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I the Public Health of the Central Region

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I the Public Health of the Central Region I health Funding Authority Health Funding Authority Special Report 4 The Public Health of the Central Region 7.North 4 MHonARohOT.Rki Boom NOW Midland Central lè fhog Ii,o A H, Kokma, Tkwa I Health Funding Authority Special Report 4 The Public Health of the Central Region Barry Borman, PhD Deborah Read, MB, ChB, FAFPHM Sandy Brinsdon, BSc, DPH Public Health Group, Central Office, Health Funding Authority IJealth Funding Authority Published by the Health Funding Authority (Central Office) Wellington New Zealand. September 1998 ISBN 0-478-20278-4 I Acknowledgements 2 Introduction 3 Highlights 6 Determinants of Health 13 Physical environment 14 Emergent public health issues 17 Demographic structure 23 Socio-economic factors 42 Tobacco 57 Patterns of health 67 Communicable disease 68 Non communicable disease 73 Age groups 99 Under 1 year 99 1-4 years 112 5-14 years 118 15-24 years 124 25-44 years 131 45-64 years 139 65-74 years 148 75+ years 154 Special Health Issues 163 Cervical cancer 164 Sexually transmitted diseases 166 Unintentional injury 170 Hearing 183 Abuse notifications 185 Mental health 190 Appendix tables 195 The Public Health of the Central Region - Page 1 Acknowledgements We would like to thank a number of people, who contributed to the production of this report. Cynthia Malmg, Manager, Public Health Group, Central Office, Health Funding Authority (HFA), gave constant support and encouragement and provided the environment for the authors to bring the project to fruition. Jim Fraser and Tracey Stewart, NZHIS, were most generous in their time and effort in fulfilling our almost constant requests for data. We also had tremendous cooperation in the provision of data from Paul Graham, LTSA, Josephine Ryan, Statistics New Zealand, Yvonne Galloway, ESR:Kenepuru Science Centre, Michael Parkin, Ministry of Education, Annalisa Manaton, ACC, Di Best, Philip Saysell and Sandi Matcham, National Cervical Screening Register, Andy Elvey, CYPFS, and Peter Crampton, Health Services Research Centre Rachel Lamb, Public Health Group, Central Office, HFA, and Jo Harvey, assisted us in collating, entering and checking data. Page 2 - The Public Health of the Central Region I The report has two aims. Firstly, to describe the state of public health in the Central region, and secondly, to provide public health providers and others involved in the design and delivery of public health programmes with a compendium of public health. Attempts have been made to include the most up-to-date data available from a variety of sources. It is intended to provide regular updates of these data. The publication has three sections. The first section, determinants of health, provides data on factors in the physical environment (eg, drinking and recreational water, food quality and safety, and emergent public health issues), hazardous substances, the demographic structure (eg, age, gender, ethnicity), socio-economic environment (eg, levels of education, income, employment, household characteristics) and tobacco consumption which influence the public health status of Hawkes Bay, Wanganui, Manawatu, Wellington, Wairarapa, and Nelson/Marlborough subregions. The second section, patterns of public health, presents numbers and rates of communicable disease and deaths, hospitalisations and cancer registration in the subregions by age groups. The third section, special health issues, includes data on cervical cancer, sexually transmitted diseases, unintentional injury, hearing loss, abuse notifications and mental health. A perennial problem associated with data from a variety of sources is that the geographical boundaries of individual areas/regions are not always consistent. We have indicated when boundaries are different from those used to demarcate the areas within the Central region. Under the new locality management structure of the HFA, the Central Office, based in Wellington will cover the Tairawhiti, Hawkes Bay, Wanganui, Manawatu, Wellington, and Wairarapa areas. Nelson/Marlborough, included in this report as part of the region covered by the previous Central Regional Health Authority, will be managed from the Christchurch office of the HFA. The Public Health of the Central Region - Page 3 U Areas covered by the Central region In this report the areas encompassed by the Central region are: Subregion Territorial local authority Hawkes Bay Wairoa District Hastings District 11 Napier City Central Hawkes Bay District Chatham Islands District Wanganui Waimarino Ward2 Waiouru Ward Wanganui District Rangitikei District Manawatu Manawatu District Palmerston North City Tararua District Horowhenua District Wellington Kapiti Coast District Porirua City Upper Huff City 1] Lower Huff City