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Figure 116. Sudden Unexpected Death in Infancy, Midland DHBs vs. New Zealand 1996–2009500450400DHB SUDINZ SUDIMortality per 100,000 Live Births3503002502001501005001996–971998–992000–012002–032004–052006–072008–091996–971998–992000–012002–032004–052006–072008–091996–971998–992000–012002–032004–052006–072008–091996–971998–992000–012002–032004–052006–072008–091996–971998–992000–012002–032004–052006–072008–09Waikato Bay of Plenty Lakes DHB Tairawhiti TaranakiSource: Numerator: National Mortality Collection; Denominator: Birth Registration DatasetInfant Mortality and SUDI - 272
Local Policy Documents and Evidence-Based Reviews Relevant to thePrevention of Sudden Unexpected Death in Infancy (SUDI)The causes of infant mortality differ markedly with the age of the infant and reflect different causalpathways arising from conception to the first year of life. A review of interventions to address all thecauses of infant mortality is beyond the scope of this review. Table 68 below therefore provides abrief overview of local policy documents and evidence-based reviews relevant to the prevention ofsudden unexpected death in infancy, a relatively discrete cause of infant mortality, but a cause thatis both amenable to prevention and characterised by marked inequalities in New Zealand. Maternalsmoking, a risk factor for SUDI, is addressed in Table 34, page 197.In addition, social adversities in pregnancy have been linked to adverse pregnancy outcomes,including increased risk of infant mortality. The in-depth topic on Page 277 discusses services andinterventions for women experiencing multiple adversities in pregnancy.Table 68. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention ofSudden Unexpected Death in Infancy (SUDI)Ministry of Health Policy DocumentsMinistry of Health and the Child and Youth Mortality Review Committee. 2010. Preventing Sudden Unexpected Deathin Infancy (SUDI): Information for parents and caregivers. https://www.healthed.govt.nz/resource/preventingsudden-unexpected-death-infancy-sudiThis website provides recommendations to parent and carers on reducing the risk of SUDI. Recommendations include:no smoking during pregnancy; putting babies to sleep on their backs; creating a safe sleeping environment; andbreastfeeding. The recommended sleeping environment is having the baby sleeping in a cot or bassinette near theparents’ bed. It advises that co-sleeping (a parent who sleeps with their baby in bed) is dangerous when: the baby’smother smoked during pregnancy; the adult in bed with the baby has been drinking, or taking drugs or medicines thatmight reduce their awareness; and the co-sleeping adult is excessively tired.Systematic ReviewsStrehle E-M, et al. 2012. Can home monitoring reduce mortality in infants at increased risk of sudden infant deathsyndrome? A systematic review. Acta Paediatrica, 101(1), 8-13.This review assessed the effectiveness of home monitoring devices in the prevention of SIDS. The 11 studies identifiedincluded only one controlled trial, a feasibility study (for a proposed RCT) that compared outcomes for 100 infants born toparents who had had a previous SIDS death, allocated to weighing scales or home monitors and assessed over sixmonths. No differences were identified. Of the 10 cohort studies, of variable quality, included in the review, twosuggested that home monitoring may help to reduce SIDS rates in at risk infants. The authors concluded that there wasno high-level evidence that home monitoring is useful in preventing SIDS, with the wide variety of monitoring devicesused making comparison between studies difficult.Hauck FR, et al. 2011. Breastfeeding and Reduced Risk of Sudden Infant Death Syndrome: A Meta-analysis.Pediatrics, 128(1), 103-10.This meta-analysis measured the association between breastfeeding and sudden infant death syndrome (SIDS), with theaim of identifying whether breastfeeding specifically lowers the risk of SIDS. Eighteen original case-control studies fromEurope, North America and Australasia, were included. For infants who received any amount of breast milk for anyduration, the univariable summary odds ratio (SOR) was 0.40 (95% CI 0.35 to 0.44), and the multivariable SOR was 0.55(95% CI 0.44 to 0.69), suggesting that breastfeeding itself is protective and not merely a marker of other potentiallyprotective factors. For any breastfeeding at two months of age or older, the univariable SOR was 0.38 (95% CI: 0.27 to0.54). The effect was strongest for exclusive breastfeeding of any duration (univariable SOR 0.27, 95% CI 0.24 to 0.31).While the findings are based on observational studies, the consistency of the results leads the authors conclude thatmothers should be recommended to breastfeed their infants as a potential way to reduce the risk of SIDS.Task Force On Sudden Infant Death Syndrome. 2011. Policy Statement. SIDS and Other Sleep-Related InfantDeaths: Expansion of Recommendations for a Safe Infant Sleeping Environment. Pediatrics, 128 (5), 1030-39.Task Force on Sudden Infant Death Syndrome. 2011. Technical Report. SIDS and Other Sleep-Related InfantDeaths: Expansion of Recommendations for a Safe Infant Sleeping Environment. Pediatrics, 128(5), e1341-e67.This policy statement and background technical report from the American Academy of Pediatrics (AAP) provides anupdated set of evidence-based recommendations on SIDS prevention and safe sleep environments that can reduce therisk of all sleep-related infant deaths including suffocation, asphyxia and entrapment. Recommendations include placingthe baby in a supine position to sleep, using a firm sleeping surface, breastfeeding, room-sharing without bed-sharing,routine immunisations, considering the use of a pacifier, and avoiding soft bedding, overheating and exposure to tobaccosmoke, alcohol and illicit drugs. The technical report provides a review on which the recommendations are based.Infant Mortality and SUDI - 273
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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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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
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Figure 95. Proportion of Year 10 St
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TOBACCO USE IN YOUNG PEOPLEIntroduc
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Figure 96. Daily Smoking Rates in Y
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2009 New Zealand Tobacco Use Survey
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Source of Tobacco in the Last Month
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Carson KV, et al. 2011. Community i
Page 222 and 223: Other Relevant PublicationsMāori A
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Page 226 and 227: ALCOHOL-RELATED HOSPITAL ADMISSIONS
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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
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Page 256 and 257: Midland Region Distribution by Caus
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
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
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Page 284 and 285: Family ViolenceDefinitions and New
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Page 306 and 307: In ConclusionWhile it is hoped that
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Page 310 and 311: Data Source and MethodsDefinition1.
Page 316 and 317: Local Policy Documents and Evidence
Page 318 and 319: Other Systematic ReviewsLouwers ECF
Page 320 and 321: INJURIES ARISING FROM ASSAULT IN YO
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New Zealand Distribution by Age and
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Midland Region Distribution and Tre
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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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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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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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