NORTHLAND AREA HEALTH BOARD Co >
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- NORTHLAND AREA HEALTH BOARD > tt i,ñ co 4. = - Kaitaia ..( COUNTY .• 4. -. HANGAROA _a) . - COUNTY 9_. -. i-. •. BAY OF - - - -. 0 ISLANDS - COUNTY p __ - -- - HOKIANGA • - a) COUNTY Kaikohe Jr WHANGAREI COUNTY r HOBSON Whangarei - cJ\COUNTY City jc • DargaviIle - - - % OTAMATEA ., COUNTY STACK - èuary 1989 qA MOH Library El - 989 - .. I 100760M 1No IO,O FOREWORD Planning for, and action on matters to do with health and ill health need accurate and relevant data on the population, the main causes of ill health, and on social and economic indicators. The objective of the "Area Health Profile" is to present available information in a concise, understandable and visually arresting way Boardwide, and by territorial authority. Information on Northlands population, its size, structure and projected future development is fundamental to planning for health as well as other issues. While causes of death emphasise ill health rather than health, it is of course most important data, especially when looked at in terms of premature death. All the main causes of premature death in Northland are preventable to greater or lesser degrees. This must be a spur for increased effort to promote health and prevent Ill health. This involves all of us as matters of health are germane to other local bodies, agencies and community groups as well as the Northland Area Health Board. Social and economic conditions cannot be separated from health issues and the profile contains a certain amount of local information on these subjects. In the future we hope to be able to present a health profile with more emphasis on health status as opposed to ill health and deaths. Meanwhile I believe the "Area Health Profile." should stimulate debate and progress, both in the Northland Area Health Board, its staff and committees, as well as other local bodies, groups, and the community at large. D M G Beasley Chairman Northland Area Health Board HEI only NORTHLAND AREA HEALTH BOARD COMMUNITY HEALTH SERVICES AREA HEALTH PROFILE Date Due Ph.D a1th Initiated and Financed by COMMUNITY HEALTH SERVICES T°tI;ea%thU 0O2G0 We11ifl° (a. f2132-a i. TABLE OF CONTENTS Page FOREWORD 1 POPULATION TRENDS .. 1 2 MORTALITY .. .. 3 All Causes of Death .. 3 Age Structure and Mortality .. 7 The Seven Most Common Causes of Death and Premature Death in Northland 9 2.1 Motor Vehicle Accidents 10 2.2 Coronary Heart Disease 12 2.3 Lung Cancer 14 2.4 Stroke .. 15 2.5 Emphysema and Chronic Bronchitis 16 2.6 Cancer of the Bowel 17 27 Breast Cancer 18 3 CIGARETTE SMOKING IN NORTHLAND 19 APPENDICES APPENDIX A Most Common Causes of Death in New Zealand 20 APPENDIX B Neighbourhoods in the Northland area 21 B1.a Counties and Boroughs 21 B1.b Whangarei City 24 B1.c Statistical Summary of the Northland Neighbourhood 26 B2 Update on Health and Equity 27 B3 Mortality and Population Characteristics in Northland Neighbourhoods 29 B3.a Mortality 29 B3.b Population Characteristics: Far North District 30 Whangarei District 31 Kaipara District 32 Mangonui and Whangaroa 33 Kaitaia .. 34 Hokianga 35 Bay of Islands 36 Kaikohe .. 37 WhangareiCounty 38 Whangaréi.City .- 39 Otamatea 40 Hobson 41 Dargaville 42 1. POPULATION TRENDS The Northland Area Health Board serves an area extending north from Kaiwaka to Cape Reinga. In the 1986 Census there were 124,947 people usually resident in the area. It is New Zealands seventh largest Area Health Board and Is comparable in size to Taranaki Area Health Board or the Palmerston North Hospital Board. Northlands population is somewhat younger than the New Zealand average, with 27% under 15. A smaller proportion of Northland people are over 65, only 9.5%. The graph shows that this situation is changing. The darker bars represent the present population. The lighter bars show the projected population for the year 2011. The number of children will remain relatively stable. Working age adults over 35 will be much more numerous. A considerable increase in the number of aged people will have an impact on the health care services. PRESENT POPULATION AND PROJECTED POPULATION IN 2011 Age group 80+ 70-79 60-69 50-59 40-49 30-39 20-29 10-19 0-9 I I I I I I I I I I I I I I F-1 r-- I I I —T--1 I 12 10 8 6 4 2 0 2 4 6 8 10 12 thousands of females thousands of males 1986 Census M Projected 2011 The number of live births to women in the Board Area has been increasing since 1980 in parallel with