Abstract
This report is released at a time of renewed focus on the health and wellbeing of children and young people in Aotearoa. In April 2019 Stats NZ released the first round of child poverty statistics using a revised and more robust methodology. The same week saw the release of the first summary report on the national engagement undertaken in preparation of New Zealand’s first Child Youth and Wellbeing Strategy. There is a sense of careful hope in the child health and wellbeing sector that we may see steps toward the transformative change that is required for all children to enjoy the same opportunities to fulfil their potential.
In this report the New Zealand Child and Youth Epidemiology Service (NZCYES) provides data and information to contribute to the effective planning and funding of services to improve, promote and protect the health and wellbeing of New Zealand children. The indicators of child health and wellbeing in this report cover the under-15 age group, with a focus on the school years. Indicators reported on in 2017 had a focus on the first five years of life. The 2019 report will extend further along the life course, to age 24 years.
Indicator data for this report were extracted in 2018 from a range of routinely collected national datasets. For each indicator the report provides an analysis of the most recent data available at the time of writing, followed by evidence for good practice derived from current policies, guidelines and the evidence-based literature. Where possible, the evidence for good practice includes discussion of equity issues relevant to each indicator, to inform service planning and delivery.
The 2018 report begins with a population snapshot comparing the population profile by age and gender in each district health board (DHB) with the national demographic profile. This helps to provide a context for the data presented in the report for specific indicators. Data should be interpreted in light of the differing patterns in age structure, ethnic composition, social and material deprivation in different regions and in Aotearoa overall.
Equity is a key concern in child health. The Ministry of Health has a clear mandate to take a bold approach to addressing health inequities. The first review topic, Health equity, summarises recent publications from the Ministry of Health, organisations of health professionals, and scholarly literature with a focus on health equity between Māori and other children and young people in Aotearoa. It should be read in the light of the Waitangi Tribunal 2575 findings from stage one of the inquiry into nationally significant health issues [1].
Selected nutritional and physical activity indicators from the New Zealand Health Survey are presented in the healthy behaviours section of the report. These indicators are important for overall wellbeing, growth, and long-term health of children and young people.
The second review topic, Children’s views on healthcare, reviews research on what children think about health services and how they are provided. This will help health service planners and providers to incorporate children’s views to make services more user-friendly and thereby more effective.
The next two sections present data on oral health and immunisation, using a combination of community-based and hospitalisation data. An overview of all-cause hospitalisation follows, with detailed analysis of the more common causes of hospitalisation in this age group. Mental health analysis in this report presents data from the New Zealand Health Survey, and hospitalisation data for under-15 year olds with a mental health diagnosis.
The opportunity to “grow up in a family environment of happiness, love and understanding” is a fundamental right of every child. The final section of this report includes indicators related to nurture and protection of children and young people. Data from the New Zealand Health Survey on physical punishment of children, and data from the National Collections on deaths and hospitalisations due to assault, neglect or maltreatment are included.
The report appendices provide detail that may be helpful when interpreting information presented in the report. They include detailed descriptions of the methods used to develop evidence for good practice, and the statistical methods used in the data analyses, descriptions of the data sources used for the various indicators reported, explanation about classification of ethnicity and social and material deprivation in the report, and a list of the clinical codes relevant to each indicator.
In summary, the 2018 report on health and wellbeing of under-15-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 level.
Reference
1. Waitangi Tribunal. 2019. Hauora: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry. Wellington: Waitangi Tribunal.