Health needs of children in State care

Background There are over 5,500 children and young people in the custody of the State in New Zealand. Their complex experiences and life stories have important implications for health services. Research has shown that children and young people in State care are a very vulnerable group with relatively high levels of unrecognised or unmet health needs (1,2). Methods A rapid literature review of the health needs of children and young people in State care and of best practice for health services in responding to those needs. Te waka hourua (the two-hulled canoe) (3) was used as a framework to understand health needs of children in State care, as well as to consider how health services can best respond to those needs. Results Children and young people in State care have needs across all health domains, including secure whānau and family attachment as well as timely assessment and effective management of physical, spiritual, and mental health needs. Many of these children experience co-occurrence of physical and mental health conditions which means there needs to be excellent co-ordination between paediatric and youth health services and mental health services within and between DHBs. Key infrastructure elements to achieve positive outcomes will include gathering and use of good data, development of staff knowledge, skills and understanding, and effective community programmes to improve child safety. Conclusion An effective child-centred approach that will enable health services to better identify and address health issues for all children, including the most vulnerable. It is also essential to remember that the journey toward health and wellbeing is also impacted by wider societal and historical influences (3). References 1. Health needs audit for looked after children and young people in the care of the London Borough of Hillingdon. Adoption & Fostering [Internet]. 2016 July 1, 2016; 40(2):[188-97 pp.]. Available from: http://aaf.sagepub.com/content/40/2/188.short 2. Szilagyi MA, Rosen DS, Rubin D, Zlotnik S, Szilagyi MA, Harmon D, et al. Health care issues for children and adolescents in foster care and kinship care. Pediatrics. 2015;136(4):e1142-e66.doi http://dx.doi.org/10.1542/peds.2015-2656 3. Pitama S, Huria T, Lacey C. Improving Māori health through clinical assessment: Waikare o te waka o meihana. The New Zealand Medical Journal. 2014;127(1393):107-19.Peer Reviewe

What's for dinner? Relative and absolute differences in food prices

Please add to the NZCYES collectionBackground: Women with children experiencing food insecurity report difficulty affording healthy food and express concern that high fat processed food and sugar sweetened beverages are often less expensive than fresh foods and milk. The New Zealand food price index monitors changes in price of various food items relative to their price in 2006. This presentation will examine how prices of food items have changed over time and consider how this may impact on the diet of children and young people in New Zealand. Methods: Analysis of data from the 2016 Food Price Index to identify for which goods prices have remained most similar to 2006 and which goods have had the greatest relative increase in price. Weighted average retail prices in June 2016 were used to compare absolute differences in price of food items at that point in time. Results: The price of pastry goods such as pies, sausage rolls and custard squares increased 5% from 2006 to 2016, the price of processed meat increased around 10% whereas the price of beef and veal increased by 50%. The largest single rise of 65% was seen for fruit. The least expensive single item in the June 2016 list of weighted average retail prices was white bread and the most expensive items were fresh meats. At $3.98 a hot meat pie was the least expensive item in the ‘ready-to-eat’ food subgroup. Conclusion: Increasing disparities in the relative prices of foods is likely to have contributed to material hardship and food insecurity in New Zealand. For households with children highly processed foods may be the most economic food choices, and may be the only choices available to those living in income poverty.Peer Reviewe

The Health of Children and Young People with Chronic Conditions and Disabilities in New Zealand 2016

This report aims to assist district health boards to plan to meet current and future demands in order to improve the quality of life for children with disabilities and chronic conditions by providing: 1. Information from a range of routinely collected data on children and young people’s disability and chronic conditions, including prevalence of conditions arising in the perinatal period 2. Information about children’s and young people’s use of secondary health services 3. Evidence for good practice derived from current policies, guidelines and evidence-based interventions for each of the indicators presented The choice of indicators included in this report was informed by an indicator framework developed by the NZ Child and Youth Epidemiology Service and by recent peer-reviewed literature about chronic conditions in children and young people. Chronic conditions and disabilities often affect people for life. Having a good quality of life and flourishing to your best ability is dependent, at least in part, on what happened as you were growing up. Understanding the dimensions of chronic conditions and disabilities among children and young people is essential to planning and developing good quality health services for New Zealand’s children and young people

