This annual report - Taranaki District Health Board

Overview of the Determinants of Health for Children andYoung People in the Midland RegionTable 1 provides an overview of the indicators in this year’s report. While the issuesassociated with each vary, a number of common themes emerge. Firstly, the challengingeconomic conditions seen nationally are reflected in the Midland DHBs’ data, withunemployment rates remaining higher than in the mid 2000s, and with rates in the Bay ofPlenty and Gisborne/Hawke’s Bay Regions being higher than the New Zealand rate. Inaddition, the increases in the number of children reliant on benefit recipients seen duringApril 2008–2011 improved only marginally in this year’s data.However, within the region there was considerable variability, with hospitalisations formedical conditions with a social gradient being consistently higher than the New Zealandrate in the Bay of Plenty, Lakes DHB and Tairawhiti, but lower than the New Zealand ratein the Waikato and Taranaki. Ethnic differences were evident in all DHBs however, withrates being higher for Māori than for European children.Ongoing ethnic differences also remain in educational outcomes, with a lower proportion ofMāori than European students leaving school with a University Entrance Standard in allMidland DHBs. Of significant concern was also the finding that maternal smoking ratesduring pregnancy and the postnatal period were significantly higher than the New Zealandrate in all Midland DHBs, with rates also being much higher for Māori than for Europeanbabies. In addition, youth suicide rates in Tairawhiti were significantly higher than the NewZealand rate, with large increases in Tairawhiti’s rates being seen during the late 2000s.Finally, patterns of access to mental health services are complex, with ethnic differences inchildren attending mental health services for conditions such as attention deficithyperactivity disorder (ADHD) and conduct disorders nationally, being less marked than foryoung people attending services for conditions such as schizophrenia. In the MidlandRegion, access to mental health services for common childhood mental health diagnoseswas significantly lower than the New Zealand rate in all DHBs except the Bay of Plenty.Such figures should not be taken as indicating the absence of disparities in need however,but rather potentially reflecting regional differences in the configuration of mental healthservices (vs. paediatric outpatient clinics) for this age group.Concluding CommentsThis report provides an overview of the underlying determinants of health for children andyoung people in the Midland Region. It also aims to assist DHB staff to consider some ofthe other agencies influencing child and youth health locally. Such an intersectoral focus isnecessary, as while addressing the large burden of avoidable morbidity and mortalityexperienced by Midland children and young people remains a formidable task.Collaborations with organisations such as Child Youth and Family to identify children atrisk of non-accidental injury, or Housing New Zealand to improve the quality of housingstock, may provide more tangible starting points. Further, while addressing issues such aschild poverty may be beyond of the scope of the health sector alone, some of theintegrated policy responses outlined in the Evidence Base Review tables on Page 62, ifimplemented, would likely result in significant health gains for children and young people.Thus as previously, one of the key roles of the health sector remains ongoing advocacy, inorder to ensure that each child and/or young person living locally is able to grow up toreach their full potential.Introduction and Overview - 26