primary Diagnosis, New Zealand 2006–2010 ........... 199

Table 60. Arranged/Waiting List Hospital Admissions for Grommets in Children Aged 0–14 Years by Primary Diagnosis, New Zealand 2006–2010 ............................. 199

Table 61. Acute Hospital Admissions for Otitis Media in Children Aged 0−14 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010 ....... 201

Table 62. Arranged/Waiting List Admissions for Grommets in Children Aged 0−14 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010................................................................................................................... 202

Table 63. Acute Hospital Admissions for Otitis Media and Arranged/Waiting List Admissions for Grommets in Children Aged 0−14 Years, South Island DHBs vs. New Zealand 2006−2010 ............................................................................................. 203

Table 64. Acute Hospital Admissions for Conditions of the Middle Ear and Mastoid in Children Aged 0−14 Years by Primary Diagnosis, South Island DHBs 2006−2010 .. 204

Table 65. Arranged/Waiting List Hospital Admissions for Grommets in Children Aged 0−14 Years by Primary Diagnosis, South Island DHBs 2006−2010 .................... 205

Table 66. Local Policy Documents and Evidence-Based Reviews Relevant to the Identification of Acquired Hearing Losses, or the Management of Otitis Media (including Grommets) ................................................................................................... 210

Table 67. Acute and Semi-Acute Hospital Admissions for Bronchiolitis in Infants <1 Year by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006–2010 ............................................................................................................................ 220

19

Table 68. Acute and Semi-Acute Hospital Admissions for Bronchiolitis in Infants <1 Year, South Island DHBs vs. New Zealand 2006−2010 ............................................... 220

Table 69. Policy Documents and Evidence-Based Reviews Relevant to the Prevention and Management of Bronchiolitis ............................................................... 225

Table 70. Acute and Semi-Acute Hospital Admissions for Bacterial/Non-Viral/Unspecified Pneumonia in Children and Young People Aged 0–24 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006–2010 ............ 231

Table 71. Acute and Semi-Acute Hospital Admissions for Viral Pneumonia in Children and Young People Aged 0−14 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010 ............................................................. 232

Table 72. Acute and Semi-Acute Hospital Admissions for Pneumonia in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2006−2010................................................................................................................... 233

Table 73. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention and Management of Pneumonia ................................................................ 239

Table 74. Acute and Semi-Acute Hospital Admissions for Asthma in Children and Young People Aged 0−24 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010 ............................................................................... 245

Table 75. Acute and Semi-Acute Hospital Admissions for Asthma in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2006−2010 .... 246

Table 76. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention and Management of Asthma in Children and Young People ...................... 251

Table 77. Acute and Semi-Acute Hospital Admissions for Children and Young People Aged 0−24 Years with Bronchiectasis by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010 ............................................................. 258

Table 78. Acute and Semi-Acute Hospital Admissions for Children and Young People Aged 0−24 Years with Bronchiectasis, South Island DHBs vs. New Zealand 2006−2010................................................................................................................... 259

Table 79. Evidence-Based Reviews Relevant to the Prevention and Management of Bronchiectasis ......................................................................................................... 262

Table 80. Acute and Semi-Acute Hospital Admissions for Pertussis in Infants <1 Year by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010................................................................................................................... 270

Table 81. Acute and Semi-Acute Hospital Admissions for Pertussis in Infants <1 Year, South Island DHBs vs. New Zealand 2006−2010 ............................................... 271

Table 82. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention of Pertussis ................................................................................................ 273

Table 83. Acute and Semi-Acute Hospital Admissions for Meningococcal Disease in Children and Young People Aged 0−24 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010 ............................................................. 278

Table 84. Acute and Semi-Acute Hospital Admissions for Meningococcal Disease in Children and Young People 0−24 Years, South Island DHBs vs. New Zealand 2006−2010................................................................................................................... 279

Table 85. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention and Management of Meningococcal Disease ............................................. 281

Table 86. Acute and Semi-Acute Hospital Admissions for Tuberculosis in Children and Young People Aged 0−24 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010 ............................................................................... 287

20

Table 87. Acute and Semi-Acute Hospital Admissions for Tuberculosis in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2006−2010................................................................................................................... 288

Table 88. Local Policy Documents and Evidence-Based Reviews Relevant to the Control of Tuberculosis ................................................................................................ 290

Table 89. Acute and Semi-Acute Hospital Admissions for Acute Rheumatic Fever and Rheumatic Heart Disease in Children and Young People Aged 0−24 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010 ............ 295

Table 90. Acute and Semi-Acute Hospital Admissions for Acute Rheumatic Fever and Rheumatic Heart Disease in Children and Young People Aged 0–24 Years, South Island DHBs vs. New Zealand 2006–2010 ......................................................... 296

Table 91. Local Guidelines and Evidence-Based Reviews Relevant to the Prevention and Management of Acute Rheumatic Fever and Rheumatic Heart Disease........................................................................................................................ 299

Table 92. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years by Primary Diagnosis, New Zealand 2006−2010 ................. 304

Table 93. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010 ............................................................................................. 306

Table 94. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years by Primary Diagnosis, Nelson Marlborough 2006−2010 ...... 307

Table 95. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years by Primary Diagnosis, South Canterbury 2006−2010 .......... 308

Table 96. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years by Primary Diagnosis, Canterbury 2006−2010..................... 309

Table 97. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years by Primary Diagnosis, the West Coast 2006−2010 .............. 310

Table 98. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years by Primary Diagnosis, Otago 2006−2010 ............................ 311

Table 99. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years by Primary Diagnosis, Southland 2006−2010 ...................... 312

Table 100. Hospital Admissions for Serious Skin Infections in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2006−2010 ............... 313

Table 101. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention or Management of Serious Skin Infections ................................................. 318

Table 102. Acute and Semi-Acute Hospital Admissions for Gastroenteritis in Children Aged 0−14 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010 ............................................................................................. 324

Table 103. Acute and Semi-Acute Hospital Admissions for Gastroenteritis in Young People Aged 15−24 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010 ............................................................................................. 325

Table 104. Acute and Semi-Acute Hospital Admissions for Gastroenteritis in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2006−2010 ..................................................................................................... 325

Table 105. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention and Management of Gastroenteritis ........................................................... 330

Table 106. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Injuries in New Zealand Children Aged 0−14 Years by Main External Cause of Injury ............................................................................................................................ 339

21

Table 107. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Injuries in Nelson Marlborough Children Aged 0−14 Years by Main External Cause of Injury ........................................................................................................................ 340

Table 108. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Injuries in South Canterbury Children Aged 0−14 Years by Main External Cause of Injury ............................................................................................................................ 341

Table 109. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Injuries in Canterbury Children Aged 0−14 Years by Main External Cause of Injury .... 342

Table 110. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Injuries in West Coast Children Aged 0−14 Years by Main External Cause of Injury .... 343

Table 111. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Injuries in Otago Children Aged 0−14 Years by Main External Cause of Injury ............ 344

Table 112. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Injuries in Southland Children Aged 0−14 Years by Main External Cause of Injury ...... 345

Table 113. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Land Transport Injuries in Children Aged 0−14 Years, South Island DHBs vs. New Zealand........................................................................................................................ 346

Table 114. Hospital Admissions for Pedestrian Injuries in Children Aged 0−14 Years by Gender, Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010................................................................................................................... 349

Table 115. Hospital Admissions for Cyclist and Motorbike Injuries in Children Aged 0−14 Years by Gender, Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010................................................................................................................... 350

Table 116. Hospital Admissions for Vehicle Occupant Injuries in Children 0−14 Years by Gender, Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010................................................................................................................... 351

Table 117. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Unintentional Non-Transport Injuries in Children Aged 0−14 Years, South Island DHBs vs. New Zealand ................................................................................................ 351

Table 118. Hospital Admissions for Accidental Poisoning in Children Aged 0−14 Years by Gender, Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010................................................................................................................... 355

Table 119. Hospital Admissions for Falls and Electricity/Fire/Burn Injuires in Children Aged 0−14 Years by Gender, Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010 ............................................................................................. 356

Table 120. Hospital Admissions for Injuries Arising from Inanimate and Animate Mechanical Forces in Children Aged 0−14 Years by Gender, Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010 ..................................................... 357

Table 121. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention of Unintentional Injuries in Children ............................................................ 359

Table 122. Proportion of Adolescents Using Publicly Funded Dental Services, South Island DHBs vs. New Zealand 2004−2009 ........................................................ 370

Table 123. Hospital Admissions for Dental Conditions in Children and Young People Aged 0−24 Years by Primary Diagnosis, New Zealand 2006−2010 ................. 373

Table 124. Hospital Admissions for Dental Caries in Children Aged 0−4 Years by Gender, Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010 ............ 374

Table 125. Hospital Admissions for Dental Caries in Children and Young People Aged 5−24 Years by Gender, Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010 ..................................................................................................... 375

22

Table 126. Hospital Admissions for Dental Conditions in Children and Young People Aged 0−24 Years, Nelson Marlborough 2006−2010......................................... 376

Table 127. Hospital Admissions for Dental Conditions in Children and Young People Aged 0−24 Years, South Canterbury 2006−2010 ............................................. 377

Table 128. Hospital Admissions for Dental Conditions in Children and Young People Aged 0−24 Years, Canterbury 2006−2010 ....................................................... 378

Table 129. Hospital Admissions for Dental Conditions in Children and Young People Aged 0−24 Years, West Coast 2006−2010 ...................................................... 379

Table 130. Hospital Admissions for Dental Conditions in Children and Young People Aged 0−24 Years, Otago 2006−2010 ............................................................... 380

Table 131. Hospital Admissions for Dental Conditions in Children and Young People Aged 0−24 Years, Southland 2006−2010 ........................................................ 381

Table 132. Hospital Admissions for Dental Caries in Children and Young People Aged 0−24 Years, South Island DHBs vs. New Zealand 2006−2010 ........................... 382

Table 133. Local Policy Documents and Evidence-Based Reviews Relevant to Oral Health Issues in Children and Young People ............................................................... 387

Table 134. Deafness Notification Database Notifications by Type of Hearing Loss, New Zealand 2000−2005 and 2010 ............................................................................. 393

Table 135. Notifications to Deafness Notification Database by Degree of Hearing Loss Using Old Criteria, New Zealand 2001−2004 and 2010 ....................................... 394

Table 136. Number of Notifications Meeting the Old Criteria for Inclusion in Deafness Notification Database by Region of Residence, New Zealand 1998−2004 ... 395

Table 137. Number of Notifications Meeting New Criteria for Deafness Notification Database by District Health Board, New Zealand 2010 ................................................ 396

Table 138. Newborn Hearing Screening Indicators by District Health Board, New Zealand 1 April 2010 to 30 September 2010 ................................................................ 398

Table 139. Newborn Hearing Screening Indicators by Ethnicity, NZ Deprivation Index Decile and Birth Location, New Zealand 1 April 2010 to 30 September 2010 ..... 399

Table 140. Policy Documents and Evidence-Based Reviews Relevant to the Early Detection and Management of Permanent Hearing Loss in Children and Young People ......................................................................................................................... 400

Table 141. Developmental Tasks of Adolescence ........................................................ 409

Table 142. Most Frequent Causes of Mortality in Young People Aged 15−24 Years by Main Underlying Cause of Death, New Zealand 2004−2008 ................................... 427

Table 143. Most Frequent Reasons for Hospital Admission in Young People Aged 15−24 Years by Admission Type, New Zealand 2006−2010 ........................................ 428

Table 144. Most Frequent Causes of Mortality in Young People Aged 15−24 Years by Main Underlying Cause of Death, Nelson Marlborough, South Canterbury and Canterbury 2004−2008 ................................................................................................ 429

Table 145. Most Frequent Causes of Mortality in Young People Aged 15−24 Years by Main Underlying Cause of Death, West Coast, Otago and Southland 2004−2008 .. 430

Table 146. Most Frequent Reasons for Hospital Admission in Young People Aged 15−24 Years by Admission Type, Nelson Marlborough 2006−2010 ............................. 431

Table 147. Most Frequent Reasons for Hospital Admission in Young People Aged 15−24 Years by Admission Type, South Canterbury 2006−2010 ................................. 432

Table 148. Most Frequent Reasons for Hospital Admission in Young People Aged 15−24 Years by Admission Type, Canterbury 2006−2010 ........................................... 433

23

Table 149. Most Frequent Reasons for Hospital Admission in Young People Aged 15−24 Years by Admission Type, West Coast 2006−2010........................................... 434

Table 150. Most Frequent Reasons for Hospital Admission in Young People Aged 15−24 Years by Admission Type, Otago 2006−2010 ................................................... 435

Table 151. Most Frequent Reasons for Hospital Admission in Young People Aged 15−24 Years by Admission Type, Southland 2006−2010 ............................................. 436

Table 152. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Injuries in New Zealand Young People Aged 15–24 Years by Cause .......................... 440

Table 153. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Injuries in Nelson Marlborough Young People Aged 15−24 Years by Cause ............... 441

Table 154. Hospital Admissions (2006–2010) and Mortality (2004−2008) from Injuries in South Canterbury Young People Aged 15−24 Years by Cause ................... 442

Table 155. Hospital Admissions (2006–2010) and Mortality (2004−2008) from Injuries in Canterbury Young People Aged 15−24 Years by Cause ............................. 443

Table 156. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Injuries in West Coast Young People Aged 15−24 Years by Cause ............................. 444

Table 157. Hospital Admissions (2006–2010) and Mortality (2004−2008) from Injuries in Otago Young People Aged 15−24 Years by Cause ..................................... 445

Table 158. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Injuries in Southland Young People Aged 15−24 Years by Cause ............................... 446

Table 159. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Land Transport Injuries in Young People 15−24 Years, South Island DHBs, vs. New Zealand........................................................................................................................ 447

Table 160. Hospital Admissions for Pedestrian and Cyclist Injuries in Young People 15−24 Years by Gender, Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010................................................................................................................... 450

Table 161. Hospital Admissions for Motorbike and Vehicle Occupant Injuries in Young People Aged 15−24 Years by Gender, Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010 ................................................................................. 451

Table 162. Hospital Admissions (2006−2010) and Mortality (2004−2008) from Unintentional Non-Transport Injuries in the South Island DHBs Young People Aged 15−24 Years, vs. New Zealand .................................................................................... 453

Table 163. Hospital Admissions for Falls and Electricity/Fire/Burn Injuires in Young People 15−24 Years by Gender, Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010 ..................................................................................................... 456

Table 164. Hospital Admissions for Injuries Arising from Inanimate and Animate Mechanical Forces in Young People Aged 15−24 Years by Gender, Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010 ............................................... 457

Table 165. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention Unintentional Injuries in Young People ....................................................... 459

Table 166. Teenage Birth Rates by Ethnicity and NZ Deprivation Index Decile, New Zealand 2006−2010 ..................................................................................................... 463

Table 167. Teenage Birth Rates, South Island DHBs vs. New Zealand 2006−2010 ..... 464

Table 168. Local Policy Documents and Evidence-Based Reviews Relevant to the Support of Teenage Parents ........................................................................................ 467

Table 169. Terminations of Pregnancy by Regional Council of Residence, New Zealand 2004−2009 ..................................................................................................... 476

24

Table 170. Terminations of Pregnancy by Healthcare Facility, New Zealand 2003−2009................................................................................................................... 477

Table 171. Local Policy Documents and Evidence-Based Reviews Relevant to Unintentional Pregnancies in Adolescents ................................................................... 478

Table 172. Restrictions Experienced by Children, by the Deprivation Score of their Family, NZ Living Standards Survey 2008 ................................................................... 501

Table 173. Number of Children Aged 0−18 Years Who Were Reliant on a Benefit or Benefit Recipient by Benefit Type, New Zealand April 2000−2011 .......................... 513

Table 174. Number of Children Aged 0−18 Years Who Were Reliant on a Benefit or Benefit Recipient by Benefit Type for Service Centres in the Nelson Marlborough, South Canterbury, Canterbury, and West Coast DHB Catchments, April 2007−2011 .......................................................................................................... 514

Table 175. Number of Children Aged 0−18 Years Who Were Reliant on a Benefit or Benefit Recipient by Benefit Type for Service Centres in the Otago and Southland DHB Catchments, April 2007−2011 ............................................................ 515

Table 176. Hospital Admissions for Conditions with a Social Gradient in Children Aged 0−14 Years (excluding Neonates) by Primary Diagnosis, New Zealand 2006−2010................................................................................................................... 521

Table 177. Mortality from Conditions with a Social Gradient in Children Aged 0−14 Years (excluding Neonates) by Main Underlying Cause of Death, New Zealand 2004−2008................................................................................................................... 522

Table 178. Risk Factors for Hospital Admissions with a Social Gradient in Children Aged 0−14 Years, New Zealand 2006−2010 ............................................................... 527

Table 179. Risk Factors for Mortality with a Social Gradient in Children Aged 0−14 Years, New Zealand 2004−2008 .................................................................................. 528

Table 180. Hospital Admissions for Conditions with a Social Gradient in Children Aged 0−14 Years, South Island DHBs vs. New Zealand 2006−2010 ........................... 529

Table 181. Hospital Admissions for Conditions with a Social Gradient in Children Aged 0−14 Years by Primary Diagnosis, Nelson Marlborough 2006−2010 .................. 530

Table 182. Hospital Admissions for Conditions with a Social Gradient in Children Aged 0−14 Years by Primary Diagnosis, South Canterbury 2006−2010 ...................... 531

Table 183. Hospital Admissions for Conditions with a Social Gradient in Children Aged 0−14 Years by Primary Diagnosis, Canterbury 2006−2010 ................................ 532

Table 184. Hospital Admissions for Conditions with a Social Gradient in Children Aged 0−14 Years by Primary Diagnosis, the West Coast 2006−2010 .......................... 533

Table 185. Hospital Admissions for Conditions with a Social Gradient in Children Aged 0−14 Years by Primary Diagnosis, Otago 2006−2010 ........................................ 534

Table 186. Hospital Admissions for Conditions with a Social Gradient in Children Aged 0−14 Years by Primary Diagnosis, Southland 2006−2010 .................................. 535

Table 187. Mortality from Conditions with a Social Gradient in Children Aged 0–14 Years (excluding Neonates) by Main Underlying Cause of Death, the South Island DHBs 2004−2008 ........................................................................................................ 536

Table 188. Hospital Admissions for Injuries Arising from the Assault, Neglect or Maltreatment of Children 0−14 Years by Ethnicity, NZ Deprivation Index Decile and Gender, New Zealand 2006−2010 ............................................................................... 544

Table 189. Nature of Injury Arising from Assault, Neglect or Maltreatment in Hospitalised Children 0−12 Years by Age Group, New Zealand 2006−2010 ................ 545

25

Table 190. Hospital Admissions for Injuries Arising from the Assault, Neglect, or Maltreatment of Children 0−14 Years, South Island DHBs vs. New Zealand 2006−2010................................................................................................................... 546

Table 191. New Paediatric ASH Codes Developed for the New Zealand Health Sector .......................................................................................................................... 567

Table 192. Weightings Applied to Potentially Avoidable Hospital Admissions by Jackson and Tobias [101] and Subsequently Used by the New Zealand Ministry of Health [299] ................................................................................................................. 568

26

27

INTRODUCTION AND OVERVIEW

28

Introduction and Overview - 29

INTRODUCTION AND OVERVIEW

Introduction

This report is the first of three reports, on the health of children and young people in the South Island, and fits into the reporting cycle as follows:

Year 1 (2011) Health Outcomes

Year 2 (2012) Health Determinants

Year 3 (2013) Disability and Chronic Conditions

While the aim of the two previous reporting cycles was to present an overview of the major issues affecting the health of children and young people in the South Island DHBs individually, this third series, while building on the frameworks developed in the previous two, aims to take a more regional approach to child and youth health needs assessment.

