This annual report - Taranaki District Health Board

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Other Relevant PublicationsMāori Affairs Committee. 2010. Inquiry into the tobacco industry in Aotearoa and the consequences of tobaccouse for Māori. Report of the Māori Affairs Committee. 49th Parliament: November.New Zealand Parliament. 2011. Government Response to the Report of the Māori Affairs Committee on itsInquiry into the tobacco industry in Aotearoa and the consequences of tobacco use for Māori (Final Response).http://www.parliament.nz/NR/rdonlyres/3AAA09C2-AD68-4253-85AE-BCE90128C1A0/188520/DBHOH_PAP_21175_GovernmentFinalResponsetoReportoft.pdf.The report details the findings of the 2009-2010 Māori Select Committee inquiry into the tobacco industry in Aotearoaand the consequences of tobacco use for Māori. The committee received 260 written submissions, 1,715 form lettersand heard 96 oral submissions. The aim of the inquiry was to develop an effective approach to reducing smoking ratesamongst Māori, and all other New Zealanders. The goal is for tobacco consumption and smoking prevalence to behalved by 2015 across all demographics, and for New Zealand to be a smoke-free nation by 2025. Stopping childrenfrom getting addicted to smoking is identified as an area requiring particular attention. The report includes acomprehensive list of recommendations.In its response, the government has agreed to examine further options for measures to limit tobacco supply including:restricting the number and location of tobacco retailers, to reduce the exposure of children and young people totobacco; continuing to prioritise advertising campaigns directed at preventing children from taking up smoking; andconsidering options to extend smoke-free restrictions to protect children.Note: The publications listed above were identified using the search methodology outlined in Appendix 1Table 43. Local Policy Documents and Evidence-Based Reviews Relevant to Smoking Cessationin Young PeopleMinistry of Health Policy DocumentsMinistry of Health. 2011. Targeting Smokers: Better Help for Smokers to Quit. Wellington: Ministry of Health.http://www.health.govt.nz/publication/targeting-smokers-better-help-smokers-quitThe health target "Better Help for Smokers to Quit" was introduced in 2009, requiring DHBs to ensure that 95% ofhospitalised smokers will be provided with advice and help to quit by July 2012. From July 2011 the target wasextended to the primary care sector, where 90% of enrolled patients who smoke and are seen in general practiceshould be provided with advice and help to quit by July 2012.Ministry of Health. 2007. New Zealand Smoking Cessation Guidelines. Wellington: Ministry of Health.http://www.health.govt.nz/publication/new-zealand-smoking-cessation-guidelinesMinistry of Health. 2007. Smoking Cessation Competencies for New Zealand. Wellington: Ministry of Health.http://www.health.govt.nz/publication/smoking-cessation-competencies-new-zealandThe New Zealand smoking cessation guidelines, and their associated competencies for delivery, identify young peopleas a priority population for cessation and suggest that it is likely that interventions need to be different, given differencesin lifestyle and attitudes to smoking and quitting. The guidelines are structured around the ‘ABC’ approach (askingabout smoking status and documenting the response; providing brief advice to stop smoking to all those who smoke,regardless of their desire or motivation to quit; and providing evidence-based cessation treatment). The guidelines statethat nicotine replacement therapy (NRT) can be considered but there is insufficient evidence to support theeffectiveness of NRT in young people.Ministry of Health. 2009. Implementing the ABC Approach for Smoking Cessation: Framework and WorkProgramme. Wellington: Ministry of Health. http://www.health.govt.nz/publication/implementing-abc-approachsmoking-cessation-framework-and-work-programmeThis document contains the framework for implementing the ABC approach for smoking cessation. The ABC approachis based on the premise that initiating multiple quit attempts with supported treatment is associated with higher numbersof smokers who cease smoking in the long term. The aim is to integrate the ABC approach into routine care, so that thehealth sector can approach smoking cessation in a systematic and continuous way.Cochrane Systematic ReviewsWhittaker R, et al. 2012. Mobile phone-based interventions for smoking cessation. Cochrane Database ofSystematic Reviews doi:10.1002/14651858.CD006611.pub3http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006611.pub3/abstractThis reviewed assessed whether mobile phone-based interventions are effective at helping smokers of any age whowanted to quit, to stop smoking. Five randomised trials (over 9000 participants) with at least six month cessationoutcomes were included in the review. Three studies involved a purely text messaging intervention that has beenadapted over the course of these three studies for different populations and contexts (first developed in New Zealand,including Māori participants). One multi-arm study assessed a text messaging intervention and an internet QuitCoachseparately and in combination. The final study involved a video messaging intervention delivered via the mobile phone.Pooled results revealed that mobile phone interventions increased the long term quit rates compared with controlprogrammes (RR 1.71, 95% CI 1.47 to 1.99). The authors conclude that the current evidence supports the use of textmessaginginterventions to help smokers to quit.Tobacco Use in Young People - 222
