This annual report - Taranaki District Health Board

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INFANT MORTALITY AND SUDDEN UNEXPECTEDDEATH IN INFANCYIntroductionInfant mortality is often used as a barometer of the social wellbeing of a country [131]. NewZealand’s infant mortality rates are middling by international standards 2 , being lower thanthose of the USA and some Eastern European countries, but higher than those of Centraland Northern Europe [133]. However, mortality during the first year of life remains muchhigher than at any other point during childhood or adolescence, with 308 New Zealandinfants dying prior to their first birthday during 2009 [134]. Further, ethnic andsocioeconomic disparities, remain with infant mortality rates in 2008 (provisional data)being 6.9 per 1,000 live births for Māori babies, 5.9 for Pacific babies, and 3.8 for non-Māori non-Pacific babies [132].Despite the relatively high number of deaths, New Zealand’s infant mortality rates havedeclined during the past 40 years, with rates falling from 16.9 per 1,000 live births in 1969,to 4.9 per 1,000 in March 2009 [134]. However, while total infant mortality rates aregenerally higher for Pacific and Māori babies, for males, and those in the most deprivedareas [135], total infant mortality is of limited utility in guiding population healthinterventions, as the causes of mortality differ markedly with the age of the infant. Duringthe neonatal period (birth–28 days) extreme prematurity, congenital anomalies andintrauterine/birth asphyxia are the leading causes of mortality, while in the post neonatalperiod (29–364 days) sudden unexpected death in infancy (SUDI) and congenitalanomalies make the greatest contribution [128]. Thus any interventions aimed at reducingNew Zealand’s infant mortality rates must, in the first instance, be based on anunderstanding of their component causes.The following section uses information from the National Mortality Collection to reviewneonatal, post neonatal and total infant mortality, as well as SUDI rates since 1990.Data Source and MethodsDefinition1. Total Infant Mortality: Death of a live born infant prior to 365 days of life2. Neonatal Mortality: Death of a live born infant in the first 28 days of life3. Post Neonatal Mortality: Death of a live born infant after 28 days but prior to 365 days of life4. Sudden Unexpected Death in Infancy (SUDI): Death of a live born infant
Total Infant, Neonatal and Post Neonatal MortalityFigure 109. Total Infant, Neonatal and Post Neonatal Mortality, New Zealand 1990–2009900Mortality per 100,000 Live Births800700600500400300200Total Infant MortalityNeonatal MortalityPost Neonatal Mortality100019901991199219931994199519961997199819992000200120022003200420052006200720082009Birth Registration YearSource: Numerator: National Mortality Collection; Denominator: Birth Registration DatasetFigure 110. Total Infant, Neonatal and Post Neonatal Mortality by Ethnicity, New Zealand1996–2009Mortality per 100,000 Live Births1,2001,000800600400200MāoriPacificEuropeanAsian/Indian01996–971998–992000–012002–032004–052006–072008–091996–971998–992000–012002–032004–052006–072008–091996–971998–992000–012002–032004–052006–072008–09Total Infant Mortality Neonatal Mortality Post Neonatal MortalitySource: Numerator: National Mortality Collection; Denominator: Birth Registration Dataset; Note: Ethnicity isLevel 1 prioritisedInfant Mortality and SUDI - 261
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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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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
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Data Sources and MethodsIndicatorPr
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Figure 75. Proportion of New Zealan
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Proportion Receiving Core Contacts
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Figure 81. Proportion of Babies who
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The B4 School CheckThe B4 School Ch
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Other Relevant EvidenceThe Scottish
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185SUBSTANCE USE
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Notes on InterpretationNote 1: The
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Maternal Smoking at First Registrat
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Table 32. Number of Cigarettes Smok
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National Institute for Health and C
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2. Proportion of babies born to mot
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Table 37. Number of Cigarettes Smok
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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 222 and 223: Other Relevant PublicationsMāori A
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
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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 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
Page 272 and 273: Figure 116. Sudden Unexpected Death
Page 274 and 275: Vennemann M, et al. 2007. Do immuni
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Page 278 and 279: with a review of interventions aime
Page 280 and 281: deprivation in some parts of the wo
Page 282 and 283: who delay a second pregnancy by two
Page 284 and 285: Family ViolenceDefinitions and New
Page 286 and 287: need for multidisciplinary interven
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Page 290 and 291: In New Zealand, information on fact
Page 292 and 293: post intervention. Engagement in ed
Page 294 and 295: antenatal care, including two nutri
Page 296 and 297: throughout pregnancy, birth and the
Page 298 and 299: Alcohol and Other DrugsNational and
Page 300 and 301: Zealand had a number of specialist
Page 302 and 303: in one Cochrane review [274] (see p
Page 304 and 305: interventions to treat antenatal de
Page 306 and 307: In ConclusionWhile it is hoped that
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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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