Report Aims and In-Depth Topics The aim of the current report is to provide an overview of the health status of children and young people in the South Island, and to assist those working to improve child and youth health regionally, to utilise all of the available evidence when developing programmes and interventions to address child and youth health need.

In this context, the role primary care plays in preventing a range of avoidable hospital admissions and mortality is crucial, with this year’s in depth topics focusing on the role of primary care in achieving health gains for children and young people. Specifically, the issues considered in this year’s in-depth topics are:

1. Models of Primary Care for Children: This in-depth topic focuses on ambulatory sensitive hospitalisations (ASH) in children, particularly those under 5 years of age. A factor common to many of these admissions is the abrupt nature of their onset. The reasons why primary care may not be addressing these acute conditions and the role of primary care in the management of chronic conditions are examined. The international literature also identifies a number of barriers to optimal service delivery that may impact at the personal or organisational level. Models that attempt to reduce such barriers by improving access, ensuring cultural and language appropriateness, and providing adequate out-of-hours services have been effective in improving services or reducing avoidable hospitalisations. Other models have focused on developing nurse-led services, or better information sharing systems within and between sectors of the health system. The literature also includes funding models that have achieved health gains. How these models could assist with the delivery of more effective primary health care to New Zealand children is discussed.

2. Models of Primary Care for Young People: This in-depth topic begins with a brief overview of the health issues most commonly encountered by New Zealand young people, before exploring the normal developmental milestones which occur during adolescence, and the implications these have for the delivery of primary healthcare. The three most frequent models of primary healthcare available to young people are then reviewed, namely: General Practitioners/Primary Health Organisations, School Based Health Services and Youth One Stop Shops. For each model of care, a brief description of the degree to which it has been implemented in the New Zealand context is provided, before the findings of any local evaluations are reviewed. Each section concludes with a brief review of the overseas literature, which seeks to identify evidence of effective service delivery, or guidance as to how optimal services might be developed. The review concludes with a brief discussion of the implications of these findings for the delivery of primary healthcare to young people in New Zealand.

Introduction and Overview - 30

Report Sections and Indicators As previously, this report is based on the Indicator Framework developed during the first cycle of DHB reporting, with the majority of indicators in the Individual and Whanau Health and Wellbeing stream being updated in this year’s edition. Within this stream, each of the indicators in this year’s report has been assigned to one of three main sections as follows:

Issues More Common in Infancy: This section considers issues more common during the first year of life, and includes indicators such as Fetal Deaths, Preterm Birth, Infant Mortality and Sudden Unexpected Death in Infancy (SUDI), and Breastfeeding.

Issues More Common in Children, or Common in both Children and Young People: This section, which focuses on issues more common to children or to both children and young people, is further subdivided into three sub-sections: Total and Avoidable Morbidity and Mortality, Infectious and Respiratory Diseases (including Upper and Lower Respiratory Tract Conditions and Infectious Diseases) and Other Issues (including Injuries in Children, Oral Health and Permanent Hearing Loss).

Issues More Common in Young People: This stream reviews a number of conditions more common in young people including The Most Frequent Causes of Hospital Admissions and Mortality, Injuries, Teenage Births and Terminations of Pregnancy.

The Children’s Social Health Monitor The Children’s Social Health Monitor is updated again in this year’s report, with a view to determining how children are faring in the current economic climate. Issues reviewed include: Economic Indicators: GDP, Income Inequality, Child Poverty, Unemployment Rates and Number of Children Reliant on Benefit Recipients; and Child Wellbeing Indicators: Hospital Admissions and Mortality with a Social Gradient, Infant Mortality, and Hospital Admissions for Injuries Arising from Assault in Children.

Evidence-Based Approaches to Intervention As previously, each of the sections in this year’s report concludes with a brief overview of local policy documents and evidence-based reviews which consider population level approaches to the prevention or management of the issue under review. Appendix 1 provides an overview of the methodology used to develop these reviews. As previously, the quality and depth of evidence available varies considerably from indicator to indicator.

Data Quality Issues and the Signalling of Statistical Significance For a number of conditions in this report, hospital admission rates for South Island Māori and European children appear much more similar than in other parts of New Zealand. While this may potentially suggest that disparities between Māori and European children are less in the South Island than elsewhere, it may also potentially signal an issue with the quality of the ethnicity data in the National Minimum Dataset. Caution is thus urged when interpreting the local ethnic specific rates presented in this report, as there is a real possibility that Māori children are being undercounted in the figures presented.

As previously Appendix 2 outlines the rationale for the use of statistical significance testing in this report and Appendix 4 to Appendix 9 contain information on the data sources used to develop each indicator. Readers are urged to be aware of the contents of these Appendices when interpreting any information in this report. (Note: As outlined in Appendix 2, in order to assist the reader to determine whether tests of statistical significance have been used in a particular section, the significance of the associations presented has been signalled in the text with the words significant, or not significant in italics. Where the words significant or not significant do not appear in the text, then the associations described do not imply statistical significance or non-significance).

Overview of the Health Status of Children and Young People in the South Island

While it is hoped that a regional approach will serve to enhance the utility of this report for regional planning purposes, the need for a consistent approach to monitoring over time means that the way the data are presented is very similar to previous years. Thus the table

Introduction and Overview - 31

which follows provides a brief overview of each of the indicators in this year’s report, including their distribution nationally and within the South Island DHBs.

While it is possible to consider each of these issues individually, when considering which should be awarded the highest priority in future regional planning, a number of the approaches to prioritising health need outlined below may provide useful starting points:

Regional Comparative Approach: One possible approach to prioritising health need is to consider those areas where the South Island DHBs differ from the New Zealand average. A brief perusal of the tables which follow however, suggests for many conditions (e.g. hospitalisations for bronchiolitis in infants, and pneumonia, asthma and skin infections in children) rates in the South Island DHBs are significantly lower than the New Zealand rate. Similarly ambulatory sensitive hospitalisations and admissions for gastroenteritis in children were also significantly lower than the New Zealand rate in all South Island DHBs except Southland, where rates were significantly higher. Hospital admissions for land transport injuries in children however, were significantly higher than the New Zealand rate in all South Island DHBs except Canterbury, while admissions for young people were significantly higher in all South Island DHBs except Canterbury and Otago.

An Inequalities Approach: An alternative approach to prioritisation would be to consider those issues for which ethnic or socioeconomic disparities were most marked. A brief review of the tables which follow however, suggests that differences between Māori and European children and young people in hospital admissions for many conditions were not marked. While this may potentially indicate smaller regional ethnic disparities, it may also signal that Māori children and young people are being undercounted in local hospital admission data, and this should be taken into account when interpreting the ethnic specific data presented in this report.

An Absolute Approach: Another approach to prioritisation is to consider those issues which, irrespective of regional or ethnic inequalities, made the greatest contributions to hospital admissions and mortality in the region. A brief perusal of the tables which follow suggests that in the South Island DHBs during the past 5 years, injuries (particularly from land transport injuries) and neoplasms were common causes of mortality for children and young people. Suicide, however, also claimed the lives of a large number of young people. In terms of hospital admissions, injuries again made a significant contribution to morbidity for both children and young people, although infectious and respiratory conditions were prominent for children, and reproductive health issues (particularly admissions for labour and delivery) were important for young people.

Consideration of Areas of Unmet Need: Finally, it is important to remember that hospital admission and mortality data does not fully capture all of the issues experienced by children and young people. In particular, there is a paucity of information on children and young people with disabilities and mental health issues, with the 2009 and 2010 reports suggesting that there may be considerable unmet need in these areas. Thus, in addition to the approaches outlined above, it is also necessary to consider whether similar areas of unmet need exist in the South Island DHBs, and if so, to consider the needs of these children and young people when allocating resources for future service development.

Conclusions In addition to providing an overview of the health status of children and young people in the South Island, this report aims to provide an entry point into the policy and evidence-based review literatures, so that child and youth health needs can be addressed in a systematic and evidence-based manner. In undertaking this task, it is suggested that DHBs combine the epidemiological data in this report, with knowledge of existing services and local stakeholders’ views. In addition, any approaches developed need to be congruent with current Ministry of Health policy, and the evidence contained in the current literature. Finally, for those developing new approaches in areas where there is currently no sound evidence base, the plea is that they build into their programmes an evaluation arm, so that learning gained can be used by others to enhance the wellbeing of children and young people and to ensure the best use of available resources.

Intr

odu

ctio

n a

nd

Ove

rvie

w -

32

Table

1. O

verv

iew

of

the H

ealth S

tatu

s o

f C

hild

ren a

nd Y

oung P

eople

in t

he S

outh

Isla

nd D

HB

s

Ind

ica

tor

New

Ze

ala

nd

Dis

trib

utio

n a

nd

Tre

nd

s

So

uth

Isla

nd

Dis

trib

utio

n a

nd

Tre

nd

s

Issue

s M

ore

Co

mm

on in

In

fancy

Reg

iona

l B

irth

s

In

Ne

w

Ze

ala

nd

, 4

6.4

%

of

ne

wb

orn

b

ab

ies

reg

iste

red

du

rin

g

201

0

we

re

Eu

rop

ean

, 2

9.2

% w

ere

M

āo

ri,

11.5

% w

ere

A

sia

n/In

dia

n,

an

d 1

1.2

% w

ere

P

acific

. W

hile

7.0

1%

we

re b

orn

to m

oth

ers

ag

ed

<2

0 y

ea

rs,

29

.1%

we

re b

orn

to

m

oth

ers

a

ge

d

35

+

ye

ars

. In

a

dd

itio

n,

15.0

%

we

re

bo

rn

into

th

e

lea

st

de

pri

ve

d (N

ZD

ep

d

ecile

1

–2

) a

rea

s,

wh

ile 2

7.1

% w

ere

b

orn

in

to th

e m

ost

de

pri

ve

d (

NZ

De

p d

ecile

9–

10

) a

rea

s.

In t

he

So

uth

Isla

nd

du

rin

g 2

00

0–

20

10

, th

e n

um

be

r of

live

bir

ths r

eg

iste

red

an

nu

ally

va

ried

, w

ith

num

be

rs i

ncre

asin

g i

n N

els

on

Ma

rlb

oro

ug

h,

Can

terb

ury

, th

e

West

Coast,

a

nd

So

uth

lan

d,

bu

t re

main

ing

m

ore

sta

tic

in

So

uth

C

an

terb

ury

an

d O

tago

. D

uri

ng 2

01

0,

the

pro

po

rtio

n o

f E

uro

pe

an

bab

ies b

orn

w

as h

igh

er

tha

n t

he

New

Ze

ala

nd

ra

te i

n a

ll o

f th

e S

ou

th I

sla

nd

DH

Bs,

wh

ile

the

p

rop

ort

ion

of

Mā

ori

, P

acific

a

nd

A

sia

n/I

nd

ian

b

abie

s

wa

s

low

er.

T

he

p

rop

ort

ion o

f b

ab

ies b

orn

in

to t

he

most

de

pri

ve

d (

NZ

Dep

de

cile

9-1

0)

are

as

wa

s m

uch

lo

we

r th

an t

he

New

Ze

ala

nd r

ate

in

Nels

on

Ma

rlb

oro

ug

h,

So

uth

C

an

terb

ury

, C

an

terb

ury

, O

tag

o

an

d

Sou

thla

nd.

In

the

West

Coa

st,

th

e

pro

po

rtio

n (

wh

ile s

till

low

er)

wa

s c

lose

r to

th

e N

ew

Ze

ala

nd

ra

te.

Fe

tal D

ea

ths

In

New

Z

ea

lan

d

du

rin

g

200

4–

200

8,

unsp

ecifie

d

cau

se

wa

s

the

most

fre

qu

en

tly lis

ted

fe

tal

cau

se

of

inte

rmed

iate

fe

tal

dea

ths (I

FD

), fo

llow

ed

b

y

extr

em

e i

mm

atu

rity

/lo

w b

irth

we

igh

t. C

ong

en

ita

l a

nd

ch

rom

osom

al

ano

malie

s

als

o m

ad

e a

sig

nific

an

t co

ntr

ibu

tio

n.

Of

IFD

s w

ith

a m

ate

rna

l ca

use

lis

ted

, th

e

mo

st

fre

que

nt

ca

use

s w

ere

pla

cen

ta p

rae

via

/ s

epa

ratio

n/h

ae

mo

rrh

age

and

ch

orio

am

nio

nitis

. U

nsp

ecifie

d c

ause

wa

s a

lso

th

e m

ost

fre

qu

en

tly l

iste

d f

eta

l ca

use

of

late

feta

l de

ath

s (

LF

D),

fo

llow

ed

by m

aln

utr

itio

n/s

low

fe

tal

gro

wth

. C

on

ge

nita

l a

nd

ch

rom

osom

al

an

om

alie

s

ag

ain

m

ad

e

a

sig

nific

ant

co

ntr

ibu

tio

n.

Of

LF

Ds w

ith

a m

ate

rna

l ca

use

lis

ted

, th

e m

ost

fre

qu

en

t cau

ses

we

re

pla

ce

nta

p

rae

via

/

sepa

ration

/

ha

em

orr

hag

e

/ o

the

r a

no

ma

ly,

an

d

co

mp

ressio

n o

f th

e u

mb

ilical co

rd.

In t

he

So

uth

Isla

nd

du

ring

200

0–

200

8,

larg

e y

ea

r to

ye

ar

va

ria

tio

ns (

like

ly a

s

the

re

sult o

f sm

all

num

be

rs)

ma

de

tre

nd

s i

n I

FD

an

d L

FD

ra

tes d

ifficult t

o

inte

rpre

t D

urin

g 20

04–

20

08

, w

hile

th

ere

w

as s

om

e re

gio

na

l va

ria

bili

ty,

IFD

a

nd

LF

D r

ate

s w

ere

no

t sig

nific

an

tly d

iffe

ren

t fr

om

th

e N

ew

Ze

ala

nd

ra

te i

n

an

y o

f th

e S

ou

th Isla

nd

DH

Bs.

Du

rin

g

20

04–

20

08

, e

xtr

em

e

imm

atu

rity

/lo

w

bir

th

we

igh

t,

co

ng

enita

l a

nd

ch

rom

oso

mal

an

om

alie

s a

nd

un

spe

cifie

d c

ause

s w

ere

fre

qu

en

tly l

iste

d f

eta

l ca

use

s o

f IF

Ds.

Of

tho

se

IF

Ds w

hic

h h

ad

a m

ate

rnal

cau

se

lis

ted

, fr

eq

uen

t ca

use

s w

ere

pla

ce

nta

pra

evia

/ o

the

r p

lace

nta

l a

nom

alie

s,

inco

mp

ete

nt

ce

rvix

/

pre

ma

ture

ru

ptu

re

of

the

m

em

bra

nes

an

d

ch

ori

oa

mn

ion

itis

. U

nsp

ecifie

d

ca

use

s,

intr

au

terin

e h

yp

oxia

an

d c

on

ge

nia

l a

nd

ch

rom

oso

ma

l a

nom

alie

s w

ere

a

lso

co

mm

on

fe

tal

ca

use

s of

LF

Ds.

Of

tho

se

LF

Ds w

hic

h h

ad

a

m

ate

rna

l ca

use

lis

ted

, fr

eq

ue

nt

ca

use

s

we

re

pla

cen

ta

pra

evia

/

oth

er

pla

ce

nta

l a

no

ma

lies a

nd

com

pre

ssio

n o

f th

e u

mb

ilica

l co

rd .