Carson KV, et al. 2012. Interventions for smoking cessation in Indigenous populations. Cochrane Database ofSystematic Reviews doi:10.1002/14651858.CD009046.pub2http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD009046/frame.htmlThis review sought to evaluate the effectiveness of smoking cessation interventions in indigenous populations, whocarry a disproportionate burden of smoking-related morbidity and mortality. Four studies met eligibility criteria, two ofwhich were New Zealand studies (mobile phone text messaging and bupropion, both in adults), highlighting the paucityof available evidence. The limited but available evidence reported indicated that smoking cessation interventionsspecifically targeted at Indigenous populations can produce smoking abstinence but further research is needed.Carson KV, et al. 2012. Training health professionals in smoking cessation. Cochrane Database of SystematicReviews doi:10.1002/14651858.CD000214.pub2http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000214/frame.htmlThis review assessed the effectiveness of training health professionals in the delivery of smoking cessationinterventions to their patients. Seventeen RCTs and cluster RCTs (28,531 participants assessed at baseline, 21,031 atfinal follow up, 1,434 individual health professionals) were included in the review. Thirteen found no evidence of aneffect for continuous smoking abstinence following the intervention. Meta-analysis of 14 studies for point prevalence ofsmoking produced a statistically and clinically significant effect in favour of the intervention (OR 1.36, 95% CI 1.20 to1.55). Meta-analysis of eight studies that reported continuous abstinence was also statistically significant (OR 1.60,95% CI 1.26 to 2.03, p= 0.03). Health professionals who had received training were significantly more likely to performsmoking cessation tasks, including: asking patients to set a quit date, make follow-up appointments, counselling ofsmokers, and provision of self-help material. No evidence of an effect was observed for the provision of nicotinegum/replacement therapy. The authors conclude that training health professionals to provide smoking cessationinterventions had a measurable effect on smoking prevalence and abstinence and professional performance.Grimshaw G & Stanton A. 2010. Tobacco cessation interventions for young people. Cochrane Database ofSystematic Reviews doi:10.1002/14651858.CD003289.pub4http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003289/frame.htmlWhile there are multiple Cochrane reviews for smoking cessation interventions in adults, this updated report reviewedstudies aimed specifically at young people. Twenty-four trials (11 RCTs, 11 cluster RCTs and 2 controlled trials),involving 5000 participants (regular smokers aged under 20 years) met inclusion criteria. Most of the trials involved aform of motivational enhancement with psychological support. Programmes that combine a variety of approaches,including taking into account the young person’s preparation for quitting, supporting behavioural change and enhancingmotivation show promise with some persistence of abstinence (30 days point prevalence abstinence or continuousabstinence at six months). The three trials with evidence about pharmacological interventions (nicotine replacementand bupropion) did not demonstrate effectiveness for adolescent smokers.Civljak M, et al. 2010. Internet-based interventions for smoking cessation. Cochrane Database of SystematicReviews doi:10.1002/14651858.CD007078.pub3http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD007078/frame.htmlThis systematic review of trials assessing the effectiveness of internet-based interventions for smoking cessationidentified 20 trials, three of which recruited adolescents. Limited meta-analysis was possible due to the heterogeneity ofthe populations, interventions and outcomes. Results suggested that some Internet-based interventions can assistsmoking cessation, especially if the information is appropriately tailored to the users and frequent automated contactswith the users are ensured, however evidence for long term benefit was limited. Of the adolescent trials, two small trialsdid not detect an effect on cessation compared to control, and one small trial detected a benefit of a web-based adjunctto a group programme.Tobacco Use in Young People - 223
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Cover Artwork: Long-tailed Blue But
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LIST OF FIGURESFigure 1. Gross Dome
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Figure 41. Number of Students Invol
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Figure 85. Proportion of Babies Bor
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Figure 127. Relationship Between th
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Table 21. Policy Documents Relevant
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Table 108. Proportion of Young Peop
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INTRODUCTION AND OVERVIEWIntroducti
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three then reviews mental health is
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Table 1. Overview of the Determinan
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Stream Indicator New Zealand Distri
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47MACROECONOMICINDICATORS
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Expenditure-based Measure of GDPThe
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Gini Coefficient: The Lorenz curve
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CHILD POVERTY AND LIVING STANDARDSI
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After Housing Costs (AHC)Relative P
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Figure 8. Proportion of Dependent C
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14 Items (Enforced Lacks) are inclu
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Local Policy Documents and Evidence
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Other Relevant New Zealand Evidence
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UNEMPLOYMENT RATESIntroductionIn th
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Figure 12. Unemployment Rates by Ag
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Unemployment Rates by Qualification
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Figure 18. Quarterly Unemployment R
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CHILDREN RELIANT ON BENEFIT RECIPIE
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Table 4. Number of Children Aged 0-
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Table 5. Number of Children Aged 0-
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YOUNG PEOPLE RELIANT ON BENEFITSInt
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Table 7. Number of Young People Age
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New Zealand Distribution by Ethnici
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Figure 25. Young People Aged 16-24
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Table 10. Number of Young People Ag
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HOUSEHOLD COMPOSITION91
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Data Source and MethodsDefinitionPr
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Figure 29. Proportion of Children A
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Robertson J, et al. 2006. Review of
