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Vennemann M, et al. 2007. Do immunisations reduce the risk for SIDS? A meta-analysis. Vaccine, 25(26), 4875-79.This meta-analysis, aimed at examining the relationship between immunisation and SIDS, identified nine case-controlstudies, four of which were adjusted for potential confounders. The summary OR was 0.58 (95% CI 0.46 to 0.73) in theunivariate analysis, suggesting that immunisations were protective, but the presence of heterogeneity made it difficult tocombine these studies. The summary OR for the four studies that reported multivariate ORs was 0.54 (95% CI 0.39 to0.76) with no evidence of heterogeneity. The authors conclude that immunisations are associated reduced risk of SIDS.A number of explanations are offered, including infection as a risk factor for SIDS, and the healthy vaccinee effect(vaccination may be avoided during illness), making the reduction in SIDS with immunisations a marker of the wellbeingof the infant, and not causally linked. It is recommended that immunisations be part of SIDS prevention campaigns.Mitchell EA, et al. 2006. Should Pacifiers Be Recommended to Prevent Sudden Infant Death Syndrome? Pediatrics,117(5), 1755-58.This report aimed to review the evidence for a reduction in the risk of SIDS with pacifier use, discuss possiblemechanisms for the reduction in SIDS risk, and assess other possible effects of pacifiers on infants and children. It isreported that in New Zealand pacifier use is low overall (approximately 10%) but there is wide variation within the countryfrom three per cent in the far south to 30 per cent in the northern North Island. The pooled the results of 7 case-controlstudies and one prospective study revealed a pooled OR of 0.83 (95% CI 0.75 to 0.93) for routine pacifier use. Eightcase-control studies also examined pacifier use for the last sleep, with a pooled OR of 0.48 (95% CI 0.43 to 0.54),supporting consistent evidence of a reduction in SIDS with pacifier use. Possible mechanisms for this effect arediscussed. Potential negative effects were reviewed, including: a possible reduction in the duration of breastfeeding (3RCTs, conflicting results): and an increased risk of infection, particularly otitis media, although this may result fromreverse causality. The authors conclude that the evidence supports an association between pacifier use and a reducedrisk of SIDS and their use should therefore not be discouraged, although they do not support active recommendation. Itis suggested that discussion of pacifier use should include advice to offer a pacifier only when breastfeeding isestablished, after the neonatal period and that they should only be used for sleeping periods in the first year of life.Hauck FR, et al. 2005. Do Pacifiers Reduce the Risk of Sudden Infant Death Syndrome? A Meta-analysis.Pediatrics, 116(5), e716-e23.This meta-analysis measured the association between pacifier use and sudden infant death syndrome (SIDS), with theaim of identifying whether pacifier use lowers the risk of SIDS. Seven case-control studies were included. The calculatedsummary odds ratios (SORs) identified a reduction in SIDS risk associated with pacifier use, suggesting that pacifier useis protective for SIDS. For usual pacifier use the univariate SOR was 0.90 (95% CI 0.59–0.85) and the multivariate SORwas 0.71 (95% CI 0.59–0.85). For pacifier use during the last sleep the univariate SOR was 0.47 (95% CI 0.40-0.55) andmultivariate SOR was 0.39 (95% CI 0.31-0.50). The authors recommend pacifier use for infants up to 1 year of age(introduced after breastfeeding has been well established in breastfed infants). Concerns about possible adverse effects,including on breastfeeding, and otitis media, led to a further review in 2006 (see above).Other Relevant Publications and ResourcesHauck F & Tanabe K. 2010. International Trends in Sudden Infant Death Syndrome and Other Sudden UnexpectedDeaths in Infancy: Need for Better Diagnostic Standardization. Current Pediatric Reviews, 6(1), 95-101.This study compared international trends in SIDS and post neonatal mortality (PNM) since the introduction of SIDS riskreduction and safe sleep campaigns for 15 countries (including New Zealand) from 1990 to the year for which most therecent data were available (2005 to 2008). SIDS rates had declined in all countries, with reductions of over 50% for mostcountries. These declines are attributed to SIDS risk reduction campaigns, which achieved success primarily in reducingrates of prone sleeping among infants. The largest declines generally occurred in the first few years after initiation ofnational campaigns. The authors highlight the need for diagnostic accuracy in comparing trends and recommend thatnational and local campaigns are re-energised to continue the early successes made in reducing SIDS incidence.McManus V, et al. 2010. Narratives of deprivation: Women's life stories around Māori sudden infant deathsyndrome. Social Science & Medicine, 71(3), 643-9.This qualitative study provides a thematic analysis of life story interviews conducted between 2002 and 2004 withnineteen Māori mothers whose infants died of SIDS. Common themes of alienation, marginalisation and exclusion andlives lived with serious deprivation within an affluent society were identified. The authors argue that constructing the riskfactors as non-modifiable is unhelpful and new approaches that build on the WHO Social Determinants of Healthframework are needed to address the high SIDS mortality rate among Māori babies.Child and Youth Mortality Review Committee, Te Rōpū Arotake Auau Mate o te Hunga Tamariki, Taiohi. 