Health and wellbeing of under-five year olds in the South Island 2017

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 in their earliest years. The indicators of child health and wellbeing reported in this report begin in the prenatal period and extend to around five years of age. Indicator data for this report were extracted in 2017 from a range of routinely collected 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 2017 report begins with the very earliest days in a child’s development, the prenatal period. Early enrolment with a lead maternity carer or district health board (DHB) primary maternity service, maternal smoking and maternal weight are sentinel indicators of the health and wellbeing of women who are pregnant. The next section presents birth outcome data including gestation at birth and birthweight, as well as data about fetal deaths (also known as stillbirths). Birth outcome data can also be used to help quantify the need for care for babies born prematurely or with low birthweight. Birth outcomes are associated with a number of factors, including access to high quality antenatal care (which can help to reduce rates of preterm birth, low birthweight, and stillbirth and also to identify when a newborn baby may require additional services). The mortality rate for children aged under five years is a high-level indicator of child health and well-being within a population. The 2017 report presents data on all deaths of under-five-year-olds, on deaths of infants in the first year of life, including sudden unexpected death in infancy (SUDI), and deaths of 1–4 year olds. Immunisation and Well Child/Tamariki Ora (WCTO) services provide a foundation for child health and wellbeing. The next three sections of the report present data on breastfeeding, immunisation coverage, and child weight. Hospitalisations for ambulatory care-sensitive conditions (ACSH) may provide an indication, at a community level, of accessibility of primary care services. However, ACSH rates are also influenced by other factors at a local level, including overall social determinants of health, and must be interpreted in the light of each DHB’s specific circumstances. The final section of this report provides data from the community oral health service on oral health of five-year-olds in the community, with further data on hospitalisations of under-five-year-olds for dental conditions. Two review topics were selected by DHBs for inclusion in this report: Making health easier: Reducing inequalities in child health through addressing low health literacy (by Dr Judith Adams) and Factors that influence inequity of oral health in New Zealand and what we can we do about them (by Deanna M Beckett and Alison M Meldrum, from the University of Otago Dental School). These two sections of the report can inform strategies to promote health and wellbeing for all children. Health services can provide information in a way that supports parents to build their knowledge and skills to keep their children well and safe. Healthy public policy and supportive environments are key components to promote good oral health for all children from their earliest years

Health and wellbeing of under-five year olds in Nelson Marlborough and South Canterbury 2017

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 in their earliest years. The indicators of child health and wellbeing reported in this report begin in the prenatal period and extend to around five years of age. Indicator data for this report were extracted in 2017 from a range of routinely collected 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 2017 report begins with the very earliest days in a child’s development, the prenatal period. Early enrolment with a lead maternity carer or district health board (DHB) primary maternity service, maternal smoking and maternal weight are sentinel indicators of the health and wellbeing of women who are pregnant. The next section presents birth outcome data including gestation at birth and birthweight, as well as data about fetal deaths (also known as stillbirths). Birth outcome data can also be used to help quantify the need for care for babies born prematurely or with low birthweight. Birth outcomes are associated with a number of factors, including access to high quality antenatal care (which can help to reduce rates of preterm birth, low birthweight, and stillbirth and also to identify when a newborn baby may require additional services). The mortality rate for children aged under five years is a high-level indicator of child health and well-being within a population. The 2017 report presents data on all deaths of under-five-year-olds, on deaths of infants in the first year of life, including sudden unexpected death in infancy (SUDI), and deaths of 1–4 year olds. Immunisation and Well Child/Tamariki Ora (WCTO) services provide a foundation for child health and wellbeing. The next three sections of the report present data on breastfeeding, immunisation coverage, and child weight. Hospitalisations for ambulatory care-sensitive conditions (ACSH) may provide an indication, at a community level, of accessibility of primary care services. However, ACSH rates are also influenced by other factors at a local level, including overall social determinants of health, and must be interpreted in the light of each DHB’s specific circumstances. The final section of this report provides data from the community oral health service on oral health of five-year-olds in the community, with further data on hospitalisations of under-five-year-olds for dental conditions. Two review topics were selected by DHBs for inclusion in this report: Making health easier: Reducing inequalities in child health through addressing low health literacy (by Dr Judith Adams) and Factors that influence inequity of oral health in New Zealand and what we can we do about them (by Deanna M Beckett and Alison M Meldrum, from the University of Otago Dental School). These two sections of the report can inform strategies to promote health and wellbeing for all children. Health services can provide information in a way that supports parents to build their knowledge and skills to keep their children well and safe. Healthy public policy and supportive environments are key components to promote good oral health for all children from their earliest years