Intr

odu

ctio

n a

nd

Ove

rvie

w -

33

Ind

ica

tor

New

Ze

ala

nd

Dis

trib

utio

n a

nd

Tre

nd

s

So

uth

Isla

nd

Dis

trib

utio

n a

nd

Tre

nd

s

Pre

term

Bir

th

In N

ew

Ze

ala

nd

du

rin

g 2

00

0–2

01

0,

pre

term

bir

th r

ate

s w

ere

re

lative

ly s

tatic.

Duri

ng

2

00

6–

201

0,

pre

term

b

irth

ra

tes w

ere

sig

nific

an

tly h

igh

er

for

male

s,

Mā

ori

>

A

sia

n/I

nd

ian

, E

uro

pe

an

a

nd

P

acific

b

abie

s,

those

b

orn

in

to m

ore

d

ep

rive

d (

NZ

Dep

decile

6–

10)

are

as,

an

d b

ab

ies b

orn

to

you

ng

er

(<2

5 y

ea

rs)

or

old

er

(35+

ye

ars

) m

oth

ers

.

In N

els

on

M

arl

bo

rou

gh

, p

rete

rm b

irth

ra

tes d

eclin

ed

du

ring

th

e m

id-2

000

s,

with

ra

tes b

ein

g l

ow

er

tha

n t

he

New

Ze

ala

nd

ra

te f

or

the

ma

jority

of

20

00

–2

01

0,

wh

ile in S

ou

th C

ante

rbury

, ra

tes e

xh

ibite

d a

flu

ctu

atin

g u

pw

ard

tre

nd

. In

C

an

terb

ury

, th

e W

est

Coast,

Ota

go

an

d S

ou

thla

nd

ra

tes f

luctu

ate

d,

with

ra

tes

in O

tag

o b

ein

g c

on

sis

ten

tly h

igh

er

than

th

e N

ew

Ze

ala

nd

ra

te,

an

d r

ate

s in

the

oth

er

thre

e D

HB

s be

ing

sim

ilar

(alth

oug

h in

S

ou

thla

nd

ra

tes w

ere

h

ighe

r d

uri

ng t

he m

id-2

00

0s).

In

Nels

on

Ma

rlb

oro

ugh

a

nd

Ota

go

du

rin

g

20

00

–20

10

, th

ere

w

ere

no

co

nsis

ten

t d

iffe

rences in

p

rete

rm bir

th ra

tes be

twe

en

M

āo

ri a

nd E

uro

pe

an

ba

bie

s,

altho

ugh

in S

ou

th C

an

terb

ury

, th

e W

est

Coa

st

and S

ou

thla

nd,

rate

s

we

re h

igh

er

for

Mā

ori

th

an

fo

r E

uro

pe

an

b

abie

s du

ring

th

e la

te 20

00s.

In

ad

ditio

n,

pre

term

b

irth

ra

tes

in

So

uth

C

an

terb

ury

a

nd

West

Coa

st

Mā

ori

b

ab

ies

incre

ase

d

du

rin

g

this

p

erio

d,

alth

oug

h

it

is

uncle

ar

wh

eth

er

this

re

flecte

d cha

nge

s in

e

thnic

ity co

din

g o

r re

al

incre

ase

s in

th

e in

cid

ence

o

f p

rete

rm b

irth

.

Infa

nt

Mo

rta

lity

an

d

Su

dd

en U

ne

xp

ecte

d

Dea

th in

In

fan

cy

(SU

DI)

Neo

na

tal

an

d P

ost

Neo

na

tal

Mo

rta

lity:

In N

ew

Z

ea

lan

d d

uri

ng

1

990

–20

08,

ne

on

ata

l an

d p

ost

ne

ona

tal

mo

rtalit

y b

oth

declin

ed

. N

eo

na

tal

mo

rtalit

y w

as

hig

he

r fo

r P

acific

and

Mā

ori

> E

uro

pe

an

> A

sia

n/I

nd

ian

infa

nts

du

rin

g t

he la

te

19

90s,

alth

oug

h e

thn

ic d

iffe

ren

ces w

ere

le

ss co

nsis

ten

t d

uri

ng

th

e 2

00

0s.

Po

st

ne

on

ata

l m

ort

alit

y

wa

s

hig

he

r fo

r M

āo

ri

>

Pa

cific

>

E

uro

pe

an

a

nd

Asia

n/I

ndia

n

infa

nts

th

rough

ou

t 19

96–

20

08

. D

urin

g

20

04

–2

008

, b

oth

o

utc

om

es w

ere

als

o s

ignific

an

tly h

igh

er

for

male

s,

tho

se

in

ave

rag

e-t

o-m

ore

d

ep

rive

d a

reas,

pre

term

in

fan

ts a

nd

th

ose

with

yo

ung

er

mo

the

rs.

SU

DI:

In

New

Ze

ala

nd

, S

UD

I d

eclin

ed

du

rin

g t

he

late

19

90s–

ea

rly 2

00

0s,

bu

t

be

cam

e m

ore

sta

tic a

fte

r 2

00

2–

03.

Whe

n b

roke

n d

ow

n b

y s

ub

-typ

e,

SID

S

de

ath

s

declin

ed

du

ring

1

996

–2

008

, w

hile

th

ose

du

e

to

su

ffo

ca

tio

n

or

str

ang

ula

tion

in

be

d

be

cam

e

mo

re

pro

min

ent

as

the

peri

od

p

rog

ressed

. D

uri

ng

2

00

4–

200

8,

SU

DI

wa

s

hig

hest

in

infa

nts

4

–7

we

eks

of

ag

e.

Su

ffo

ca

tion

/ str

an

gu

latio

n i

n b

ed

a

cco

un

ted

fo

r 57

.1%

of

all

SU

DI

de

ath

s i

n

tho

se

age

d 0

–3

we

eks a

nd

36

.8%

of

SU

DI

de

ath

s i

n t

ho

se a

ge

d 4

–7 w

ee

ks.

SU

DI

wa

s

als

o

sig

nific

an

tly

hig

he

r fo

r M

āo

ri

>

Pa

cific

>

E

uro

pe

an

>

A

sia

n/I

ndia

n i

nfa

nts

, th

ose

fro

m a

ve

rage

-to

-mo

re d

ep

rive

d (

NZ

Dep

decile

3–

10

) a

rea

s, p

rete

rm in

fan

ts, a

nd

th

ose

wh

ose

mo

the

rs w

ere

<3

0 y

ea

rs o

f a

ge

.

Neo

na

tal an

d P

ost

Neo

na

tal M

ort

alit

y:

In t

he S

ou

th I

sla

nd

DH

Bs d

urin

g 2

00

4–

20

08

, con

ge

nital a

no

malie

s a

nd

extr

em

e p

rem

atu

rity

we

re f

req

ue

nt

ca

use

s o

f n

eo

nata

l m

ort

alit

y,

alth

ou

gh

in

trau

terin

e/b

irth

a

sp

hyxia

a

lso

m

ad

e

a

co

ntr

ibu

tio

n i

n s

om

e D

HB

s.

SU

DI

an

d co

nge

nita

l an

om

alie

s w

ere

fr

eq

ue

nt

ca

use

s

of

post

ne

ona

tal

mo

rta

lity.

While

th

ere

w

ere

re

gio

nal

va

ria

tio

ns,

ne

on

ata

l m

ort

alit

y r

ate

s w

ere

no

t sig

nific

antly d

iffe

ren

t fr

om

th

e N

ew

Ze

ala

nd

rate

in

an

y o

f th

e D

HB

s.

Po

st

ne

on

ata

l m

ort

alit

y r

ate

s w

ere

lo

we

r th

an

the

New

Ze

ala

nd

ra

te in

Nels

on

Ma

rlb

oro

ug

h,

Can

terb

ury

, S

outh

Can

terb

ury

an

d

Ota

go

, a

lth

oug

h o

nly

in

th

e c

ase

of

Nels

on

Ma

rlb

oro

ug

h a

nd

Can

terb

ury

did

th

ese

diffe

rences r

each

sta

tistica

l sig

nific

ance

. S

imila

rly,

wh

ile h

igh

er,

rate

s in

So

uth

lan

d w

ere

not

sig

nific

an

tly d

iffe

rent

from

the

Ne

w Z

ea

lan

d r

ate

.

SU

DI:

In

th

e

So

uth

Is

lan

d

DH

Bs

du

ring

1

99

6–

20

08

, la

rge

ye

ar

to

ye

ar

va

ria

tio

ns m

ad

e p

recis

e i

nte

rpre

tatio

n o

f S

UD

I tr

en

ds d

ifficult,

alth

oug

h r

ate

s

in N

els

on

Ma

rlb

oro

ugh

, C

an

terb

ury

an

d O

tag

o e

xh

ibite

d a

ge

ne

ral d

ow

nw

ard

tr

en

d.

In C

ante

rbu

ry a

nd

Ota

go

du

rin

g 2

004

–20

08

, S

UD

I ra

tes w

ere

lo

we

r th

an

th

e N

ew

Ze

ala

nd

ra

te,

alth

ou

gh o

nly

in

the

ca

se

of

Cante

rbu

ry d

id t

hese

diffe

ren

ce

s r

each

sta

tistica

l sig

nific

ance

. S

UD

I ra

tes i

n S

ou

thla

nd

we

re n

ot

sig

nific

an

tly d

iffe

rent

from

th

e N

ew

Ze

ala

nd

ra

te,

wh

ile in

Nels

on M

arl

bo

rou

gh

an

d S

ou

th C

an

terb

ury

sm

all

nu

mb

ers

pre

clu

ded

a v

alid

com

pa

riso

n.

No

SU

DI

de

ath

s o

ccu

rre

d in

th

e W

est

Co

ast d

urin

g t

his

pe

rio

d.

Intr

odu

ctio

n a

nd

Ove

rvie

w -

34

Ind

ica

tor

New

Ze

ala

nd

Dis

trib

utio

n a

nd

Tre

nd

s

So

uth

Isla

nd

Dis

trib

utio

n a

nd

Tre

nd

s

Bre

astfe

edin

g

In N

ew

Ze

ala

nd d

urin

g J

un

e 2

00

4–2

011

, th

e p

rop

ort

ion

of

ba

bie

s e

xclu

siv

ely

o

r fu

lly b

rea

stf

ed

re

ma

ined

fa

irly

sta

tic,

with

ra

tes i

n t

he

ye

ar

en

din

g J

une

20

11

be

ing

66

.3%

at

<6

we

eks,

54

.9%

at

3 m

on

ths a

nd

25

.2%

at

6 m

on

ths.

Exclu

siv

e/fu

ll b

rea

stfe

edin

g ra

tes a

t <

6 w

ee

ks w

ere

co

nsis

ten

tly h

igh

er

for

Eu

rop

ean

/Oth

er

ba

bie

s t

ha

n f

or

ba

bie

s o

f o

the

r e

thn

ic g

rou

ps.

At

3 a

nd

6

mo

nth

s h

ow

eve

r, r

ate

s w

ere

ge

ne

rally

hig

he

r E

uro

pe

an

/Oth

er

> A

sia

n/In

dia

n

> M

āo

ri a

nd P

acific

ba

bie

s,

with

diffe

ren

ces b

etw

ee

n A

sia

n/In

dia

n a

nd

Mā

ori

a

nd

Pacific

ba

bie

s incre

asin

g a

s t

he

pe

rio

d p

rog

resse

d.

In

Nels

on

M

arl

bo

roug

h

an

d

Ota

go

d

uri

ng

Ju

ne

2

00

4–2

01

1,

exclu

siv

e/f

ull

bre

astf

eed

ing ra

tes at

<6 w

ee

ks a

nd 3

mo

nth

s w

ere

hig

he

r th

an

th

e N

ew

Z

ea

lan

d r

ate

, w

hile

ra

tes i

n S

ou

th C

an

terb

ury

an

d S

ou

thla

nd

we

re s

imila

r.

Rate

s in

th

e W

est

Co

ast

incre

ased

, w

ith

ra

tes b

ein

g h

ighe

r th

an

th

e N

ew

Z

ea

lan

d

rate

d

urin

g

the

la

te

20

00

s,

wh

ile

rate

s

in

Can

terb

ury

g

rad

ually

d

eclin

ed

, b

eco

min

g s

imila

r to

th

e N

ew

Ze

ala

nd

ra

te d

urin

g t

he

la

te 2

00

0s.

In

Nels

on

M

arl

bo

rou

gh

, C

an

terb

ury

, O

tag

o

an

d

So

uth

land

d

uri

ng

20

11

, b

rea

stf

eed

ing

ra

tes at

all

thre

e a

ges w

ere

lo

we

r fo

r b

ab

ies fr

om

th

e m

ost

de

pri

ve

d (

NZ

Dep

de

cile

10

vs.

1)

are

as.

Sim

ilar

patt

ern

s w

ere

se

en

in

So

uth

C

an

terb

ury

a

t <

6 w

ee

ks a

nd 3

m

on

ths,

alth

ou

gh

in

th

e W

est

Coast

sm

all

nu

mbe

rs p

reclu

de

d a

va

lid c

om

pa

rison

. In

Nels

on

Ma

rlb

oro

ug

h,

Cante

rbu

ry,

So

uth

C

an

terb

ury

, O

tago

a

nd

S

ou

thla

nd

d

uri

ng

2

00

4–

201

1,

bre

astfe

edin

g

rate

s a

t all

thre

e a

ge

s w

ere

hig

he

r fo

r E

uro

pe

an

/Oth

er

bab

ies t

ha

n f

or

Mā

ori

b

ab

ies.

In t

he

West

Co

ast h

ow

eve

r, e

thnic

diffe

rences w

ere

le

ss c

on

sis

ten

t.

Issue

s M

ore

Co

mm

on in

Child

ren

or

in C

hild

ren

and

Yo

un

g P

eo

ple

To

tal a

nd

Avoid

able

Mo

rbid

ity a

nd

Mo

rta

lity

Mo

st

Fre

qu

en

t C

au

ses o

f H

ospita

l A

dm

issio

n a

nd

M

ort

alit

y in

Ch

ildre

n

In N

ew

Ze

ala

nd

du

rin

g 2

006

–2

01

0,

inju

ry/p

ois

on

ing

an

d g

astr

oen

teritis w

ere

th

e m

ost

fre

que

nt

rea

so

ns fo

r a

cu

te h

osp

ita

l a

dm

issio

ns in

child

ren

, w

hile

n

eo

pla

sm

s/c

he

mo

the

rap

y/r

ad

ioth

era

py

an

d

inju

ry/p

ois

on

ing

w

ere

th

e

mo

st

fre

qu

en

t re

aso

ns f

or

arr

ang

ed a

dm

issio

ns.

Den

tal

pro

ce

du

res a

nd

gro

mm

ets

w

ere

th

e m

ost

fre

qu

en

t re

asons f

or

a w

aitin

g lis

t a

dm

issio

n.

Duri

ng

20

04

–2

00

8,

ne

op

lasm

s w

ere

th

e m

ost

fre

qu

en

t ca

use

of

mo

rtalit

y i

n

ch

ildre

n

ag

ed

1

–1

4

ye

ars

, fo

llow

ed

b

y

co

nge

nita

l a

no

ma

lies

an

d

ve

hic

le

occu

pa

nt

tra

nspo

rt in

jurie

s.

In t

he

So

uth

Isla

nd

DH

Bs d

uri

ng

20

06

–2

010

, in

jury

/pois

onin

g,

acu

te u

pp

er

resp

ira

tory

tra

ct

infe

ction

s a

nd g

astr

oen

teritis w

ere

th

e m

ost

fre

qu

en

t re

aso

ns

for

an

acu

te

hosp

ita

l a

dm

issio

n

in

ch

ildre

n.

Neop

lasm

s/c

hem

oth

era

py/

rad

ioth

era

py,

inju

ry/p

ois

on

ing

, d

en

tal co

nditio

ns a

nd

meta

bolic

dis

ord

ers

we

re

the

mo

st

freq

ue

nt

rea

son

s f

or

arr

ang

ed

ad

mis

sio

ns,

wh

ile d

en

tal

pro

ce

du

res,

gro

mm

ets

, to

nsill

ecto

my +

/− a

de

no

idecto

my a

nd

mu

scu

loske

leta

l p

roce

du

res

we

re t

he

mo

st

fre

qu

en

t re

aso

ns f

or

a w

aitin

g l

ist

ad

mis

sio

n.

Durin

g 2

004

–2

00

8,

ne

op

lasm

s,

co

nge

nita

l a

no

ma

lies,

tra

nsp

ort

inju

rie

s (

ve

hic

le o

ccup

ant

an

d p

ede

str

ian

) a

nd

d

row

nin

g/s

ub

me

rsio

n w

ere

a

mo

ng

th

e m

ost

fre

que

nt

ca

use

s o

f m

ort

alit

y in

child

ren

ag

ed

1–

14 y

ea

rs.

Am

bu

lato

ry S

ensitiv

e

Hosp

ita

lisa

tio

ns

(AS

H)

In N

ew

Z

ea

lan

d d

urin

g 2

00

6–

20

10,

ga

str

oe

nte

ritis,

acute

up

pe

r re

sp

ira

tory

in

fection

s a

nd

asth

ma

we

re t

he

mo

st

fre

que

nt

ca

use

s o

f A

SH

in

ch

ildre

n 0

–4

ye

ars

w

he

n

em

erg

en

cy

dep

art

me

nt

(ED

) case

s

we

re

inclu

de

d,

wh

ile

ga

str

oe

nte

ritis,

de

nta

l con

ditio

ns a

nd a

sth

ma

we

re t

he

mo

st

fre

qu

en

t cau

se

s

wh

en

ED

case

s w

ere

exclu

ded

. W

hen

bro

ke

n d

ow

n b

y a

ge,

AS

H r

ate

s w

ere

h

igh

est

in in

fan

ts a

nd

o

ne

ye

ar

old

s,

with

ra

tes th

en

ta

pe

rin

g o

ff ra

pid

ly

be

twe

en

on

e a

nd

tw

o y

ea

rs,

an

d t

he

n a

ga

in b

etw

ee

n f

ou

r an

d s

eve

n y

ea

rs o

f a

ge

. A

SH

ra

tes w

ere

als

o sig

nific

antly h

igh

er

for

male

s,

Pa

cific

> M

āo

ri >

A

sia

n/I

ndia

n >

Eu

rop

ean

child

ren

and

th

ose

fro

m a

ve

rag

e-t

o-m

ore

de

prive

d

(NZ

Dep

de

cile

3–

10

) a

reas.