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Canadian National Occupancy Standar
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Figure 33. Proportion of Children a
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Other Relevant EvidenceMarmot Revie
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108
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Note 2: The number of new school en
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Figure 36. Proportion of New Entran
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Sylva K, et al. 2004 The Effective
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Table 15. Enrolments in Māori Medi
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Table 16. Number of Students (Māor
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Local Policy Documents which Consid
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HIGHEST EDUCATIONAL ATTAINMENT AT S
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Figure 43. Highest Educational Atta
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Figure 46. Highest Educational Atta
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SENIOR SECONDARY SCHOOL RETENTION A
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Participation in Tertiary Education
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Midland Region Distribution and Tre
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The following section uses informat
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Figure 54. Age-Standardised Rates o
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Figure 56. Age-Standardised School
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TRUANCY AND UNJUSTIFIED ABSENCESInt
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Figure 60. Total Unjustified Absenc
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Figure 63. Total Unjustified Absenc
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152
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154
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Table 22. The National Immunisation
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Figure 64. Immunisation Coverage by
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Figure 67. Immunisation Coverage by
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Figure 71. Immunisation Coverage at
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Soares-Weiser K, et al. 2012. Vacci
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Briss PA, et al. 2000. Reviews of e
Page 171 and 172: Data Sources and MethodsIndicatorPr
Page 173 and 174: Figure 75. Proportion of New Zealan
Page 175 and 176: Proportion Receiving Core Contacts
Page 177 and 178: Figure 81. Proportion of Babies who
Page 179 and 180: The B4 School CheckThe B4 School Ch
Page 181 and 182: Local Policy Documents and Evidence
Page 183 and 184: Other Relevant EvidenceThe Scottish
Page 185 and 186: 185SUBSTANCE USE
Page 188 and 189: Notes on InterpretationNote 1: The
Page 190 and 191: Maternal Smoking at First Registrat
Page 192 and 193: Figure 86. Proportion of Babies Bor
Page 194 and 195: Table 32. Number of Cigarettes Smok
Page 198 and 199: National Institute for Health and C
Page 200 and 201: 2. Proportion of babies born to mot
Page 204 and 205: Table 37. Number of Cigarettes Smok
Page 208 and 209: Figure 93. Proportion of Year 10 St
Page 210 and 211: Figure 95. Proportion of Year 10 St
Page 212 and 213: TOBACCO USE IN YOUNG PEOPLEIntroduc
Page 214 and 215: Figure 96. Daily Smoking Rates in Y
Page 216 and 217: 2009 New Zealand Tobacco Use Survey
Page 218 and 219: Source of Tobacco in the Last Month
Page 220 and 221: Carson KV, et al. 2011. Community i
Page 224 and 225: Other Cochrane Systematic Reviews o
Page 226 and 227: ALCOHOL-RELATED HOSPITAL ADMISSIONS
Page 228 and 229: Figure 100. Alcohol-Related Hospita
Page 230 and 231: Table 45. Listed External Causes of
Page 232 and 233: Midland Region Distribution and Tre
Page 234 and 235: Local Policy Documents and Evidence
Page 236 and 237: Shults RA, et al. 2009. Effectivene
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Page 244 and 245: Mortality from conditions with a so
Page 246 and 247: Table 50. Mortality from Conditions
Page 248 and 249: Figure 105. Hospital Admissions for
Page 250 and 251: Midland Region Distribution and Tre
Page 252 and 253: Table 55. Hospital Admissions for C
Page 254 and 255: Table 57. Hospital Admissions for C
Page 256 and 257: Midland Region Distribution by Caus
Page 258 and 259: Figure 107. Hospital Admissions for
Page 260 and 261: INFANT MORTALITY AND SUDDEN UNEXPEC
Page 262 and 263: New Zealand Distribution and Trends
Page 264 and 265: Figure 111. Total Infant Mortality,
Page 266 and 267: Table 62. Neonatal and Post Neonata
Page 268 and 269: Table 65. Neonatal and Post Neonata
Page 270 and 271: Distribution by Ethnicity, NZ Depri
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Figure 116. Sudden Unexpected Death
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Vennemann M, et al. 2007. Do immuni
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276
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with a review of interventions aime
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deprivation in some parts of the wo
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who delay a second pregnancy by two
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Family ViolenceDefinitions and New
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need for multidisciplinary interven
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6 days to determine gestational age
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In New Zealand, information on fact
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post intervention. Engagement in ed
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antenatal care, including two nutri
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throughout pregnancy, birth and the
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Alcohol and Other DrugsNational and
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Zealand had a number of specialist
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in one Cochrane review [274] (see p
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interventions to treat antenatal de
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In ConclusionWhile it is hoped that
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308