2009. Chapter1: Sudden Unexpected Death in Infancy (SUDI) in Fifth Report to the Minister of Health: Reporting mortality2002–2008. Wellington: Child and Youth Mortality Review Committee.http://www.hqsc.govt.nz/assets/CYMRC/Publications/cymrc-5th-report-chp1-sudi.pdfThis report includes an analysis of SUDI mortality data from 2003-2007, including an assessment of risk factors for SUDI,recommendations from local mortality review groups, and observations and recommendations from the Child and YouthMortality Review Committee on how to reduce incidents of SUDI in New Zealand.Hymel K. 2006. Distinguishing sudden infant death syndrome from child abuse fatalities. Pediatrics 118(1) 421-7.This clinical report from the American Academy of Pediatrics provides guidance for professionals regarding proceduresto help avoid stigmatizing families of sudden infant death syndrome victims while allowing accumulation of appropriateevidence in potential cases of infanticide.Infant Mortality and SUDI - 274
Schluter PJ, et al. 2007. Infant care practices associated with sudden infant death syndrome: findings from thePacific Islands Families study. Journal of Paediatrics & Child Health, 43(5), 388-93.The Pacific Islands Families Study followed a cohort of Pacific infants born at Middlemore Hospital in 2000. Mothers(1376 in total) were interviewed about infant care practices at around six weeks after the birth of their infant. Bed sharingwas found to be common (50% of infants) and mostly occurred in the parents’ bed. Most infants (95%) wholly or partlyshared a bedroom with their parents. The authors note that despite these practices, and the socio-economicdisadvantage of many Pacific families, the rate of SIDS among Pacific families was substantially lower than the MāoriSIDS rate. It is recommended that mothers should receive adequate information antenatally about the risks and benefitsof room-sharing, bed-sharing and safe-sleeping practices and environments.http://www.hqsc.govt.nz/our-programmes/mrc/cymrc/publications-and-resources/sudi/This website provides links to SUDI prevention publications and resources developed by the Child and Youth MortalityReview Committee (CMYRC), a statutory committee accountable to the Health Quality and Safety Commission.Resources include safe sleeping guidelines, links to CMYRC mortality reports, and examples of DHB safe sleepingpolicies.http://www.whakawhetu.co.nz/Whakawhetu National SUDI Prevention for Māori (previously known as Māori SIDS) is a national kaupapa Māoriorganisation dedicated to reducing the rate of SUDI for Māori. The organisation provides policy advice, disseminatesevidence-based information, and delivers training, education and workforce development with the aim of strengtheningSUDI prevention services that engage with whānau. The website includes safe sleeping advice, news, resources andinformation. It provides information on the wahakura, a woven flax baby bed designed to protect baby by providing a safesleeping space in an adult bed, and the pēpi-pod, a plastic baby bed, providing a cheaper alternative to a wahakura.http://www.taha.org.nz/TAHA Well Pacific Mother and Infant Service works collaboratively in the health sector on key areas of health andwellbeing for Pacific mothers and infants with the purpose of reducing a range of maternal and infant morbidity andmortality. The website provides links to a variety of resources, including SUDI prevention resources.http://www.changeforourchildren.co.nz/Change for our Children is a ‘social innovation company’ that aims to build a culture of respect for children. The websiteincludes a variety of resources related to SUDI prevention, including information on the pēpi-pod project in Christchurch,which provides a cheap plastic baby bed that aims to create a safe sleeping space(http://www.changeforourchildren.co.nz/files/docs/usingpepi-podsreport.pdf).Note: the publications listed were identified using the search methodology outlined in Appendix 1Infant Mortality and SUDI - 275
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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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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
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Other Relevant PublicationsMāori A
Page 224 and 225: Other Cochrane Systematic Reviews o
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 248 and 249: Figure 105. Hospital Admissions for
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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 272 and 273: Figure 116. Sudden Unexpected Death
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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
Page 286 and 287: need for multidisciplinary interven
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Page 290 and 291: In New Zealand, information on fact
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Page 294 and 295: antenatal care, including two nutri
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Page 298 and 299: Alcohol and Other DrugsNational and
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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
Page 322 and 323: 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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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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