Sim

ilar

pa

tte

rns w

ere

se

en

wh

en

ED

ca

se

s w

ere

e

xclu

de

d,

altho

ugh

ad

mis

sio

n r

ate

s f

or

Asia

n/I

ndia

n w

ere

sig

nific

an

tly l

ow

er

tha

n fo

r E

uro

pe

an

child

ren

.

Am

on

gst

the

S

ou

th

Isla

nd

D

HB

s

du

rin

g

200

0–2

01

0,

ED

in

clu

de

d

and

exclu

de

d

AS

H

rate

s

in

ch

ildre

n

0–

4

ye

ars

d

iffe

red

ve

ry

little

, p

ote

ntia

lly

su

gge

stin

g t

ha

t th

e w

ay t

he

So

uth

Isla

nd

DH

Bs a

re m

an

ag

ing

/co

din

g t

heir

ED

ca

se

s

diffe

rs

from

so

me

oth

er

DH

Bs.

In

Nels

on

M

arl

bo

roug

h,

Sou

th

Can

terb

ury

an

d O

tago

AS

H r

ate

s w

ere

rela

tive

ly s

tatic,

wh

ile i

n C

an

terb

ury

a

nd

the

West

Coast

rate

s e

xh

ibite

d a

flu

ctu

ating

do

wn

wa

rd t

ren

d.

In c

ontr

ast,

ra

tes i

n S

ou

thla

nd

decre

ase

d d

uri

ng

th

e e

arl

y 2

00

0s,

bu

t ra

pid

ly i

ncre

ased

ag

ain

afte

r 2

00

6-0

7.

In C

an

terb

ury

, A

SH

ra

tes w

ere

hig

he

r fo

r P

acific

ch

ildre

n

tha

n fo

r ch

ildre

n o

f o

the

r e

thn

ic g

rou

ps.

While

A

SH

ra

tes w

ere

h

igh

er

for

Mā

ori

ch

ildre

n

tha

n

for

Eu

rop

ea

n

child

ren

in

N

els

on

M

arl

bo

rou

gh

an

d

So

uth

lan

d d

urin

g t

he m

id-l

ate

20

00

s,

eth

nic

diffe

ren

ces i

n S

ou

th C

an

terb

ury

, th

e W

est

Coa

st

and

Ota

go

were

le

ss c

on

sis

ten

t. I

n C

an

terb

ury

, O

tag

o a

nd

So

uth

lan

d d

urin

g 2

00

6–2

01

0,

AS

H w

ere

ge

ne

rally

hig

he

r in

win

ter

an

d s

pri

ng

, a

lth

ou

gh

in

Nels

on

Ma

rlb

oro

ug

h,

So

uth

C

an

terb

ury

an

d

the

W

est

Coast

se

aso

nal va

riatio

ns w

ere

less e

vid

en

t .

Intr

odu

ctio

n a

nd

Ove

rvie

w -

35

Ind

ica

tor

New

Ze

ala

nd

Dis

trib

utio

n a

nd

Tre

nd

s

So

uth

Isla

nd

Dis

trib

utio

n a

nd

Tre

nd

s

Upp

er

Re

sp

irato

ry T

ract

Cond

itio

ns

Acu

te U

pp

er

Resp

ira

tory

Tra

ct

Infe

ctio

ns a

nd

T

on

sill

ecto

my

Acu

te U

pp

er

Resp

ira

tory

In

fectio

ns:

In N

ew

Ze

ala

nd

du

rin

g 2

00

6–2

010

, a

cute

u

pp

er

resp

ira

tory

tra

ct

infe

ction

s (

UR

TI)

of

mu

ltip

le/u

nspe

cifie

d s

ite

s w

ere

th

e

mo

st

fre

qu

en

t re

aso

n

for

an

U

RT

I a

dm

issio

n

in

ch

ildre

n,

follo

we

d

by

cro

up/a

cu

te

lary

ng

itis

/tra

che

itis

. U

RT

I a

dm

issio

ns

we

re

mo

st

com

mon

in

in

fants

an

d on

e ye

ar

old

s,

with

ra

tes ta

pe

rin

g off

ra

pid

ly th

ere

afte

r. R

ate

s

we

re

als

o

sig

nific

an

tly

hig

her

for

ma

les,

Pa

cific

>

M

āo

ri

>

Eu

rop

ean

>

A

sia

n/I

ndia

n c

hild

ren a

nd t

hose

in

ave

rag

e-t

o-m

ore

de

prive

d (

NZ

Dep

de

cile

4

–1

0)

are

as.

To

nsill

ecto

my:

In N

ew

Ze

ala

nd

du

rin

g 2

00

6–2

010

, ch

ron

ic t

on

sill

itis

wa

s t

he

m

ost

freq

ue

nt

prim

ary

dia

gn

osis

in

ch

ildre

n

adm

itte

d

to

ho

spital

for

ton

sill

ecto

my +

/− a

de

no

ide

cto

my,

acco

un

ting

fo

r 6

0.1

% o

f a

ll a

dm

issio

ns.

Hyp

ert

rop

hy

of

the

to

nsils

/ad

en

oid

s

wa

s

the

se

co

nd

le

ad

ing

dia

gn

osis

, fo

llow

ed

by s

leep

apn

oea

. A

dm

issio

ns incre

ase

d d

urin

g t

he p

re-s

ch

oo

l ye

ars

, to

re

ach

th

eir

hig

he

st

poin

t at

fou

r ye

ars

of

ag

e in

Eu

rop

ean a

nd

Asia

n/I

ndia

n

ch

ildre

n,

at

five

ye

ars

of

age i

n M

āo

ri c

hild

ren

, an

d a

t six

ye

ars

of

ag

e i

n

Pa

cific

ch

ildre

n.

Ove

rall,

adm

issio

ns w

ere

sig

nific

antly h

ighe

r fo

r E

uro

pe

an

>

Mā

ori

>

A

sia

n/I

ndia

n a

nd

P

acific

ch

ildre

n,

and

sig

nific

an

tly lo

we

r fo

r th

ose

livin

g in

the

le

ast d

epri

ve

d (

NZ

Dep

decile

1)

are

as.

Acu

te U

pp

er

Resp

irato

ry I

nfe

ctio

ns:

In C

ante

rbu

ry a

nd t

he

West

Coast

du

ring

20

00

–2

010

, ho

spital

ad

mis

sio

ns f

or

UR

TI

in c

hild

ren

de

clin

ed

, w

hile

in S

ou

th

Can

terb

ury

adm

issio

ns i

ncre

ase

d.

In c

on

trast,

ra

tes i

n N

els

on M

arl

bo

rou

gh,

Ota

go

and

So

uth

lan

d f

luctu

ate

d f

rom

ye

ar

to y

ea

r. I

n C

an

terb

ury

adm

issio

ns

we

re

hig

he

r fo

r P

acific

>

E

uro

pe

an

>

A

sia

n/In

dia

n

ch

ildre

n,

altho

ugh

d

iffe

ren

ce

s f

or

Mā

ori

child

ren w

ere

mo

re v

ari

ab

le.

In t

he

oth

er

So

uth

Isla

nd

DH

Bs,

no

con

sis

ten

t d

iffe

rence

s w

ere

se

en

b

etw

ee

n M

āo

ri a

nd

E

uro

pea

n

ch

ildre

n. A

dm

issio

ns in

all

DH

Bs w

ere

hig

he

st d

urin

g th

e c

oo

ler

mo

nth

s.

To

nsill

ecto

my:

In

Nels

on

M

arl

bo

rou

gh

a

nd

S

ou

th

Cante

rbu

ry,

arr

ang

ed

/ w

aitin

g

list

ad

mis

sio

ns

for

ton

sill

ecto

my

+/−

a

de

no

idecto

my

in

ch

ildre

n

flu

ctu

ate

d d

uri

ng t

he

ea

rly-m

id 2

00

0s,

bu

t in

cre

ase

d r

ap

idly

aft

er

20

06

–0

7.

In

Can

terb

ury

ad

mis

sio

ns d

eclin

ed

du

rin

g t

he

ea

rly-2

00

0s,

rea

ch

ed

the

ir l

ow

est

po

int

in 2

00

2–0

3 a

nd

th

en

gra

du

ally

in

cre

ased

aga

in,

wh

ile in

th

e W

est

Coast

rate

s e

xh

ibite

d a

d

ow

nw

ard

tr

en

d.

In O

tag

o,

adm

issio

ns in

cre

ased

ra

pid

ly

du

rin

g t

he m

id-l

ate

20

00s,

wh

ile i

n S

outh

lan

d,

ad

mis

sio

ns d

ecre

ased

du

ring

the

ea

rly 2

000

s,

bu

t in

cre

ase

d a

ga

in a

fte

r 2

00

4–0

5.

In C

an

terb

ury

ad

mis

sio

ns

we

re g

en

era

lly h

ighe

r fo

r E

uro

pe

an

an

d M

āo

ri c

hild

ren

th

an

fo

r P

acific

and

Asia

n/I

ndia

n c

hild

ren

, w

hile

in N

els

on

Ma

rlb

oro

ug

h,

So

uth

Can

terb

ury

, O

tago

a

nd

S

ou

thla

nd

, ra

tes

we

re

ge

ne

rally

hig

he

r fo

r E

uro

pe

an

th

an

fo

r M

āo

ri

ch

ildre

n. In

th

e W

est

Co

ast

how

eve

r, e

thn

ic d

iffe

rence

s w

ere

le

ss c

onsis

ten

t.

Mid

dle

Ea

r C

on

ditio

ns:

Otitis

Me

dia

an

d G

rom

me

ts

In

New

Z

ea

lan

d

du

rin

g

2006

–2

010

, o

titis

me

dia

w

as

the

m

ost

fre

que

nt

pri

ma

ry d

iagn

osis

in t

hose

adm

itte

d a

cu

tely

with

con

ditio

ns o

f th

e m

iddle

ea

r a

nd

ma

sto

id,

as w

ell

as f

or

tho

se

ad

mitte

d s

em

i-acu

tely

/fro

m t

he

wa

itin

g l

ist

for

the inse

rtio

n o

f g

rom

me

ts.

Acu

te a

dm

issio

ns f

or

otitis m

ed

ia w

ere

hig

he

st

in i

nfa

nts

an

d o

ne

ye

ar

old

s,

with

ra

tes d

eclin

ing

rap

idly

th

ere

aft

er.

Rate

s w

ere

hig

he

r fo

r M

āo

ri a

nd

Pacific

>

Eu

rop

ea

n >

Asia

n/I

nd

ian

child

ren

du

rin

g t

he

first

fou

r ye

ars

, a

lth

oug

h e

thn

ic

diffe

ren

ce

s w

ere

less c

onsis

ten

t th

ere

afte

r. I

n c

on

tra

st, a

rra

ng

ed/w

aitin

g l

ist

ad

mis

sio

ns f

or

the

inse

rtio

n o

f g

rom

me

ts w

ere

re

lative

ly in

fre

qu

ent

du

ring

the

firs

t ye

ar

of

life,

bu

t in

cre

ase

d r

ap

idly

th

ere

aft

er.

Rate

s r

ea

ch

ed

th

eir

hig

hest

po

int

in E

uro

pe

an

child

ren

a

t o

ne

ye

ar,

in

M

āo

ri ch

ildre

n a

t tw

o ye

ars

, in

A

sia

n/I

ndia

n c

hild

ren

at

fou

r ye

ars

an

d in

Pa

cific

ch

ildre

n a

t six

ye

ars

of

ag

e.

Ove

rall,

du

rin

g t

he

fir

st

fou

r ye

ars

ad

mis

sio

ns w

ere

hig

he

r fo

r E

uro

pe

an

and

Mā

ori

> P

acific

> A

sia

n/In

dia

n c

hild

r en

, w

hile

aft

er

six

ye

ars

, a

dm

issio

ns w

ere

h

igh

er

for

Pa

cific

> M

āo

ri >

Euro

pe

an >

Asia

n/I

ndia

n c

hild

ren.

In th

e S

ou

th Is

land

d

uri

ng 20

06

–20

10

, o

titis m

ed

ia w

as th

e m

ost

fre

qu

en

t p

rim

ary

dia

gn

osis

in t

hose

adm

itte

d a

cu

tely

with

con

ditio

ns o

f th

e m

iddle

ea

r a

nd

ma

sto

id,

as w

ell

as f

or

tho

se

ad

mitte

d s

em

i-acu

tely

/fro

m t

he

wa

itin

g l

ist

for

the inse

rtio

n o

f g

rom

me

ts.

In N

els

on

Ma

rlb

oro

ug

h,

the

West

Coast,

Can

terb

ury

, S

outh

Can

terb

ury

an

d

Ota

go

, acu

te a

dm

issio

ns f

or

otitis m

ed

ia w

ere

lo

we

r th

an

th

e N

ew

Ze

ala

nd

ra

te,

alth

oug

h o

nly

in

Nels

on M

arl

bo

roug

h a

nd

So

uth

Cante

rbu

ry d

id t

he

se

diffe

ren

ce

s r

ea

ch

sta

tistical sig

nific

ance

. R

ate

s in

So

uth

lan

d w

ere

sig

nific

antly

hig

he

r th

an

th

e N

ew

Ze

ala

nd r

ate

. In

co

ntr

ast, g

rom

me

ts a

dm

issio

ns w

ere

sig

nific

an

tly

low

er

tha

n

the

New

Z

ea

lan

d

rate

in

th

e

West

Coast

and

C

an

terb

ury

, b

ut

sig

nific

antly

hig

he

r in

S

ou

th

Can

terb

ury

, O

tag

o

and

So

uth

lan

d, a

nd s

imila

r in

Ne

lso

n M

arl

bo

rou

gh

.

In C

an

terb

ury

, g

rom

me

ts a

dm

issio

ns w

ere

g

en

era

lly h

ighe

r fo

r P

acific

an

d

Mā

ori

>

E

uro

pe

an

>

A

sia

n/In

dia

n

child

ren

, w

hile

in

th

e

West

Coa

st

and

So

uth

lan

d a

dm

issio

ns w

ere

g

en

era

lly h

ighe

r fo

r M

āo

ri th

an

fo

r E

uro

pea

n

ch

ildre

n.

In O

tag

o (

with

th

e e

xce

ptio

n o

f 2

010

) a

dm

issio

ns w

ere

hig

he

r fo

r E

uro

pe

an

th

an

fo

r M

āo

ri child

ren

, w

hile

in

N

els

on

M

arl

boro

ug

h an

d S

ou

th

Can

terb

ury

eth

ni c

diffe

ren

ce

s w

ere

le

ss c

onsis

tent.

Intr

odu

ctio

n a

nd

Ove

rvie

w -

36

Ind

ica

tor

New

Ze

ala

nd

Dis

trib

utio

n a

nd

Tre

nd

s

So

uth

Isla

nd

Dis

trib

utio

n a

nd

Tre

nd

s

Lo

we

r R

esp

irato

ry T

ract

Cond

itio

ns

Bro

nchio

litis

In N

ew

Ze

ala

nd

du

rin

g 2

00

0–

20

10,

bro

nchio

litis

adm

issio

ns r

em

ain

ed

sta

tic

du

rin

g t

he

ea

rly-m

id 2

000

s,

bu

t th

en

incre

ase

d b

etw

ee

n 2

00

6–

07

an

d 2

008

–0

9.

On

a

ve

rag

e

du

rin

g

200

0–

200

8,

on

e

infa

nt

each

ye

ar

die

d

from

b

ron

ch

iolit

is.

Durin

g 2

00

6–

201

0,

bro

nchio

litis

a

dm

issio

ns w

ere

sig

nific

an

tly

hig

he

r fo

r m

ale

s,

Pa

cific

> M

āo

ri >

Eu

rop

ea

n >

Asia

n/In

dia

n in

fants

an

d t

hose

fro

m a

ve

rag

e-t

o-m

ore

dep

rived

(N

ZD

ep

de

cile

3–

10

) a

reas.

In e

ach o

f th

e S

outh

Isla

nd D

HB

s d

urin

g 2

00

6–

20

10,

bro

nch

iolit

is a

dm

issio

ns

in i

nfa

nts

we

re s

ign

ific

an

tly l

ow

er

tha

n t

he

New

Ze

ala

nd

rate

. In

Can

terb

ury

d

uri

ng

20

00

–2

010

, a

dm

issio

ns w

ere

hig

he

r fo

r P

acific

> M

āo

ri >

Eu

rop

ea

n >

A

sia

n/I

ndia

n in

fan

ts,

alth

oug

h in

th

e W

est

Coa

st

no

con

sis

ten

t diffe

ren

ce

s

we

re se

en

b

etw

ee

n M

āo

ri a

nd

E

uro

pe

an

in

fan

ts.

