Abstract
This report was produced as the result of a contract between the District Health Boards (DHBs) and the University of Otago, on behalf of the NZ Child and Youth Epidemiology Service (NZCYES).
In exploring the underling determinants of health for New Zealand’s children and young people, each of the indicators in this report has been assigned to one of four sections:
1. The Wider Macroeconomic and Policy Context: Indicators in this section consider the wider economic and policy environment and include gross domestic product (GDP), income inequality, child poverty and living standards, unemployment, children reliant on benefit recipients and young people reliant on benefits.
2. Socioeconomic and Cultural Determinants: This section is divided into two parts, with the first considering factors related to household composition, including children living in sole parent households, and household crowding. The second considers education as a determinant of health, with indicators including early childhood education, enrolments in kura kaupapa Māori, educational attainment at school leaving, senior secondary school retention, stand-downs, suspensions, exclusions and expulsions, and truancy and unjustified absences.
3. Risk and Protective Factors: This section is also divided into two parts, with the first considering issues relevant to the Well Child/Tamariki Ora Schedule, including immunisation coverage and the uptake of Well Child/Tamariki Ora contacts (via Plunket and B4 School Checks). The second part considers a range of issues associated with substance use, including smoking in pregnancy, exposure to secondhand cigarette smoke, smoking in young people, and alcohol-related harm.
4. Health Outcomes as Determinants: This section is divided into three parts, with the first considering hospital admissions and mortality from a range of socioeconomically sensitive conditions. The second part considers children and young people’s exposure to family violence and assault, with indicators including injuries arising from the assault, neglect or maltreatment of children, injuries arising from assault in young people, notifications to Child Youth and Family, and Police Family Violence investigations. Part three then reviews mental health issues, including children and young people’s access to mental health services and suicide and self-harm.
The first of this year’s in-depth topics thus focuses on services and interventions to improve outcomes for women experiencing multiple adversities during pregnancy. The early years are also a crucial period of personal, social and emotional development, with the second of this year’s in-depth topics considering mental health issues in children.