Health and wellbeing of under-five year olds in Hutt Valley, Capital & Coast and Wairarapa 2017

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 in their earliest years. The indicators of child health and wellbeing reported in this report begin in the prenatal period and extend to around five years of age. Indicator data for this report were extracted in 2017 from a range of routinely collected 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 2017 report begins with the very earliest days in a child’s development, the prenatal period. Early enrolment with a lead maternity carer or district health board (DHB) primary maternity service, maternal smoking and maternal weight are sentinel indicators of the health and wellbeing of women who are pregnant. The next section presents birth outcome data including gestation at birth and birthweight, as well as data about fetal deaths (also known as stillbirths). Birth outcome data can also be used to help quantify the need for care for babies born prematurely or with low birthweight. Birth outcomes are associated with a number of factors, including access to high quality antenatal care (which can help to reduce rates of preterm birth, low birthweight, and stillbirth and also to identify when a newborn baby may require additional services). The mortality rate for children aged under five years is a high-level indicator of child health and well-being within a population. The 2017 report presents data on all deaths of under-five-year-olds, on deaths of infants in the first year of life, including sudden unexpected death in infancy (SUDI), and deaths of 1–4 year olds. Immunisation and Well Child/Tamariki Ora (WCTO) services provide a foundation for child health and wellbeing. The next three sections of the report present data on breastfeeding, immunisation coverage, and child weight. Hospitalisations for ambulatory care-sensitive conditions (ASCH) may provide an indication, at a community level, of accessibility of primary care services. However, ACSH rates are also influenced by other factors at a local level, including overall social determinants of health, and must be interpreted in the light of each DHB’s specific circumstances. The final section of this report provides data from the community oral health service on oral health of five-year-olds in the community, with further data on hospitalisations of under-five-year-olds for dental conditions. Two review topics were selected by DHBs for inclusion in this report: Making health easier: Reducing inequalities in child health through addressing low health literacy (by Dr Judith Adams) and Factors that influence inequity of oral health in New Zealand and what we can we do about them (by Deanna M Beckett and Alison M Meldrum, from the University of Otago Dental School). These two sections of the report can inform strategies to promote health and wellbeing for all children. Health services can provide information in a way that supports parents to build their knowledge and skills to keep their children well and safe. Healthy public policy and supportive environments are key components to promote good oral health for all children from their earliest years

Health and wellbeing of under-five year olds in Hawke’s Bay 2017

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 in their earliest years. The indicators of child health and wellbeing reported in this report begin in the prenatal period and extend to around five years of age. Indicator data for this report were extracted in 2017 from a range of routinely collected 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 2017 report begins with the very earliest days in a child’s development, the prenatal period. Early enrolment with a lead maternity carer or district health board (DHB) primary maternity service, maternal smoking and maternal weight are sentinel indicators of the health and wellbeing of women who are pregnant. The next section presents birth outcome data including gestation at birth and birthweight, as well as data about fetal deaths (also known as stillbirths). Birth outcome data can also be used to help quantify the need for care for babies born prematurely or with low birthweight. Birth outcomes are associated with a number of factors, including access to high quality antenatal care (which can help to reduce rates of preterm birth, low birthweight, and stillbirth and also to identify when a newborn baby may require additional services). The mortality rate for children aged under five years is a high-level indicator of child health and well-being within a population. The 2017 report presents data on all deaths of under-five-year-olds, on deaths of infants in the first year of life, including sudden unexpected death in infancy (SUDI), and deaths of 1–4 year olds. Immunisation and Well Child/Tamariki Ora (WCTO) services provide a foundation for child health and wellbeing. The next three sections of the report present data on breastfeeding, immunisation coverage, and child weight. Hospitalisations for ambulatory care-sensitive conditions (ACSH) may provide an indication, at a community level, of accessibility of primary care services. However, ACSH rates are also influenced by other factors at a local level, including overall social determinants of health, and must be interpreted in the light of each DHB’s specific circumstances. The final section of this report provides data from the community oral health service on oral health of five-year-olds in the community, with further data on hospitalisations of under-five-year-olds for dental conditions. Two review topics were selected by DHBs for inclusion in this report: Making health easier: Reducing inequalities in child health through addressing low health literacy (by Dr Judith Adams) and Factors that influence inequity of oral health in New Zealand and what we can we do about them (by Deanna M Beckett and Alison M Meldrum, from the University of Otago Dental School). These two sections of the report can inform strategies to promote health and wellbeing for all children. Health services can provide information in a way that supports parents to build their knowledge and skills to keep their children well and safe. Healthy public policy and supportive environments are key components to promote good oral health for all children from their earliest years