In N

els

on

M

arl

bo

roug

h,

So

uth

Cante

rbu

ry,

Ota

go

an

d S

ou

thla

nd

, w

hile

eth

nic

diffe

ren

ces w

ere

no

t co

nsis

ten

t, a

dm

issio

ns w

ere

hig

he

r fo

r M

āo

ri in

fan

ts t

ha

n f

or

Eu

rop

ean

in

fan

ts

in a

num

be

r o

f ye

ars

. A

dm

issio

ns h

ow

eve

r, w

ere

hig

he

r d

uri

ng w

inte

r an

d

ea

rly s

pr in

g in

all

So

uth

Isla

nd D

HB

s.

Pn

eu

mo

nia

In N

ew

Ze

ala

nd

, b

acte

ria

l /

no

n-v

ira

l /

unsp

ecifie

d p

ne

um

on

ia a

dm

issio

ns i

n

ch

ildre

n d

eclin

ed

du

rin

g 2

000

–2

00

7.

A s

mall

upsw

ing

in

ra

tes w

as e

vid

en

t in

2

00

8–0

9,

be

fore

ra

tes d

eclin

ed

aga

in i

n 2

01

0.

Sim

ilar

patt

ern

s w

ere

se

en f

or

yo

un

g

pe

ople

. In

co

ntr

ast,

vir

al

pn

eu

mo

nia

ad

mis

sio

ns

incre

ase

d

in

bo

th

ch

ildre

n a

nd y

ou

ng p

eop

le,

with

th

e m

ost

rap

id incre

ases in c

hild

ren

occu

rrin

g

be

twe

en

20

04

–05

and

200

8–

09

.

Pn

eu

mo

nia

ad

mis

sio

ns (

bo

th t

yp

es)

we

re h

igh

est

in o

ne

ye

ar

old

s,

with

th

e

ne

xt

hig

he

st

rate

s b

ein

g in

in

fan

ts <

1 y

ea

r. M

ort

alit

y w

as h

ighe

st

in infa

nts

< 1

ye

ar.

Ad

mis

sio

ns f

or

ba

cte

ria

l /

no

n-v

ira

l /

unsp

ecifie

d p

ne

um

on

ia i

n c

hild

ren

we

re a

lso

sig

nific

an

tly h

igh

er

for

ma

les,

Pacific

>

M

āo

ri >

A

sia

n/I

nd

ian

>

E

uro

pe

an

child

ren

an

d t

ho

se

in

ave

rag

e–m

ore

de

pri

ve

d (

NZ

Dep

de

cile

3–1

0)

are

as.

Fo

r yo

un

g p

eop

le,

adm

issio

ns w

ere

sig

nific

antly h

igh

er

for

Pacific

>

Mā

ori

> E

uro

pe

an

>A

sia

n/In

dia

n y

ou

ng

pe

op

le,

an

d t

hose

in a

ve

rag

e-t

o-m

ore

d

ep

rive

d (

NZ

Dep

decile

5–

10)

are

as.

Ad

mis

sio

ns f

or

vira

l p

ne

um

onia

we

re

hig

he

r fo

r P

acific

> M

āo

ri >

Eu

rop

ean

and

Asia

n/In

dia

n c

hild

ren

an

d t

ho

se

in

ave

rag

e-t

o-m

ore

dep

rive

d (

NZ

Dep

decile

6–1

0)

are

as.

In a

ll o

f th

e S

ou

th I

sla

nd

DH

Bs d

urin

g 2

00

6–

20

10

, ho

spita

l a

dm

issio

ns f

or

ba

cte

ria

l/n

on

-vir

al/un

sp

ecifie

d p

ne

um

onia

in

ch

ildre

n w

ere

sig

nific

an

tly l

ow

er

tha

n th

e N

ew

Z

ea

lan

d ra

te.

While

ad

mis

sio

ns in

yo

un

g pe

op

le w

ere

a

lso

low

er

tha

n t

he N

ew

Ze

ala

nd

ra

te,

on

ly i

n C

an

terb

ury

, S

ou

th C

an

terb

ury

and

Ota

go

did

th

ese

d

iffe

rences

reach

sta

tistical

sig

nific

an

ce.

Sim

ilarly,

wh

ile

ad

mis

sio

ns f

or

vir

al

pne

um

on

ia i

n c

hild

ren

we

re l

ow

er

tha

n t

he

New

Ze

ala

nd

rate

in a

ll D

HB

s,

on

ly i

n t

he

ca

se

of

Nels

on

Ma

rlb

oro

ug

h,

Ca

nte

rbu

ry,

Ota

go

an

d S

ou

thla

nd

did

th

ese

diffe

ren

ces r

ea

ch s

tatistica

l sig

nific

an

ce.

In

Can

terb

ury

d

uri

ng

2

000

–2

010

, a

dm

issio

ns

for

ba

cte

ria

l/n

on

-vir

al/

un

spe

cifie

d p

neu

mon

ia w

ere

hig

he

r fo

r P

acific

> M

āo

ri a

nd

Eu

rop

ean

> A

sia

n/

Ind

ian

child

ren

a

nd

yo

un

g

pe

op

le,

wh

ile

in

Nels

on

M

arl

bo

rou

gh

, S

ou

th

Can

terb

ury

, th

e

West

Coa

st

an

d

So

uth

lan

d

the

re

we

re

no

con

sis

ten

t d

iffe

ren

ce

s i

n a

dm

issio

ns b

etw

ee

n M

āo

ri a

nd

Eu

rop

ea

n c

hild

ren

an

d y

ou

ng

p

eo

ple

. A

dm

issio

ns in

Ota

go

we

re h

igh

er

for

Mā

ori

th

an

fo

r E

uro

pe

an

ch

ildre

n

an

d

yo

ung

p

eop

le.

Ad

mis

sio

ns

for

vir

al

and

b

acte

ria

l/n

on

-vir

al/un

spe

cifie

d

pn

eum

onia

we

re h

igh

er

in w

inte

r a

nd

ea

rly s

pri

ng

in

all

DH

Bs.

Asth

ma

In N

ew

Ze

ala

nd

du

rin

g 2

00

0–2

01

0,

asth

ma a

dm

issio

ns i

n c

hild

ren

gra

du

ally

in

cre

ased

, w

hile

adm

issio

ns i

n y

ou

ng

pe

ople

we

re m

ore

sta

tic a

fte

r 2

00

4–

20

05

. O

n a

ve

rage

d

uri

ng

2

00

0–

200

8,

five

ch

ildre

n o

r you

ng

p

eop

le ea

ch

ye

ar,

d

ied

fr

om

a

sth

ma.

Duri

ng

2

00

6–2

01

0,

ad

mis

sio

ns

we

re

rela

tive

ly

infr

equ

en

t d

urin

g i

nfa

ncy b

ut

incre

ase

d r

apid

ly t

he

rea

fte

r, r

ea

ch

ing

a p

eak a

t 2

ye

ars

of

ag

e.

In c

on

trast,

asth

ma

dea

ths w

ere

mo

st

fre

quen

t a

mo

ng

st

tho

se

in

th

eir

la

te t

een

s a

nd

ea

rly t

we

nties.

Asth

ma

adm

issio

ns in

ch

ildre

n w

ere

als

o

sig

nific

an

tly h

ighe

r fo

r m

ale

s,

Pa

cific

>

M

āo

ri >

A

sia

n/Ind

ian

>

E

uro

pe

an

ch

ildre

n a

nd

th

ose

liv

ing i

n ave

rag

e-t

o-m

ore

dep

rive

d (

NZ

Dep

decile

3–

10)

are

as.

In co

ntr

ast,

asth

ma

ad

mis

sio

ns

in

yo

un

g

pe

ople

w

ere

sig

nific

an

tly

hig

he

r fo

r fe

ma

les,

Pacific

an

d

Mā

ori

>

E

uro

pe

an

>

A

sia

n/I

ndia

n

yo

un

g

pe

op

le,

an

d th

ose

in a

ve

rage

-to

-mo

re d

ep

rive

d (

NZ

De

p d

ecile

4–

10

) a

rea

s.

In e

ach

of

the

Sou

th I

sla

nd D

HB

s d

urin

g 2

006

–2

01

0,

asth

ma

ad

mis

sio

ns i

n

ch

ildre

n w

ere

sig

nific

an

tly lo

we

r th

an t

he

Ne

w Z

ea

lan

d r

ate

. W

hile

adm

issio

ns

in y

ou

ng

peo

ple

we

re a

lso

lo

we

r th

an

the

New

Ze

ala

nd

ra

te in

all

DH

Bs,

on

ly

in

Nels

on

M

arl

bo

rou

gh,

Ca

nte

rbu

ry,

Ota

go

a

nd

S

ou

thla

nd

did

th

ese

diffe

ren

ce

s re

ach

sta

tistical

sig

nific

an

ce

. In

C

an

terb

ury

d

uri

ng

2

00

0–

20

10,

ad

mis

sio

ns w

ere

ge

ne

rally

hig

he

r fo

r P

acific

> M

āo

ri >

Eu

rop

ean

> A

sia

n/

Ind

ian

ch

ildre

n a

nd

yo

un

g p

eo

ple

, w

hile

in N

els

on

Ma

rlb

oro

ug

h,

Ota

go

an

d

So

uth

lan

d

asth

ma

a

dm

issio

ns

we

re

ge

ne

rally

h

igh

er

for

Mā

ori

th

an

fo

r E

uro

pe

an

ch

ildre

n a

nd

yo

ung

pe

op

le.

Eth

nic

diffe

ren

ce

s i

n S

ou

th C

an

terb

ury

a

nd

the

West

Coa

st

we

re le

ss c

onsis

ten

t fr

om

ye

ar

to y

ea

r.

Intr

odu

ctio

n a

nd

Ove

rvie

w -

37

Ind

ica

tor

New

Ze

ala

nd

Dis

trib

utio

n a

nd

Tre

nd

s

So

uth

Isla

nd

Dis

trib

utio

n a

nd

Tre

nd

s

Bro

nchie

cta

sis

In

New

Z

ea

land

, h

ospita

l a

dm

issio

ns fo

r ch

ildre

n a

nd

you

ng

pe

op

le

with

bro

nch

iecta

sis

in

cre

ase

d d

urin

g t

he

ea

rly 2

000

s,

reache

d a

pe

ak i

n 2

00

4–

05

an

d t

he

n d

eclin

ed

, w

ith

six

ch

ildre

n o

r yo

un

g p

eo

ple

ha

vin

g b

ron

chie

cta

sis

lis

ted

as th

eir

m

ain

un

de

rlyin

g cau

se

o

f d

ea

th du

ring

20

00

–20

08

. D

uri

ng

20

06

–2

010

, a

dm

issio

ns in

cre

ase

d r

ap

idly

aft

er

the

fir

st

ye

ar

of

life

, w

ith

ra

tes

rem

ain

ing

e

leva

ted d

urin

g child

ho

od

, b

ut

dro

pp

ing

a

wa

y a

mo

ngst

tho

se

in

th

eir

te

en

s a

nd

ea

rly t

we

ntie

s.

Ad

mis

sio

ns w

ere

als

o s

ign

ific

an

tly h

igh

er

for

Pa

cific

> M

āo

ri >

Asia

n/In

dia

n >

Eu

rop

ea

n c

hild

ren

an

d y

ou

ng

pe

ople

and

th

ose

in

ave

rag

e-t

o-m

ore

de

prive

d (

NZ

De

p d

ecile

3–

10)

are

as.

In N

els

on

Ma

rlb

oro

ug

h,

So

uth

Can

terb

ury

, C

an

terb

ury

, th

e W

est

Coast

an

d

Ota

go

du

rin

g 2

00

0–

20

10

, la

rge

ye

ar

to y

ea

r va

ria

tion

s (

as t

he

re

sult o

f sm

all

nu

mbe

rs)

mad

e t

rend

s i

n h

osp

ita

l a

dm

issio

ns f

or

ch

ildre

n a

nd

yo

ung

pe

ople

w

ith

b

ron

chie

cta

sis

d

ifficu

lt

to

inte

rpre

t.

In

So

uth

land

ho

we

ve

r,

rate

s

incre

ased

, w

ith

th

e m

ost

rap

id i

ncre

ases b

ein

g s

ee

n b

etw

ee

n 2

006

–0

7 a

nd

20

08

–0

9.

Du

rin

g 2

00

6–

20

10

, a

dm

issio

ns w

ere

sig

nific

an

tly lo

we

r th

an

th

e

New

Z

ea

lan

d ra

te in

N

els

on

Ma

rlb

oro

ug

h,

Cante

rbu

ry an

d O

tag

o,

wh

ile in

S

ou

thla

nd a

dm

issio

n ra

tes w

ere

sim

ilar.

S

ma

ll n

um

be

rs pre

clu

de

d a

va

lid

an

aly

sis

in

S

ou

th

Can

terb

ury

, w

hile

n

o

ad

mis

sio

ns

occu

rre

d

in

the

W

est

Coa

st d

uri

ng

this

pe

rio

d.

Infe

ctio

us D

ise

ases

Pe

rtu

ssis

In

New

Z

ea

lan

d

du

rin

g

20

00

–2

010

, h

osp

ita

l a

dm

issio

ns

for

pe

rtu

ssis

in

in

fants

fluctu

ate

d,

with

p

ea

ks

occu

rrin

g

in

200

0

an

d

20

04

. A

dm

issio

ns

rea

che

d t

he

ir l

ow

est

poin

t in

20

07

, w

ith

ra

tes i

ncre

asin

g g

rad

ua

lly t

he

rea

fte

r.

Duri

ng

th

e e

arl

y-m

id 2

00

0s o

ne

in

fan

t e

ach

ye

ar

die

d f

rom

pe

rtu

ssis

, alth

ou

gh

no

de

ath

s

occu

rred

du

rin

g

20

06

–2

00

8.

Duri

ng

2

00

6–

20

10,

pe

rtussis

a

dm

issio

ns

we

re

hig

hest

in

infa

nts

<

1

yea

r,

with

ra

tes

de

clin

ing

rapid

ly

the

rea

fte

r.

Sim

ilarl

y,

du

rin

g

20

04

–2

008

, a

ll p

ert

ussis

d

ea

ths

occu

rre

d

in

infa

nts

<1

ye

ar.

Ad

mis

sio

n r

ate

s w

ere

als

o s

ign

ific

an

tly h

ighe

r fo

r P

acific

and

M

āo

ri

>

Eu

rop

ea

n

>

Asia

n/In

dia

n

infa

nts

a

nd

th

ose

fr

om

m

ore

d

ep

rive

d

(NZ

Dep

decile

5–1

0)

are

as.

In

the

S

ou

th

Isla

nd

d

urin

g

20

00

–2

01

0,

the

re

we

re

larg

e

ye

ar

to

ye

ar

flu

ctu

atio

ns i

n h

ospital

adm

issio

ns f

or

pe

rtu

ssis

in

in

fants

age

d <

1 y

ea

r in

all

DH

Bs.

Duri

ng

20

06

–20

10

, adm

issio

ns w

ere

lo

we

r th

an

th

e N

ew

Ze

ala

nd

ra

te

in N

els

on

Ma

rlb

oro

ug

h,

Cante

rbu

ry,

Ota

go

an

d S

outh

lan

d,

alth

ou

gh

on

ly i

n

Can

terb

ury

did

th

ese

diffe

ren

ce

s r

each

sta

tistica

l sig

nific

ance

. S

ma

ll n

um

be

rs

pre

clu

ded

a v

alid

co

mp

ari

so

n in

th

e W

est C

oast

and

So

uth

Ca

nte

rbu

ry.

Me

nin

go

coccal

Dis

ease

In N

ew

Ze

ala

nd

, ho

spita

l a

dm

issio

ns f

or

me

nin

go

cocca

l dis

ease

in

child

ren

an

d y

ou

ng

pe

op

le d

eclin

ed

ra

pid

ly d

uri

ng

the

ea

rly-m

id 2

00

0s,

bu

t b

ecam

e

mo

re sta

tic a

fte

r 2

006

–07

. S

imila

r p

atte

rns w

ere

se

en

fo

r m

ort

alit

y d

urin

g

20

00

–2

008

, a

ltho

ugh

th

e n

um

be

r o

f d

ea

ths i

n 2

00

8 w

as h

igh

er

tha

n i

n t

he

pre

vio

us f

ou

r ye

ars

. A

dm

issio

ns a

nd

mort

alit

y w

ere

bo

th h

igh

est

for

infa

nts

<1

ye

ar.

Duri

ng

200

6–2

01

0,

ad

mis

sio

ns w

ere

als

o s

ign

ific

an

tly h

igh

er

for

ma

les,

Pa

cific

a

nd M

āo

ri>

Eu

rop

ea

n >

Asia

n/I

ndia

n child

ren

a

nd yo

un

g p

eop

le a

nd

tho

se

fro

m m

ore

de

pri

ve

d (

NZ

Dep

decile

5–1

0)

are

as.

In t

he

So

uth

Isla

nd d

urin

g 2

000

–2

010

, ho

spita

l a

dm

issio

ns f

or

men

ingo

cocca

l d

isea

se

in

ch

ildre

n a

nd

yo

ung

pe

ople

decre

ased

in

all D

HB

s.

Duri

ng

20

06

–2

01

0,

adm

issio

ns

we

re

sig

nific

an

tly

low

er

tha

n

the

N

ew

Z

ea

land

ra

te

in

Nels

on

M

arl

bo

rou

gh

a

nd

Can

terb

ury

, w

hile

in

S

ou

thla

nd

ra

tes

we

re

sig

nific

an

tly h

ighe

r. In

th

e W

est

Coast,

S

ou

th C

ante

rbu

ry a

nd

O

tag

o ra

tes

we

re n

ot

sig

nific

an

tly d

iffe

ren

t fr

om

th

e N

ew

Ze

ala

nd

ra

te.