the increasing number of women of child-bearing age. Projections show little increase in the number of women aged under 35, so the number of live births each year will remain fairly steady. PAST AND PROJECTED LIVE BIRTHS IN NORTHLAND Average annual number of births, 1974 to 2109 250 200 Live births 150 100 50 74 84 87 94 104 79 86 89 99 109 Years since 1900 2 2. MORTALITY It is very hard to find a measure of the health of our people in Northland. We can only look at the age at which death occurs and at the causes of death if we want to compare Northland with New Zealand as a whole. The causes of death which prevent people from reaching a ripe old age are most likely to be preventable causes. We want to know which deaths are preventable. Because of our small population, however, we can only look at the commonest causes of death. All causes of death Compared to New Zealand as a whole, people in Northland have a favourable life expectancy. Because our population is younger that is not surprising. But people in Northland are slightly better than New Zealand as a whole even when we adjust the figures for the age distributions. All the figures on mortality we use which are adjusted this way are called age-adjusted rates. To make comparisons easy, we have used the average rate per 1000 people per year for all the figures. The graph shows another feature of mortality. At all ages males are more likely to die than females. For each of the years 1980 to 1985 females in Northland had 6.0 deaths per thousand while males had 9.7 deaths per 1000. ALL CAUSES OF DEATH Average annual deaths per 1000, age-adjusted 10 9 8 7 6 5 4 3 2 1 0 Female Male U New Zealand 0 Northland 3 We can look at the death rates for each age group. The graph shows the very sharp increase in the rates in the older age groups. The excess mortality for males compared to females is also apparent. From age 55 onward until age 80 the rate for men In one five year age group Is greater than the rate for women in the next higher five year age group. This indicates that women have a markedly higher life expectancy than men. ALL CAUSES OF DEATH, BY 5 YEAR AGE GROUP Average annual deaths per 1000 population 140 Male 120 Female 100 80 60 40 20 0 <1 <9 <19 <29 <39 <49 <59 <69 <79 <4 <14 <24 <34 <44 <54 <64 <74 80+ If we look just at death before age 65 it IS clear that deaths to infants under 1 year old is an important issue. The excess deaths for males 15-30 Is notable. 4 ALL CAUSES OF DEATH, BY 5 YEAR AGE GROUP Average annual deaths per 1000 population aged under 65 20 18 Male 16 Female 14 12 10 8 6 4 2 0 <1 <9 <19 <29 <39 <49 <59 <4 <14 <24 <34 <44 <54 <64 Despite the apparently large columns for infant deaths, Northland Is better off than most places in New Zealand. The main advantage Northland has is in its "north-ness". The most Important cause of death In Infancy, especially after the first few weeks of life, Is Cot Death. Cot death, called the Sudden Infant Death syndrome, is much more common as one travels south in New Zealand. The rate is twice as high in places south of Christchurch than it is in Northland. DEATHS OF LIVE-BORN INFANTS BY CAUSE Rates per 1000 live births per annum averaged over 1980-1985 10 9 8 7 6 5 4 3 2 1 0 NZ Northland •Cot death DOther causes 5 The life expectancy for Maori people is lower than for other New Zealanders. In Northland the favourable comparison with New Zealand as a whole only holds for Pakeha Northlanders. The figures used for the graphs are actually uncertain. Maori death rates in urban areas are likely to be lower than in rural areas because people facing death may choose to return to their home marae. The population figures used which come from the 1981 Census name as Maori only those people who reported half or more Maori ancestry. The identification of a person as Maori or other at the time of death is made by the funeral director. It is unknown to what extent the funeral directors simply leave the question blank (so that it will be counted as other than Maori). It is also unknown to what extent the funeral director names as Maori a person who could not claim half or more Maori ancestry but who is a well-known and respected kaumatua. To complicate matters still further, the population figures from the 1986 Census use a different criterion for determining which people will be counted as Maori. When people were asked in 1986 to specify their ancestry they were given options which included Maori among other choices.