Wellington City Wairarapa Masterton District Carterton District LI South Wairarapa District Nelson/Marlborough Tasman District Nelson City [} Marlborough District LI Some data sources do not distinguish the Waimarino Ward and Waiouru Ward, which are included in the Central region, from the other constituent areas (Ohura Ward, Taumarunui Ward, National park Ward) of the Ruapehu District. ci U Page 4— The Public Health of the Central Region 0 I Sources and analyses of health data Mortality data Mortality data for the Central Region for the period 1990 to 1994 were obtained from the New Zealand Health Information Service (NZHIS). Cumulative rates for the five-year period - not averaged rates - were calculated using the 1991 Census usually resident population for the region and subregions. Morbidity data Morbidity data for the Central Region for 1995 and 1996 were obtained from NZHIS. Throughout the text these discharges from hospitals are referred to as hospitalisations. Cumulative rates for the two years were calculated. For purposes of comparison, tables of hospitalisations by subregion and ethnicity show the leading causes of hospitalisation for Maori, and these may not be the main leading causes for nonMaori. For this reason, the tables for nonMaori males and females have been labeled Selected leading causes of hospitalisation..... Injury data Morbidity data were obtained from NZHIS for the years 1995 and 1996, giving the external cause (E code) for cases of injury and poisoning. These were classified into two groups, intentional injury (E950-E969) and unintentional injury (E800-E949, which includes adverse effects from therapeutic use of drugs, medicinal and biological substances). Cumulative rates for the two years were calculated. Cancer data Cancer registration data from NZHIS Cancer Registry for the years 1990 to 1993 were used to calculate cumulative rates for the 4-year period. Populations used were the 1991 Census usually resident populations for the region and subregions. Mental health data Inpatient mental health care data for 1992 and 1993 were obtained from NZHIS and used to calculate cumulative rates for the two-year period. Populations used were the 1991 Census usually resident populations for the region and subregions. Small numbers Rates have not been calculated where numbers for a particular category are less than five. The Public Health of the Central Region - Page 5 Environment • 49 percent of the population in the Central region (excluding Wairarapa) are served by a registered supply receive drinking water with at least a Bb grading • in the Wellington/Hutt area about 15,000 people receive water with an A grading for its source and treatment, but only a d grading for its distribution • Nelson and Wanganui have unsatisfactory water supplies In 1996-97 there were: • 31 disease outbreaks reported to the Public Health Group, Central Health • outbreaks of viral gastroenteritis reported in two rest homes • an outbreak of salmonellosis in a prison, and four outbreaks of campylobacteriosis • 9 of the 16 foodbome disease outbreaks associated with food premises • 595 food complaints reported to CHEs • 27 chemical incidents were reported with lead the most common hazardous substance reported Population • the population in the Central region at the 1996 Census was 892,302, almost a 4 percent increase from the 1991 Census • 42 percent of the regional population resides in the Wellington subregion and 30 percent are aged 25-44 years • Maori comprise 14 percent of the total regional population, but 25 percent of the Hawkes Bay population • almost 4 percent of the Central regions population are Pacific Islanders with 30 percent living in the Porirua/Kapiti area • between 1996-2010 the population in the region is expected to increase by more than 4 percent with the largest increases in the 45-64 years age group and in the Kapiti Coast District and Nelson/Marlborough region Page 6 - The Public Health of the Central Region LIJ I Social-economic Income there are wide disparities in income levels within the Central region • the median income for males and females in Wellington City is at least 30 percent higher than the respective national medians • more than half the population in Horowhenua District are receiving income support Education • the proportion of the populations in Wellington City, Palmerston North City and Lower Huff City with a university qualification is higher than the national average • at least 40 percent of the populations in the districts of Wairoa, Horowhenua and Tararua have no academic qualifications • more than half the schools in Wairoa District, Horowhenua District and Porirua City have low socio-economic status Employment • less than 40 percent of the population in the districts ofKapiti Coast, Horowhenua, Wanganui and Wairoa are in fulltime employment
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