Tu

be

rcu

losis

In N

ew

Ze

ala

nd

, h

ospita

l a

dm

issio

ns f

or

tub

erc

ulo

sis

in

ch

ildre

n a

nd

yo

ung

pe

op

le d

eclin

ed

aft

er

200

2–

03,

alth

oug

h a

sm

all

upsw

ing

in

ra

tes w

as e

vid

en

t in

20

10

. D

uri

ng

200

6–2

01

0,

ad

mis

sio

ns w

ere

hig

hest

am

on

gst

tho

se

in

the

ir

late

te

ens

an

d

ea

rly

twe

ntie

s.

Rate

s

we

re

als

o

sig

nific

an

tly

hig

he

r fo

r A

sia

n/I

ndia

n,

Pacific

an

d M

āo

ri c

hild

ren

an

d y

ou

ng

pe

op

le t

ha

n f

or

Eu

rop

ean

ch

ildre

n a

nd

yo

ung

pe

ople

and

fo

r th

ose f

rom

mo

re d

ep

rive

d (

NZ

Dep d

ecile

5

–1

0)

are

as.

In t

he

Sou

th I

sla

nd d

uri

ng 2

000

–2

010

, sm

all

num

bers

mad

e t

ren

ds in

ho

spital

ad

mis

sio

ns f

or

tub

erc

ulo

sis

in c

hild

ren

an

d y

ou

ng

pe

ople

difficult t

o i

nte

rpre

t.

Duri

ng

20

06

–2

010

, w

hile

adm

issio

ns w

ere

lo

we

r th

an

th

e N

ew

Ze

ala

nd

ra

te in

Nels

on

M

arl

bo

rou

gh

a

nd

C

an

terb

ury

, in

ne

ithe

r case

d

id th

ese

d

iffe

ren

ces

rea

ch

sta

tistical

sig

nific

an

ce

. S

ma

ll nu

mb

ers

pre

clu

ded

a va

lid a

naly

sis

in

S

ou

th C

an

terb

ury

an

d O

tag

o,

wh

ile t

he

re w

ere

no

ad

mis

sio

ns f

or

tube

rculo

sis

in

West

Coast o

r S

ou

thla

nd

child

ren

and

yo

un

g p

eop

le d

uri

ng

th

is p

erio

d.

Intr

odu

ctio

n a

nd

Ove

rvie

w -

38

Ind

ica

tor

New

Ze

ala

nd

Dis

trib

utio

n a

nd

Tre

nd

s

So

uth

Isla

nd

Dis

trib

utio

n a

nd

Tre

nd

s

Acu

te R

he

um

atic

Fe

ve

r a

nd

Rh

eum

atic

Hea

rt D

ise

ase

In N

ew

Ze

ala

nd

, h

osp

ital a

dm

issio

ns f

or

ch

ildre

n a

nd

yo

un

g p

eo

ple

with

acu

te

rhe

um

atic f

eve

r d

eclin

ed g

radu

ally

du

ring

the

ea

rly-m

id 2

000

s,

bu

t in

cre

ase

d

ag

ain

aft

er

200

6–

07

. In

con

tra

st,

ad

mis

sio

ns f

or

tho

se

with

rh

eum

atic h

ea

rt

dis

ea

se

we

re r

ela

tive

ly s

tatic d

uri

ng

th

e m

id-2

00

0s,

alth

ou

gh

a d

ow

nsw

ing

in

rate

s w

as e

vid

en

t in

2

010

. D

uri

ng 2

006

–20

10

, acu

te rh

eu

matic fe

ve

r a

nd

he

art

d

ise

ase

ad

mis

sio

ns

we

re

infr

equ

en

t d

urin

g

infa

ncy,

bu

t in

cre

ased

rap

idly

du

rin

g c

hild

ho

od

, to

re

ach

a p

ea

k a

t 1

1-1

2 y

ea

rs.

Acu

te r

he

um

atic

feve

r a

dm

issio

ns

we

re

sig

nific

an

tly

hig

he

r fo

r m

ale

s,

Pa

cific

>

M

āo

ri

>

Eu

rop

ean

an

d

Asia

n/I

nd

ian

ch

ildre

n

and

yo

ung

p

eo

ple

a

nd

th

ose

fr

om

a

ve

rag

e-t

o-m

ore

d

ep

rive

d

(NZ

Dep

d

ecile

3

–1

0)

are

as.

Rhe

um

atic

he

art

d

isea

se

a

dm

issio

ns

we

re

sig

nific

antly

hig

he

r fo

r fe

ma

les,

Pa

cific

>M

āo

ri

>E

uro

pea

n>

Asia

n/I

ndia

n c

hild

ren

and

yo

ung

pe

ople

an

d t

hose

fro

m a

ve

rag

e-

to-m

ore

dep

rive

d (

NZ

Dep

decile

3–1

0)

are

as.

In C

an

terb

ury

an

d O

tago

du

rin

g 2

006

–20

10

, ho

sp

ital

adm

issio

ns f

or

ch

ildre

n

an

d y

ou

ng

peo

ple

with

acu

te r

he

um

atic f

eve

r a

nd

rh

eum

atic h

eart

dis

ease

we

re s

ignific

an

tly l

ow

er

than

th

e N

ew

Ze

ala

nd

ra

te,

wh

ile i

n t

he W

est

Coa

st

no

ad

mis

sio

ns f

or

eith

er

ou

tco

me

occu

rred

du

ring

this

pe

rio

d,

an

d i

n S

ou

th

Can

terb

ury

sm

all

nu

mb

ers

p

reclu

ded

a

va

lid

an

aly

sis

. R

he

um

atic

he

art

d

isea

se

adm

issio

ns

in

Nels

on

M

arl

bo

rou

gh

an

d

So

uth

lan

d

we

re

als

o

sig

nific

an

tly

low

er

tha

n

the

N

ew

Z

ea

lan

d

rate

, alth

ou

gh

sm

all

num

be

rs

pre

clu

ded

a v

alid

an

aly

sis

fo

r a

cu

te r

heu

matic f

eve

r.

Se

rio

us S

kin

In

fectio

ns

In

New

Z

ea

lan

d

du

rin

g

20

00

–2

010

, h

osp

ital

ad

mis

sio

ns

for

se

rio

us

skin

in

fection

s i

ncre

ase

d i

n b

oth

ch

ildre

n a

nd y

ou

ng p

eop

le.

Du

rin

g 2

006

–20

10

, ce

llulit

is

an

d

cu

tan

eou

s

abscesse

s/fu

runcle

s/c

arb

un

cle

s

we

re

the

m

ost

fre

qu

en

t p

rim

ary

dia

gn

ose

s i

n c

hild

ren

adm

itte

d w

ith

se

rious s

kin

in

fectio

ns,

wh

ile

in

yo

un

g

peo

ple

, cuta

ne

ou

s

abscesse

s/fu

runcle

s/c

arb

un

cle

s

and

ce

llulit

is w

ere

th

e m

ain

re

ason

s f

or

adm

issio

n.

Ad

mis

sio

ns w

ere

hig

hest

in

infa

nts

<1

ye

ar,

with

a s

eco

nd

, sm

alle

r p

eak e

vid

ent

am

ong

st

those

in

th

eir

late

te

en

s a

nd

ea

rly t

we

ntie

s.

Ad

mis

sio

ns in

ch

ildre

n w

ere

sig

nific

antly h

ighe

r fo

r m

ale

s,

Pacific

> M

āo

ri >

Eu

rop

ean

an

d A

sia

n/In

dia

n c

hild

ren

an

d t

ho

se

fro

m

ave

rage

-to

-mo

re

dep

rive

d

(NZ

Dep

d

ecile

3

–1

0)

are

as.

Fo

r yo

ung

pe

op

le,

adm

issio

ns w

ere

sig

nific

an

tly h

ighe

r fo

r P

acific

an

d M

āo

ri >

Eu

rop

ea

n

>

Asia

n/I

ndia

n

yo

un

g

pe

op

le

an

d

tho

se

fr

om

a

ve

rage

-to

-mo

re

de

prive

d

(NZ

Dep

decile

3–1

0)

are

as.

In t

he

Sou

th I

sla

nd

du

rin

g 2

00

0–

201

0,

ho

spital

adm

issio

ns f

or

se

rio

us s

kin

in

fection

s

in

ch

ildre

n

an

d

you

ng

p

eo

ple

in

cre

ase

d

in

all

DH

Bs,

with

th

e

exce

ptio

n o

f th

e W

est

Coa

st, w

he

re a

dm

issio

ns i

n y

ou

ng

pe

op

le d

eclin

ed

, w

hile

a

dm

issio

ns in

ch

ildre

n flu

ctu

ate

d.

Duri

ng

2

00

6–

201

0,

ad

mis

sio

ns in

ch

ildre

n w

ere

sig

nific

an

tly lo

we

r th

an

the

New

Ze

ala

nd

ra

te in

all

So

uth

Isla

nd

DH

Bs.

While

a

dm

issio

ns fo

r yo

un

g p

eop

le w

ere

a

lso

lo

wer

tha

n th

e N

ew

Z

ea

lan

d r

ate

, o

nly

in

Can

terb

ury

, S

ou

th C

an

terb

ury

, O

tag

o a

nd

So

uth

land

did

th

ese

d

iffe

ren

ces

rea

ch

sta

tistica

l sig

nific

an

ce.

In

Ca

nte

rbu

ry,

adm

issio

ns

we

re h

igh

er

for

Pa

cific

> M

āo

ri a

nd

Eu

rop

ea

n >

Asia

n/Ind

ian

ch

ildre

n a

nd

yo

un

g

pe

op

le,

altho

ug

h

in

the

W

est

Coa

st

an

d

Sou

th

Can

terb

ury

n

o

co

nsis

ten

t e

thn

ic d

iffe

ren

ce

s w

ere

se

en

. In

Nels

on M

arl

bo

rou

gh a

dm

issio

ns

we

re

hig

he

r fo

r M

āo

ri

tha

n

for

Eu

rop

ean

ch

ildre

n

and

yo

un

g

pe

op

le

thro

ugh

ou

t 2

000

–2

01

0,

wh

ile in

Ota

go

, a

dm

issio

ns w

ere

hig

he

r fr

om

200

4–

05

on

wa

rds,

and

in S

ou

thla

nd

ra

tes w

ere

hig

he

r du

ring

200

8–10

.

Ga

str

oe

nte

ritis

In N

ew

Z

ea

lan

d,

ga

str

oe

nte

ritis a

dm

issio

ns in

cre

ase

d g

rad

ua

lly d

uri

ng

th

e

ea

rly-m

id 2

00

0s b

ut

be

ca

me s

tatic a

fte

r 2

00

6-0

7 i

n b

oth

ch

ildre

n a

nd y

ou

ng

pe

op

le.

Duri

ng

20

02

–20

08

, on

ave

rag

e o

ne

child

or

yo

ung p

ers

on

pe

r ye

ar

die

d

from

ga

str

oe

nte

ritis.

Duri

ng

2

006

–2

01

0,

adm

issio

ns

we

re

hig

he

st

in

infa

nts

<

1 ye

ar,

w

ith

ra

tes ta

pe

rin

g o

ff ra

pid

ly d

uri

ng th

e p

resch

ool

ye

ars

. M

ort

alit

y w

as a

lso

h

igh

est

in in

fan

ts <

1 ye

ar.

A

dm

issio

ns in

ch

ildre

n w

ere

sig

nific

an

tly h

ighe

r fo

r m

ale

s,

Pa

cific

> A

sia

n/In

dia

n a

nd

Eu

rop

ean

> M

āo

ri

ch

ildre

n

and

th

ose

from

a

ve

rag

e-t

o-m

ore

de

pri

ve

d

(NZ

Dep

d

ecile

4

–1

0)

are

as.

In c

on

trast,

ad

mis

sio

ns i

n y

ou

ng p

eop

le w

ere

sig

nific

an

tly h

igh

er

for

fem

ale

s,

Eu

rop

ean

>

P

acific

a

nd

M

āo

ri >

A

sia

n/In

dia

n yo

un

g p

eop

le,

and

tho

se

fro

m a

ve

rage

-to

-mo

re d

ep

rive

d (

NZ

Dep

decile

4–

10

) are

as.

Duri

ng

2

00

6–2

01

0,

ga

str

oe

nte

ritis a

dm

issio

ns in

child

ren

w

ere

sig

nific

an

tly

low

er

tha

n th

e N

ew

Z

ea

lan

d ra

te in

a

ll o

f th

e S

ou

th Is

lan

d D

HB

s e

xce

pt

So

uth

lan

d,

wh

ere

ad

mis

sio

ns w

ere

sig

nific

an

tly h

igh

er.

Adm

issio

ns i

n y

ou

ng

pe

op

le w

ere

sig

nific

an

tly lo

we

r th

an

the

New

Ze

ala

nd

ra

te in

th

e W

est

Coast,

Can

terb

ury

, a

nd

S

ou

thla

nd

, w

hile

ra

tes

in

Nels

on

Ma

rlb

oro

ug

h,

So

uth

C

an

terb

ury

an

d O

tago

we

re n

ot

sig

nific

antly d

iffe

ren

t fr

om

th

e N

ew

Ze

ala

nd

rate

. In

C

ante

rbu

ry,

adm

issio

ns

we

re

ge

ne

rally

hig

he

r fo

r E

uro

pe

an

and

Pa

cific

> M

āo

ri a

nd

Asia

n/I

ndia

n c

hild

ren a

nd y

ou

ng

peo

ple

, w

hile

in

Nels

on

Ma

rlb

oro

ug

h,

the

West

Coa

st,

O

tag

o a

nd

S

ou

thla

nd ra

tes w

ere

h

igh

er

for

Eu

rop

ean

th

an

fo

r M

āo

ri ch

ildre

n an

d yo

un

g p

eo

ple

. E

thn

ic d

iffe

rences in

S

ou

th

Can

terb

ury

w

ere

le

ss

co

nsis

ten

t.

Adm

issio

ns

we

re

als

o

ge

ne

rally

h

igh

er

in s

prin

g a

nd

ea

rly s

um

me

r in

all

DH

Bs.

Intr

odu

ctio

n a

nd

Ove

rvie

w -

39

Ind

ica

tor

New

Ze

ala

nd

Dis

trib

utio

n a

nd

Tre

nd

s

So

uth

Isla

nd

Dis

trib

utio

n a

nd

Tre

nd

s

Oth

er

Issu

es

Inju

rie

s in

Child

ren

In N

ew

Ze

ala

nd d

urin

g 2

00

6–

20

10

fa

lls,

follo

we

d b

y i

na

nim

ate

mech

anic

al

forc

es w

ere

th

e le

ad

ing

ca

use

s o

f in

jury

ad

mis

sio

ns in

ch

ildre

n,

alth

oug

h

tra

nsp

ort

inju

rie

s a

s a

gro

up

als

o m

ad

e a

sig

nific

an

t co

ntr

ibu

tio

n.

In c

ontr

ast,

accid

enta

l th

rea

ts t

o b

rea

thin

g,

follo

we

d b

y v

ehic

le o

ccu

pan

t in

juri

es w

ere

th

e

lea

din

g c

ause

s o

f child

ho

od

in

jury

mo

rta

lity d

urin

g 2

00

4–

20

08

. D

urin

g 2

00

0–

20

08

, m

ort

alit

y fr

om

la

nd

tr

an

sp

ort

in

jurie

s a

nd u

nin

tention

al

no

n-t

ran

sp

ort

in

jurie

s in

ch

ildre

n b

oth

d

eclin

ed

, w

hile

m

ort

alit

y fr

om

accid

en

tal

thre

ats

to

bre

ath

ing

in

cre

ase

d.

Th

e m

ajo

rity

of

accid

enta

l th

rea

ts t

o b

rea

thin

g d

ea

ths

ho

we

ve

r, o

ccu

rred

in

in

fants

<1

ye

ar,

wh

o w

ere

co

ded

as d

yin

g a

s a

re

su

lt o

f su

ffoca

tio

n/s

tran

gula

tio

n i

n b

ed

, an

d t

hus th

e po

tential

exis

ts fo

r so

me th

e

incre

ases s

een

to

ha

ve

arise

n fro

m a

dia

gn

ostic s

hift in

th

e c

od

ing o

f S

UD

I.

In t

he

Sou

th I

sla

nd

du

rin

g 2

006

–2

010

fa

lls,

follo

we

d b

y in

anim

ate

me

cha

nic

al

forc

es,

we

re t

he

le

adin

g c

ause

s o

f in

jury

ad

mis

sio

ns i

n c

hild

ren

in

all

DH

Bs,

alth

ou

gh

tra

nsp

ort

inju

rie

s a

s a

gro

up

als

o m

ad

e a

sig

nific

an

t co

ntr

ibu

tio

n.

Duri

ng

2

00

4–2

00

8,

accid

enta

l th

rea

ts

to

bre

ath

ing

, ve

hic

le

occup

an

t,

pe

destr

ian

an

d o

the

r tr

an

spo

rt i

nju

ries,

an

d a

ssa

ults w

ere

am

on

g t

he

le

ad

ing

ca

use

s o

f in

jury

mo

rtalit

y in S

ou

th Isla

nd

ch

ildre

n.