Health and wellbeing of under-five year olds in Southern District Health Board 2017

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 in their earliest years. The indicators of child health and wellbeing reported in this report begin in the prenatal period and extend to around five years of age. Indicator data for this report were extracted in 2017 from a range of routinely collected 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 2017 report begins with the very earliest days in a child’s development, the prenatal period. Early enrolment with a lead maternity carer or district health board (DHB) primary maternity service, maternal smoking and maternal weight are sentinel indicators of the health and wellbeing of women who are pregnant. The next section presents birth outcome data including gestation at birth and birthweight, as well as data about fetal deaths (also known as stillbirths). Birth outcome data can also be used to help quantify the need for care for babies born prematurely or with low birthweight. Birth outcomes are associated with a number of factors, including access to high quality antenatal care (which can help to reduce rates of preterm birth, low birthweight, and stillbirth and also to identify when a newborn baby may require additional services). The mortality rate for children aged under five years is a high-level indicator of child health and well-being within a population. The 2017 report presents data on all deaths of under-five-year-olds, on deaths of infants in the first year of life, including sudden unexpected death in infancy (SUDI), and deaths of 1–4 year olds. Immunisation and Well Child/Tamariki Ora (WCTO) services provide a foundation for child health and wellbeing. The next three sections of the report present data on breastfeeding, immunisation coverage, and child weight. Hospitalisations for ambulatory care-sensitive conditions (ASCH) may provide an indication, at a community level, of accessibility of primary care services. However, ACSH rates are also influenced by other factors at a local level, including overall social determinants of health, and must be interpreted in the light of each DHB’s specific circumstances. The final section of this report provides data from the community oral health service on oral health of five-year-olds in the community, with further data on hospitalisations of under-five-year-olds for dental conditions. Two review topics were selected by DHBs for inclusion in this report: Making health easier: Reducing inequalities in child health through addressing low health literacy (by Dr Judith Adams) and Factors that influence inequity of oral health in New Zealand and what we can we do about them (by Deanna M Beckett and Alison M Meldrum, from the University of Otago Dental School). These two sections of the report can inform strategies to promote health and wellbeing for all children. Health services can provide information in a way that supports parents to build their knowledge and skills to keep their children well and safe. Healthy public policy and supportive environments are key components to promote good oral health for all children from their earliest years

Series Two

This report, which focuses on the underlying determinants of health for Māori children and young people, aims to: 1. Provide a snapshot of progress in addressing many of the determinants of health including child poverty and living standards, housing, early childhood education, oral health, tobacco use, alcohol related harm, and children’s exposure to family violence. 2. Assist those working in the health sector to consider the roles other agencies play in influencing child and youth health outcomes related to these determinants. In exploring the underlying determinant of health for Māori children and young people, each of the indicators in this year’s report has been assigned to one of four sections: • The Wider Macroeconomic and Policy Context • Socioeconomic and Cultural Determinants • Risk and Protective Factors • Health Outcomes as Determinants A viewpoint by Dr Bridget Robson beginning on page 32 reflects on the findings of the report in the context of Māori economic value

Child Poverty Monitor 2015

The Child Poverty Monitor and this Technical Report provide data on a set of indicators that assess aspects of child poverty in New Zealand and their implications for child wellbeing. In it are data on income and non-income measures of poverty, including measures that reflect increasing levels of severity. Other data include indicators related to health, living conditions, education, and a selection of economic measures used to assess how well we are doing as a nation that are relevant to the wellbeing of children and their families. The Child Poverty Monitor is a partnership comprising the Office of the Children’s Commissioner, the University of Otago’s New Zealand Child and Youth Epidemiology Service (NZCYES) and the J R McKenzie Trust. The purpose is to compile and share robust information on child poverty measures that are publicly available and easily accessible. Only by having the essential measures on child poverty in New Zealand compiled, published and disseminated annually can we tell how well we are progressing in effectively reducing child poverty in our nation