Abstract
In this report the New Zealand Child and Youth Epidemiology Service (NZCYES) presents information to assist in the planning and funding of services that can collectively improve, promote and protect the health and wellbeing of children and young people aged under-25 years. This is the final of three age-based reports: indicators presented in 2017 had a focus on the first five years of life, and the 2018 report had a focus on the health and wellbeing of under-15 year olds. Data for the indicators presented in this report were extracted in 2019 from a range of routinely collected national datasets. The report provides an analysis of the most recent data available for each indicator at the time of writing. Unadjusted rates should be interpreted in light of the differing patterns in age structure, ethnic composition, social and material deprivation in each DHB and in Aotearoa overall. Evidence for good practice is presented for each section, compiled from published scholarly literature and from publicly available guidelines, policies, and reports. Where possible, the evidence for good practice includes discussion of equity issues relevant to each indicator, to inform service planning and delivery. The two review topics included in this report were selected by DHB representatives: Alcohol use in young people by Lee Smith and Promoting mental wellbeing in schools by Judith Adams and Georgia Richardson. These two sections of the report can inform strategies to promote health and wellbeing for all young people. Intervention and treatment services, supportive environments, and healthy cultural norms around drinking are some key components to addressing hazardous alcohol consumption in Aotearoa’s youngest generations. Through school-based initiatives, services can support the mental wellbeing of children and adolescents and thus invest in their long-term flourishing. Navigating sexual and reproductive health is important to the lives of many young people. Information on reproductive planning and pregnancy rates can provide an indication about the accessibility of services and provide an indication about the future social and economic participation of this generation of young people and the sustainability of the overall population and economy.1 These indicators are presented in the section on Reproductive health. The section on Mental Health presents information on the prevalence of selected mental health diagnoses in young people, the mental health services utilised by young people and the hospitalisations of young people that are associated with mental health issues. Selected indicators about substance use and smoking, alcohol and drug service utilisation, and alcohol and drug hospitalisations are presented in the Substance use section. These indicators are important for overall wellbeing, growth, and long-term health of children and young people and inextricably linked to other wellbeing measures presented in the 2019 report. The United Nations Convention on the Rights of the Child establishes that every child is deserving of a state-level commitment towards the promotion of their social, spiritual and mental wellbeing, as well as towards their protection from all forms of violence and harm.2 The section on Safety and Security provides an overview of indicators relating to the protection of children and young people in Aotearoa, including information about assault and self-harm. Supporting and adding value to the lives of children and young people with cancer is an important part of planning and funding decisions and is presented in the section on Cancer. The report appendices describe the processes used in compiling information for these reports, including the methods used to develop evidence for good practice, and the statistical methods used in the data analyses. The appendices give further information about the data sources used for the indicators in the report, explanation about classification of ethnicity and social and material deprivation, and a list of the clinical codes relevant to each indicator. In summary, the 2019 report on health and wellbeing of under-25 year olds presents data and interpretation on a set of relevant indicators extracted from national health datasets. The data used were the most recent available at the time of writing, and provide a snapshot of achievements and challenges in these areas. This report cannot address questions that require outpatient data, as these are not yet available at a national level. Developing systems that can provide a fuller picture of outpatient and primary health care data is important to inform child health service planning at national and DHB levels. The NZCYES is liaising with the Ministry of Health as they develop and roll out a patient flow system that will include primary care and outpatient data.