Ora

l H

ea

lth

Sch

ool

Den

tal

Se

rvic

e D

ata

: In

N

ew

Z

ea

lan

d d

urin

g 2

00

0–

20

10,

the

%

of

ch

ildre

n ca

ries-f

ree a

t 5 ye

ars

w

as hig

he

r in

a

rea

s w

ith

flu

ori

date

d sch

oo

l w

ate

r su

pplie

s,

wh

ile m

ea

n D

MF

T sco

res a

t 12

ye

ars

w

ere

lo

we

r. D

urin

g

20

03

–2

010

, a

h

igh

er

% o

f E

uro

pe

an

/Oth

er

ch

ildre

n,

than M

āo

ri o

r P

acific

ch

ildre

n w

ere

ca

ries-f

ree

at

5 y

ea

rs,

wh

ile m

ea

n D

MF

T s

co

res a

t 1

2 y

ea

rs

we

re h

igh

er

for

Mā

ori

an

d P

acific

ch

ildre

n t

han

fo

r E

uro

pe

an

/Oth

er

child

ren

.

Den

tal

Carie

s A

dm

issio

ns:

In N

ew

Ze

ala

nd

du

ring

20

06

–2

01

0,

de

nta

l ca

ries

we

re th

e le

ad

ing

re

aso

ns fo

r d

en

tal

ad

mis

sio

ns in

child

ren

0

–4 a

nd

5–

14

ye

ars

. In

co

ntr

ast,

e

mb

ed

ded

/im

pa

cte

d te

eth

w

ere

th

e le

ad

ing

re

aso

ns in

yo

un

g p

eo

ple

15–

24

ye

ars

.

Den

tal

ca

rie

s a

dm

issio

ns i

n c

hild

ren

0–

4 y

ea

rs w

ere

sig

nific

an

tly h

igh

er

for

ma

les,

Pacific

> M

āo

ri >

Asia

n/I

ndia

n >

Eu

rope

an

ch

ildre

n a

nd

tho

se

fro

m

ave

rag

e-t

o-m

ore

de

pri

ve

d (

NZ

De

p d

ecile

2–

10

) a

rea

s,

wh

ile a

dm

issio

ns f

or

ch

ildre

n 5

–14

ye

ars

we

re s

ign

ific

an

tly h

igh

er

for

ma

les,

Mā

ori

an

d P

acific

>

Asia

n/I

ndia

n a

nd

Eu

rop

ean

child

ren

an

d t

ho

se

fro

m a

ve

rag

e-t

o-m

ore

de

prive

d

(NZ

Dep

de

cile

3–1

0)

are

as.

Fo

r yo

un

g p

eo

ple

15

–2

4 y

ea

rs,

ad

mis

sio

ns w

ere

sig

nific

an

tly h

igh

er

for

Eu

rope

an

an

d M

āo

ri >

Pa

cific

> A

sia

n/I

ndia

n y

oun

g

pe

op

le a

nd

tho

se f

rom

mo

re d

ep

rive

d (

NZ

Dep

decile

5–

10

) are

as.

Sch

ool

Den

tal

Se

rvic

e D

ata

: In

th

e S

ou

the

rn D

HB

du

rin

g 2

01

0,

49

.5%

of

5

ye

ar

old

s e

xa

min

ed

by t

he

Sch

ool

De

nta

l S

erv

ice

ha

d a

cce

ss t

o f

luo

rida

ted

Sch

ool

wa

ter,

a

s

com

pa

red

to

0.6

%

in

Can

terb

ury

a

nd

0

%

in

Nels

on

Ma

rlb

oro

ug

h,

So

uth

Ca

nte

rbu

ry a

nd

the

West

Coa

st. I

n a

ll S

ou

th I

sla

nd

DH

Bs

du

rin

g 2

00

3–

20

09

, a

hig

he

r p

rop

ort

ion

of

Eu

rop

ea

n/O

the

r child

ren

th

an

Mā

ori

ch

ildre

n w

ere

ca

ries-f

ree

at

5 y

ea

rs,

wh

ile m

ea

n D

MF

T s

co

res a

t 1

2 y

ea

rs

we

re

hig

he

r fo

r M

āo

ri,

tha

n

for

Eu

rop

ean

/Oth

er

child

ren

. In

N

els

on

Ma

rlb

oro

ug

h d

urin

g 2

00

9,

80

.4%

of

elig

ible

ad

ole

scen

ts (

age

d ≈

13

–18

ye

ars

) w

ere

re

po

rted

as a

cce

ssin

g p

ub

licly

fun

de

d d

en

tal

se

rvic

es,

as c

om

pa

red t

o

76

.5%

in

th

e W

est

Coast,

67

.1%

in

Can

terb

ury

, 8

8.1

% i

n S

ou

th C

an

terb

ury

, 8

3.7

% in

Ota

go

an

d 7

3.7

% in

So

uth

lan

d.

Den

tal

Carie

s

Ad

mis

sio

ns:

Du

rin

g 2

00

6–2

010

, d

enta

l ca

ries w

as th

e

lea

din

g r

easo

n f

or

a d

en

tal

adm

issio

n i

n c

hild

ren

age

d 0

–4

an

d 5

–1

4

ye

ars

in

all

So

uth

Isla

nd

DH

Bs,

wh

ile e

mb

ed

de

d/

imp

acte

d t

eeth

or

den

tal

ca

rie

s

we

re

the

lea

din

g

reaso

ns

for

adm

issio

ns

in

yo

un

g

peo

ple

1

5–2

4

ye

ars

. In

S

outh

land

, h

osp

ita

l a

dm

issio

ns

for

den

tal

ca

ries in

ch

ildre

n 0

–4

an

d 5

–1

4 y

ea

rs a

nd

yo

ung

peo

ple

15–

24 y

ears

w

ere

sig

nific

antly h

ighe

r th

an t

he N

ew

Ze

ala

nd

ra

te.

In a

ll o

f th

e o

ther

So

uth

Isla

nd

DH

Bs h

ow

eve

r, n

o c

onsis

tent

patt

ern

s w

ere

se

en

, w

ith

a

dm

issio

ns in

so

me

a

ge

g

rou

ps b

ein

g sig

nific

antly h

igh

er

tha

n th

e

Ne

w Z

ea

lan

d r

ate

, w

hile

in

oth

ers

ra

tes w

ere

sim

ilar

or

sig

nific

antly

low

er.

Intr

odu

ctio

n a

nd

Ove

rvie

w -

40

Ind

ica

tor

New

Ze

ala

nd

Dis

trib

utio

n a

nd

Tre

nd

s

So

uth

Isla

nd

Dis

trib

utio

n a

nd

Tre

nd

s

Pe

rma

ne

nt

Hea

ring

L

oss

Dea

fness

Notifica

tio

n

Data

ba

se:

In

New

Z

ea

land

du

rin

g

20

10

, 1

20

no

tificatio

ns w

ere

re

ce

ive

d b

y t

he

Dea

fness N

otifica

tio

n D

ata

ba

se

fo

r ch

ildre

n

with

bila

tera

l h

ea

rin

g l

osse

s o

f >

26

dB

in

th

e b

ette

r e

ar

and

60

no

tifica

tion

s

we

re r

ece

ive

d f

or

ch

ildre

n w

ith u

nila

tera

l lo

sses.

Duri

ng

20

10,

15

% o

f ch

ildre

n

no

tifie

d t

o t

he

DN

D h

ad

pro

fou

nd

losse

s,

6%

had

se

ve

re l

osses,

37

% h

ad

mo

de

rate

lo

sse

s a

nd

42

% ha

d m

ild lo

sse

s.

When

u

nila

tera

l, acq

uire

d an

d

ove

rse

as b

orn

cases w

ere

exclu

de

d,

the

ave

rag

e a

ge

at

co

nfirm

atio

n o

f a

he

ari

ng

loss i

n 2

01

0 w

as 5

1 m

on

ths,

alth

ou

gh

the

ave

rag

e a

ge

of

susp

icio

n

wa

s m

uch e

arlie

r (3

1 m

on

ths).

New

bo

rn

Hea

rin

g

Scre

en

ing:

In

New

Z

ea

lan

d

du

ring

1

A

pri

l 2

010

–30

Se

pte

mb

er

20

10

, th

e ca

reg

ive

rs o

f 7

7.8

% o

f e

ligib

le b

ab

ies co

nse

nte

d to

n

ew

bo

rn h

ea

ring

scre

enin

g,

alth

ou

gh

th

i s p

rop

ort

ion

va

ried

by D

HB

. O

f th

ose

co

mp

letin

g s

cre

enin

g 9

4.0

% d

id s

o w

ith

in o

ne

mo

nth

, w

ith

2.4

% o

f b

ab

ies

co

mp

letin

g s

cre

enin

g re

ceiv

ing

a

n au

dio

log

y re

ferr

al. O

f th

ose

ba

bie

s w

ho

p

asse

d

scre

enin

g,

a

furt

he

r 7

.4%

w

ere

d

ee

me

d

to

ha

ve

risk

facto

rs

for

de

laye

d o

nse

t/p

rog

ressiv

e h

eari

ng

lo

ss w

hic

h w

arr

an

ted

follo

w u

p o

ve

r tim

e.

Dea

fness N

otifica

tio

n D

ata

base

: In

th

e S

ou

th Is

land

D

HB

s d

urin

g 2

01

0,

a

tota

l o

f 49

ch

ildre

n w

ere

notified

to

the

De

afn

ess N

otifica

tio

n D

ata

base

.

New

bo

rn H

ea

rin

g S

cre

en

ing

: In

th

e S

ou

th I

sla

nd D

HB

s (

exclu

din

g S

ou

the

rn

DH

B

wh

ere

h

ea

rin

g scre

en

ing

co

mm

ence

d p

art

w

ay th

rou

gh

th

e p

erio

d),

n

ew

bo

rn h

ea

rin

g s

cre

en

ing c

on

sen

t ra

tes r

ang

ed

fro

m 6

0.8

% t

o 9

8.7

%,

with

the

pro

po

rtio

n o

f b

ab

ies b

ein

g r

efe

rre

d f

or

au

dio

log

y a

sse

ssm

en

t ra

ng

ing

fro

m

0%

to 2

.1%

an

d t

he p

rop

ort

ion b

ein

g t

arg

ete

d f

or

follo

w u

p r

an

gin

g f

rom

4.4

%

to 1

0.4

%.

Issue

s M

ore

Co

mm

on in

Yo

ung

Pe

ople

To

tal a

nd

Avoid

able

Mo

rbid

ity a

nd

Mo

rta

lity

Mo

st

Fre

qu

en

t C

au

ses o

f H

ospita

l A

dm

issio

ns a

nd

M

ort

alit

y

In

New

Z

ea

land

d

urin

g

200

6–

201

0,

issu

es

associa

ted

with

p

reg

nan

cy,

de

live

ry

an

d

the

p

ostn

ata

l pe

rio

d

we

re

the

le

ad

ing

re

aso

ns

for

ho

spital

ad

mis

sio

n

in

yo

un

g

pe

ople

. In

te

rms

of

oth

er

ad

mis

sio

n

typ

es,

inju

ry/p

ois

on

ing

an

d a

bd

om

inal/p

elv

ic p

ain

we

re t

he

le

ad

ing

re

ason

s f

or

acu

te

ad

mis

sio

ns,

inju

ry/p

ois

on

ing

a

nd

n

eo

pla

sm

s/c

hem

oth

era

py/r

ad

ioth

era

py th

e

lea

din

g

rea

son

s

for

arr

ang

ed

a

dm

issio

ns,

an

d

muscu

loske

leta

l an

d

ga

str

oin

testin

al

pro

ce

du

res th

e le

ad

ing

re

ason

s fo

r w

aitin

g lis

t a

dm

issio

ns.

Duri

ng

20

04

–2

008

, in

ten

tio

nal

se

lf-h

arm

, ve

hic

le o

ccu

pa

nt

tra

nsp

ort

in

juries

an

d n

eo

pla

sm

s w

ere

th

e l

ead

ing

cau

ses o

f m

ort

alit

y i

n y

ou

ng

pe

op

le a

ged

15

–2

4 y

ea

rs.

In th

e S

ou

th Is

land

d

urin

g 20

06

–20

10

, is

su

es a

ssocia

ted w

ith

p

reg

na

ncy,

de

live

ry

an

d

the

p

ostn

ata

l pe

rio

d

we

re

the

le

ad

ing

re

aso

ns

for

ho

spital

ad

mis

sio

ns i

n y

oun

g p

eo

ple

in

all

DH

Bs.

In t

erm

s o

f o

the

r a

dm

issio

n t

yp

es,

inju

ry/p

ois

on

ing

, m

en

tal

he

alth

is

su

es an

d ab

dom

ina

l/pe

lvic

p

ain

w

ere

th

e

lea

din

g

rea

so

ns

for

acu

te

adm

issio

ns.

Inju

ry/p

ois

on

ing

, n

eop

lasm

/ ch

em

oth

era

py/r

adio

the

rap

y,

me

nta

l h

ealth

is

su

es,

dia

lysis

a

nd

d

en

tal

co

nditio

ns

we

re

fre

qu

ent

rea

so

ns

for

arr

an

ge

d

ad

mis

sio

ns,

wh

ile

ga

str

oin

testin

al,

muscu

loske

leta

l,

an

d

skin

p

roce

du

res,

ton

sill

ecto

my

+/−

a

de

noid

ecto

my a

nd

de

nta

l p

roce

du

res w

ere

fre

qu

en

t re

ason

s f

or

wa

itin

g l

ist

ad

mis

sio

ns.

Durin

g 2

004

–2

00

8,

inte

ntio

na

l se

lf-h

arm

a

nd ve

hic

le occu

pa

nt

tra

nsp

ort

in

juries w

ere

th

e le

ad

ing

ca

uses o

f m

ort

alit

y in

yo

un

g p

eo

ple

.

Oth

er

Issu

es

Inju

rie

s in

Yo

un

g

Pe

op

le

In N

ew

Z

ea

lan

d du

ring

20

06

–2

01

0,

ina

nim

ate

m

ech

an

ical

forc

es a

nd

fa

lls

we

re t

he

le

ad

ing

cau

se

s o

f in

jury

ad

mis

sio

ns i

n y

ou

ng

pe

ople

, a

lth

oug

h a

s a

g

rou

p

tra

nsp

ort

in

jurie

s

als

o

ma

de

a

sig

nific

an

t con

trib

utio

n.

In

con

tra

st,

du

rin

g 2

004

–2

00

8,

inte

ntio

na

l se

lf-h

arm

an

d v

eh

icle

occu

pa

nt

inju

rie

s w

ere

th

e le

ad

ing

ca

use

s o

f in

jury

re

late

d m

ort

alit

y.

In t

he

Sou

th I

sla

nd

du

rin

g 2

00

6–

201

0,

ina

nim

ate

me

ch

an

ica

l fo

rce

s a

nd

fa

lls

we

re a

lso

th

e l

ead

ing

ca

uses o

f in

jury

ad

mis

sio

ns i

n y

oun

g p

eo

ple

, a

lth

ou

gh

as a

gro

up

tra

nspo

rt inju

rie

s a

ga

in m

ad

e a

sig

nific

an

t co

ntr

ibu

tio

n.

In c

on

trast,

du

rin

g 2

004

–2

00

8,

inte

ntio

na

l se

lf-h

arm

an

d v

eh

icle

occu

pa

nt

inju

rie

s w

ere

th

e le

ad

ing

ca

use

s o

f in

jury

re

late

d m

ort

alit

y.

Intr

odu

ctio

n a

nd

Ove

rvie

w -

41

Ind

ica

tor

New

Ze

ala

nd

Dis

trib

utio

n a

nd

Tre

nd

s

So

uth

Isla

nd

Dis

trib

utio

n a

nd

Tre

nd

s

Te

en

ag

e P

reg

na

ncy

In N

ew

Ze

ala

nd

, te

en

age

liv

e b

irth

s d

eclin

ed

du

ring

th

e l

ate

19

90

s a

nd e

arly

20

00s,

to r

each

th

eir

lo

we

st

po

int

in 2

00

2.

Bir

th r

ate

s t

he

n g

rad

ua

lly in

cre

ased

ag

ain

, re

ach

ing

a

pe

ak

of

32

.4

pe

r 1

,00

0

in

200

8.

In

co

ntr

ast,

te

en

ag

e

term

ina

tio

ns in

cre

ase

d d

urin

g th

e la

te 1

990

s a

nd

e

arl

y 20

00

s,

reach

ed

a

pla

tea

u d

urin

g 2

002

–2

00

7,

an

d th

en

d

eclin

ed

, w

ith

te

en

ag

e liv

e b

irth

a

nd

term

ina

tio

n r

ate

s b

ein

g r

ou

ghly

eq

uiv

ale

nt

du

rin

g 2

002

–20

04

.

Duri

ng

20

06–

201

0,

tee

na

ge

liv

e b

irth

ra

tes w

ere

sig

nific

an

tly h

igh

er

for

Mā

ori

> P

acific

> E

uro

pea

n >

Asia

n/In

dia

n w

om

en

an

d t

ho

se

fro

m a

ve

rag

e-t

o-m

ore

d

ep

rive

d (

NZ

Dep

de

cile

2–1

0)

are

as.

Hig

he

r te

en

age

liv

e b

irth

ra

tes f

or

Mā

ori

a

nd

Pa

cific

wo

me

n h

ow

eve

r, m

ust

be

see

n i

n t

he

co

nte

xt

of

hig

he

r o

ve

rall

fert

ility

ra

tes (

at a

ll a

ges)

for

Mā

ori

an

d P

acific

wo

men

.

In S

outh

lan

d d

urin

g 2

006

–201

0,

tee

na

ge b

irth

ra

tes w

ere

sig

nific

an

tly h

igh

er

tha

n t

he

New

Ze

ala

nd

ra

te,

wh

ile i

n N

els

on

Ma

rlb

oro

ugh

, C

an

terb

ury

, a

nd

O

tag

o ra

tes w

ere

sig

nific

an

tly lo

we

r. R

ate

s in

th

e W

est

Coa

st

an

d S

ou

th

Can

terb

ury

w

ere

n

ot

sig

nific

an

tly d

iffe

ren

t fr

om

th

e N

ew

Z

ea

lan

d ra

te.