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Data Source and MethodsDefinition1.
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Figure 119. Hospital Admissions for
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Other Systematic ReviewsLouwers ECF
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INJURIES ARISING FROM ASSAULT IN YO
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New Zealand Distribution by Age and
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Flood M & Fergus L. 2008. An Assaul
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Note 2: The numbers in this section
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Table 78. Number of Notifications t
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Table 80. Outcome of Assessment for
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Table 82. Number of Notifications R
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Table 84. Outcome of Assessment for
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Data Source and MethodsDefinition1.
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Family Violence Investigations Wher
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Table 90. Local Policy Documents an
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Stover CS, et al. 2009. Interventio
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348
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350
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oader contextual influences on the
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In addition, Table 112 on Page 414
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Williams SB, et al. 2009. Screening
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Ministries of Education, Health, Ju
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Figure 129. Children and Young Peop
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Table 92. Children Aged 0-14 Years
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IN-DEPTH TOPIC: MENTAL HEALTH ISSUE
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this [350]. The review stated that
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psychotic disorders including first
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Social Workers in SchoolsIn 2011 th
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Children or young people with sever
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EpidemiologyThe 2009 review by Meri
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A diagnosis of conduct disorder acc
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programme using a questionnaire. Si
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developmentally appropriate diagnos
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playthings or the environment, appe
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state more than it cost) provided t
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ACCESS TO MENTAL HEALTH SERVICES: L
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Table 97. Children and Young People
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Midland Region DistributionChildren
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ACCESS TO MENTAL HEALTH SERVICES: L
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Table 101. Hospital Admissions for
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Numbers Accessing Services by Diagn
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Table 103. Young People Aged 15-24
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Table 108. Proportion of Young Peop
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Midland Region DistributionAmongst
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Fletcher A, et al. 2008. School Eff
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New Zealand Distribution and Trends
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Figure 138. Mortality from Suicide
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Figure 139. Mortality from Suicide
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Ougrin D & Latif S. 2011. Specific
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426
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428
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Guide to Community Preventive Servi
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information on all of the events oc
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3. In addition, some providers admi
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as in the majority of the analyses
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APPENDIX 5: THE NATIONAL MORTALITYC
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As a result of these changes, there
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2. Research also suggests that ethn
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APPENDIX 8: POLICE AREA BOUNDARIESF
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Figure 142. Police Area Boundaries
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3. The condition exhibits a socioec
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REFERENCES1. Children's Commissione
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33. Mackay R. 2005. The Impact of F
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71. Ministry of Health. 2011. Immun
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107. ASH New Zealand. 2011. Nationa
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141. Child and Youth Mortality Revi
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175. Pihama L. 2011. Overview of M
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208. King-Hele S, Webb RT, Mortense
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244. Nelson Marlborough District He
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274. Ramsay J, Carter Y, Davidson L
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306. Jewkes R. 2002. Intimate partn
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347. Heflinger CA, Hinshaw SP. 2010
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376. Ministry of Education. 2012. W
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410. Ministry of Health. 2001. New
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443. Zeanah PD, Bailey LO, Berry S.
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480. Weinberg MK, Olson KL, Beeghly
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