In

Can

terb

ury

, te

ena

ge b

irth

rate

s w

ere

hig

he

r fo

r M

āo

ri >

Pa

cific

> E

uro

pe

an

>

Asia

n/I

ndia

n w

om

en

, w

hile

in t

he

re

ma

inin

g S

ou

th I

sla

nd

DH

Bs,

rate

s w

ere

h

igh

er

for

Mā

ori

tha

n fo

r E

uro

pe

an

wo

me

n.

Te

rmin

atio

ns o

f P

reg

na

ncy

In N

ew

Ze

ala

nd

du

rin

g 1

98

0–2

01

0,

term

ina

tio

ns o

f p

regn

ancy w

ere

hig

he

st

in

wo

me

n a

ge

d 2

0-2

4 y

ea

rs,

follo

we

d b

y t

ho

se

25

-29

ye

ars

an

d 1

5-1

9 y

ea

rs.

Te

rmin

atio

n r

ate

s i

ncre

ased

du

rin

g t

he

19

80

s a

nd

199

0s,

with

ra

tes r

ea

ch

ing

a p

eak f

or

most

age

gro

up

s in

th

e e

arly 2

00

0s a

nd

the

n b

eg

inn

ing t

o g

rad

ually

d

eclin

e.

Durin

g 2

006

–20

10

, te

rmin

ation

s w

ere

hig

he

r fo

r P

acific

an

d M

āo

ri >

E

uro

pe

an

> A

sia

n t

een

age

rs,

wh

ile a

mo

ngst

those

20

–2

4 y

ea

rs,

term

ina

tion

s

we

re h

igh

er

for

Pacific

> M

āo

ri >

Asia

n a

nd

Eu

rop

ean

wo

men

.

Duri

ng

20

09,

a to

tal

of

3,5

50 te

rmin

atio

ns o

f p

regn

ancy w

ere

re

co

rded

as

occu

rrin

g

am

ong

st

wo

me

n

livin

g

in

the

S

ou

th

Isla

nd

’s

Reg

iona

l C

ou

ncil

ca

tch

me

nts

.

Th

e C

hild

ren

’s S

ocia

l H

ea

lth

Mo

nito

r

Eco

nom

ic I

nd

ica

tors

Gro

ss D

om

estic

Pro

du

ct

(GD

P)

In N

ew

Ze

ala

nd

, G

DP

de

cre

ase

d f

or

five

co

nse

cu

tive

qua

rte

rs f

rom

Ma

rch

2

00

8–

Ma

rch

20

09

, b

efo

re

incre

asin

g

ag

ain

, fo

r five

co

nse

cu

tive

q

ua

rte

rs,

fro

m

Jun

e

20

09–

Jun

e

20

10

. G

DP

th

en

brie

fly

de

clin

ed

by

0.1

%

in

the

Se

pte

mb

er

qu

art

er

of

20

10,

be

fore

in

cre

asin

g

ag

ain

, b

y

0.6

%

in

the

Dece

mb

er

20

10

qu

art

er,

by 0

.9%

in

th

e M

arc

h 2

011

qua

rter

an

d b

y 0

.1%

in

the

Jun

e 2

01

1 qu

art

er.

E

con

om

ic

activity fo

r th

e ye

ar

en

din

g Ju

ne

2

01

1

incre

ased

by 1

.5%

.

Incom

e In

eq

ua

lity

In N

ew

Ze

ala

nd

du

rin

g 1

98

4–

20

10

in

co

me

in

equ

alit

y,

as m

easu

red

by t

he

P8

0/P

20

ra

tio

an

d G

ini

co

effic

ien

t, w

as h

ighe

r a

fter

ad

justing

fo

r h

ousin

g

co

sts

tha

n p

rio

r to

th

is a

dju

stm

en

t. T

he

most

rapid

ris

es i

n i

ncom

e i

neq

ua

lity

occu

rre

d

be

twe

en

th

e

late

19

80

s

and

e

arly

19

90

s.

Durin

g

the

e

arl

y–

mid

2

00

0s h

ow

eve

r, i

ncom

e i

neq

ua

lity d

eclin

ed

, a c

ha

nge

Pe

rry a

ttrib

ute

s l

arg

ely

to

th

e W

ork

ing

fo

r F

am

ilie

s p

ackag

e.

Add

itio

nal fa

lls in incom

e in

eq

ua

lity w

ere

se

en i

n 2

01

0,

with

Pe

rry a

ttrib

uting

this

to a

fa

ll in

hig

he

r in

com

es,

co

uple

d

with

sm

all

gain

s f

or

low

er

incom

e h

ou

se

hold

s.

Intr

odu

ctio

n a

nd

Ove

rvie

w -

42

Ind

ica

tor

New

Ze

ala

nd

Dis

trib

utio

n a

nd

Tre

nd

s

So

uth

Isla

nd

Dis

trib

utio

n a

nd

Tre

nd

s

Child

Po

ve

rty a

nd

L

ivin

g S

tan

da

rds

In N

ew

Ze

ala

nd

du

ring

198

8–1

99

2, ch

ild p

ove

rty r

ate

s in

cre

ase

d m

ark

edly

, a

s

a r

esult o

f risin

g u

nem

plo

ym

en

t a

nd t

he

19

91

Be

nefit

cu

ts.

Duri

ng

19

94

–1

998

ho

we

ve

r,

rate

s

declin

ed

, a

s

econ

om

ic

co

nd

itio

ns

imp

rove

d

and

un

em

plo

ym

en

t fe

ll. D

urin

g 1

99

8–

200

4,

ch

ild p

ove

rty t

rend

s v

ari

ed

, d

ep

en

din

g

on

th

e

mea

su

re

use

d,

bu

t be

twe

en

2

00

4

and

2

00

7

the

y

ag

ain

d

eclin

ed,

follo

win

g t

he

ro

ll o

ut

of

the

Wo

rkin

g f

or

Fam

ilies p

ackag

e.

Fo

r th

e m

ajo

rity

of

this

pe

riod

, ch

ild p

ove

rty r

ate

s w

ere

hig

he

r fo

r yo

ung

er

ch

ildre

n (

0–

11

vs.

12–

17

ye

ars

), la

rge

r h

ouse

ho

lds (

3 o

r m

ore

child

ren

vs.

1–2

ch

ildre

n),

so

le p

are

nt

ho

use

hold

s a

nd

ho

use

hold

s w

he

re t

he

ad

ults w

ere

eith

er

wo

rkle

ss,

or

wh

ere

n

on

e w

ork

ed

fu

ll tim

e.

Une

mplo

ym

ent

Rate

s

In t

he

qu

art

er

en

din

g S

epte

mb

er

20

11

, se

aso

na

lly a

dju

ste

d u

nem

plo

ym

en

t ra

tes

rose

to

6

.6%

, w

hile

se

aso

nally

a

dju

ste

d

un

em

plo

ym

en

t n

um

be

rs

incre

ased

fr

om

15

4,0

00

to

1

57

,00

0.

Duri

ng

S

ep

tem

be

r 1

98

7–

201

1,

un

em

plo

ym

en

t ra

tes w

ere

hig

he

r fo

r yo

un

ge

r p

eo

ple

(1

5–

19

ye

ars

> 2

0–2

4

ye

ars

>

2

5–

29

ye

ars

>

3

5–

39

ye

ars

a

nd

4

5–

49

ye

ars

) an

d th

ose

w

ith

n

o

qu

alif

ica

tio

ns

>

sch

ool

qua

lific

atio

ns,

or

po

st

sch

oo

l b

ut

no

sch

oo

l q

ua

lific

atio

ns >

bo

th p

ost

sch

oo

l a

nd

sch

ool

qua

lific

ations,

alth

ou

gh

th

ere

w

ere

no

co

nsis

ten

t g

en

de

r d

iffe

ren

ce

s f

or

yo

un

g p

eo

ple

15

–2

4 y

ea

rs.

Durin

g

20

07

(Q4

)–2

011

(Q3

) un

em

plo

ym

en

t ra

tes w

ere

hig

he

r fo

r M

āo

ri a

nd

Pacific

>

Asia

n/I

ndia

n

>

Eu

rope

an

pe

op

le.

Unem

plo

ym

en

t ra

tes

incre

ased

fo

r all

eth

nic

gro

up

s d

uri

ng

20

08

and

20

09

, bu

t b

ecam

e m

ore

sta

tic d

uri

ng

20

10

–2

01

1(Q

3)

for

Mā

ori

, P

acific

a

nd

E

uro

pe

an

p

eop

le.

Rate

s fo

r A

sia

n/In

dia

n

pe

op

le d

eclin

ed

be

twe

en

20

10(Q

2)

an

d 2

01

1(Q

2).

In th

e S

outh

Is

lan

d d

urin

g 2

00

5(Q

1)–

20

11

(Q3

) u

nem

plo

ym

en

t tr

end

s w

ere

sim

ilar

to t

ho

se

occu

rrin

g n

atio

na

lly.

Rate

s f

luctu

ate

d d

uring

20

05

–2

00

8,

bu

t b

eg

an to

rise

t h

ere

afte

r. R

ate

s w

ere

lo

we

r th

an

th

e N

ew

Z

ea

lan

d ra

te in

C

an

terb

ury

, T

asm

an

/Nels

on/M

arl

bo

rou

gh

/West

Coa

st,

an

d

So

uth

land

thro

ugh

ou

t th

is

pe

rio

d,

wh

ile

in

Ota

go

rate

s

we

re

low

er

du

rin

g

20

08

-–2

01

1(Q

3).

Child

ren

Re

lian

t o

n

Be

ne

fit R

ecip

ien

ts

In N

ew

Ze

ala

nd

, th

e p

ropo

rtio

n o

f child

ren

ag

ed

0–

18

ye

ars

wh

o w

ere

re

lian

t o

n a

be

ne

fit,

or

be

ne

fit

recip

ien

t, f

ell

fro

m 2

4.9

% i

n A

pri

l 2

00

0 t

o 1

7.5

% i

n

Ap

ril 2

008

, b

efo

re in

cre

asin

g a

ga

in t

o 2

0.4

% in

Ap

ril 2

011

. A

la

rge

pro

po

rtio

n

of

the

in

itia

l de

clin

e w

as d

ue t

o a

fa

ll i

n t

he

num

be

r o

f ch

ildre

n r

elia

nt

on

un

em

plo

ym

en

t b

ene

fit

recip

ien

ts (

fro

m 4

.5%

of

ch

ildre

n i

n 2

000

to

0.5

% i

n

Ap

ril 2

008

, b

efo

re incre

asin

g t

o 1

.4%

in

Ap

ril 2

011

). T

he

pro

po

rtio

n o

f child

ren

relia

nt

on

DP

B r

ecip

ien

ts a

lso

fe

ll, f

rom

17

.2%

of

child

ren i

n A

pri

l 20

00

, to

1

3.8

% in

Ap

ril 2

008

, b

efo

re in

cre

asin

g to

15

.8%

in

Ap

ril 20

11

.

At

the

en

d o

f A

pril

201

1,

the

re w

ere

36

,095

child

ren

ag

ed

0–

18

ye

ars

wh

o

we

re r

elia

nt

on

a b

en

efit

or

be

ne

fit

recip

ien

t an

d w

ho

re

ceiv

ed

th

eir

be

nefits

fr

om

Se

rvic

e C

en

tres in

th

e N

els

on

Ma

rlb

oro

ug

h (

n=

5,5

35

), S

ou

th C

an

terb

ury

(n

=1

,96

5),

C

an

terb

ury

(n

=1

8,1

77

), W

est

Coast

(n=

1,1

59

), O

tag

o (n

=5

,19

8)

an

d

So

uth

lan

d

(n=

4,0

61

) D

HB

ca

tchm

en

ts.

While

th

e

ma

jority

o

f th

ese

ch

ildre

n w

ere

re

lian

t on

DP

B r

ecip

ien

ts,

incre

ases i

n t

he n

um

be

r re

liant

on

un

em

plo

ym

en

t b

en

efit

recip

ien

ts w

ere

evid

en

t be

twe

en

Apri

l 2

00

8 a

nd

Ap

ril

20

11

.

Intr

odu

ctio

n a

nd

Ove

rvie

w -

43

Ind

ica

tor

New

Ze

ala

nd

Dis

trib

utio

n a

nd

Tre

nd

s

So

uth

Isla

nd

Dis

trib

utio

n a

nd

Tre

nd

s

Hea

lth

an

d W

ellb

ein

g In

dic

ato

rs

Hosp

ita

l A

dm

issio

ns

an

d M

ort

alit

y w

ith

a

So

cia

l G

rad

ien

t

In N

ew

Ze

ala

nd

du

ring

20

06

–2

01

0,

ga

str

oe

nte

ritis,

bro

nchio

litis

, a

nd

asth

ma

we

re th

e le

ad

ing

ca

use

s o

f h

ospita

lisa

tion

s fo

r m

ed

ica

l co

nd

itio

ns w

ith

a

so

cia

l g

radie

nt,

wh

ile f

alls

, fo

llow

ed

by i

na

nim

ate

mech

an

ical

forc

es w

ere

th

e

lea

din

g c

au

se

s o

f in

jury

adm

issio

ns.

Durin

g 2

004

–20

08

SU

DI

wa

s t

he

le

ad

ing

ca

use

of

mo

rta

lity w

ith

a s

ocia

l g

rad

ien

t. V

eh

icle

occup

an

t d

ea

ths,

follo

we

d b

y

pe

destr

ian

in

juries

and

d

row

nin

g,

ma

de

the

larg

est

co

ntr

ibu

tio

n

to

inju

ry

rela

ted

d

ea

ths,

wh

ile b

acte

ria

l/n

on

-vir

al

pne

um

on

ia w

as th

e le

ad

ing

ca

use

fro

m m

edic

al co

nditio

ns.

Me

dic

al

adm

issio

ns w

ith

a s

ocia

l g

rad

ient

incre

ased

du

rin

g t

he

ea

rly 2

00

0s,

rea

che

d p

eak in

20

02 a

nd

then

declin

ed

, w

ith

an u

psw

ing

in

ra

tes a

ga

in b

ein

g

evid

en

t d

urin

g 2

00

7–

20

09

. In

co

ntr

ast, i

nju

ry a

dm

issio

ns d

eclin

ed

th

roug

ho

ut

20

00

–2

010

. D

uri

ng

th

is p

eriod

, h

osp

italis

atio

ns f

or

me

dic

al

co

nd

itio

ns w

ere

h

igh

er

for

Pa

cific

> M

āo

ri >

Eu

rop

ean

an

d A

sia

n/In

dia

n c

hild

ren

. F

or

Pacific

ch

ildre

n,

rate

s incre

ased

du

ring

th

e e

arl

y 2

00

0s,

reach

ed

a p

ea

k in

20

03

and

the

n d

eclin

ed

. A

n u

psw

ing

in

ra

tes w

as a

gain

evid

ent

duri

ng 2

007

–2

00

9,

with

rate

s t

hen

declin

ing

du

ring

201

0.

For

Mā

ori

child

ren

, ra

tes w

ere

sta

tic d

uri

ng

the

mid

-20

00s,

bu

t th

en

in

cre

ase

d d

urin

g 2

00

7–

20

09

, w

hile

fo

r A

sia

n/I

ndia

n

an

d E

uro

pea

n c

hild

ren

ra

tes w

ere

sta

tic d

urin

g t

he

mid

-200

0s b

ut

incre

ased

aft

er

200

7.

Inju

ry

ad

mis

sio

ns

with

a

so

cia

l g

rad

ien

t w

ere

a

lso

hig

he

r fo

r P

acific

an

d M

āo

ri >

E

uro

pean

>

Asia

n/I

nd

ian

child

ren

. A

dm

issio

n ra

tes fo

r E

uro

pe

an

a

nd

M

āo

ri

child

ren

d

eclin

ed

d

urin

g

20

00

–2

010

, w

hile

ra

tes

for

Pa

cific

an

d A

sia

n/I

nd

ian c

hild

ren

we

re m

ore

sta

tic.

In

the

So

uth

Is

lan

d

du

ring

2

00

6–2

010

, ho

spita

l a

dm

issio

ns

for

me

dic

al

co

nditio

ns

with

a

socia

l g

rad

ien

t w

ere

sig

nific

an

tly

low

er

tha

n

the

N

ew

Z

ea

lan

d r

ate

in

all

DH

Bs.

While

in

jury

adm

issio

ns w

ith

a s

ocia

l g

rad

ien

t w

ere

a

lso

sig

nific

an

tly lo

we

r th

an

the

New

Ze

ala

nd

ra

te in

Nels

on

Ma

rlb

oro

ug

h a

nd

Ota

go

, ra

tes in

So

uth

Can

terb

ury

, th

e W

est

Coa

st,

Can

terb

ury

an

d S

ou

thla

nd

we

re s

imila

r to

th

e N

ew

Ze

ala

nd

ra

te.

Asth

ma

, ga

str

oe

nte

ritis a

nd

up

pe

r re

spir

ato

ry t

ract

infe

ction

s w

ere

th

e m

ost

fre

qu

en

t re

ason

s

for

ho

sp

italis

atio

ns

for

me

dic

al

con

ditio

ns

with

a

socia

l g

rad

ien

t in

th

e S

ou

th I

sla

nd D

HB

s,

alth

ou

gh v

ira

l in

fectio

ns o

f u

nspe

cifie

d s

ite

an

d b

ronch

iolit

is als

o m

ad

e a

co

ntr

ibu

tio

n in

so

me

D

HB

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