Regional Health Data Handbook Northland PROFILE AND INFORMATION SOURCES NORTHLAND HEALTH SERVICES INVENTORY PREPARED BY: PREPARED BY: Janet Hickling, Northland Health Services Management Services and Advisory Unit, Research Unit, P.O. Box 1491, Department of Health, Whangarei. P.O. Box 5013, Wellington. NORTHLAND REGIONAL HEALTH DATA HANDBOOK CONTENTS INTRODUCTION • Health Planning • Development of the Handbook • Structure, Preparation and Use of the Handbook PROFILE SECTION 1 REGIONAL DESCRIPTION SECTION 2 POPULATION CHARACTERISTICS AND TRENDS • Population Distribution and Growth • Population Structure and Projections • Births • Deaths • Migration and Mobility SECTION 3 SOCIAL AND ECONOMIC CHARACTERISTICS • Lifecycle/Lifestyle • Education • Employment • Income • Offences Against the Law • Housing • Transport SECTION 4 HEALTH STATUS Mortality • Mortality rates and numbers • Cause of death • Infant mortality Hospitalisation Other Health Status Indicators • Community Health and Disability • Dental Health • Notifiable diseases • Immune status • Child Health Screening • Child Vision/Hearing defects SECTION 5 HEALTH RISKS Lifestyle • Accidents • Abuse of alcohol • Cigarett smoking Environment • Environmental Services and Quality • Industrial and Occupational Health INVENTORY SECTION 6 INVENTORY OF NORTHLAND HEALTH SERVICES 1981 Department of Health Hospitals Northland Hospital Board Other Statutory Authorities Private Agencies Voluntary Organisations Health Promotion in Northland Index of Organisations and Workers by Type of Service INFORMATION SOURCES SECTION 7 INFORMATION SOURCES General Catalogues and Indexes Section 1 Regional Description Section 2 Population Characteristics and Trends Section 3 Social and Economic Characteristics Section 4 Health Status Section 5 Health Risks Appendices ACKNOWLEDGEMENTS In the process of assembling data for the profile I have received assistance from many people within the Department of Health and other government departments and organisations. In particular I would like to acknowledge the help of: o Judith Davey of Urban Research Associates, for her help in compiling the synopsis of contents for the profile and for providing guidance in the early stages of the project. 0 The staff of the Northland and Wellington Health Services Advisory Units, the Whangarei District Office and the Northland Hospital Board as well as other health professionals and administrators in various parts of New Zealand, whose helpful advice and criticism we have tried to incorporate into the publication. o The staff of the National Health Statistics Centre for their assistance and co-operation in providing so much of the health status and health risk data. o The many government departments and organisations who provided information, in particular, the Departments of Statistics, Social Welfare, Labour, Education, Police, Justice and Ministry of Works and Development as well as The Alcoholic Liquor Advisory Council and the Accident Compensation Corporation. o Brian Dobbie and Carol Ratnam of Review and Development Section for their assistance and support during various stages of the project. o Jennifer Wood, Gillian Linney and Lau Kalapu for their willingness and co-operation in typing the many tables. Janet Hickling INTRODUCTION HEALTH PLANNING The post-war decades of general prosperity in New Zealand coincided with rapid growth in medical technology and an era of social security medicine. That particular coincidence is now over. Because of the long lead time between authorisation and production some of the effects of decisions made during that time are only now becoming apparent. This applies both in the field of health manpower and major hospital works. It is hardly surprising that the past decade has seen a significant emphasis placed on the need to plan for health and to plan for the services needed to promote, protect and preserve health. The two moves, first towards reorganisation of health services administration and second improved allocation of resources have emphasised the need for suitable planning structures and processes at national, regional or local levels as well as along services lines. Good information is the cornerstone of good planning. Planning in the health services is inevitably complex but if it is to be effective, all the following areas of planning need to be harmonised and integrated. Resource planning with health service planning; service planning with plans to improve community health status; health planning with the wider social and economic planning. In short: "If planning for health is to be comprehensive, all aspects of health problems, all health aspects of social problems, and all services directed to the prevention or amelioration of these problems must be at least considered." (1 p.291) A commitment to health planning means a commitment to a wide view of health and the four major influences which determine health. The first influence is the environment, which includes the physical, the educational, the economic, and the social. The second is the sum of personal habits and health behaviour. This covers such things as smoking, drinking and driving habits as well as the way people avail themselves of health services. Genetic heritage is the third factor. This had commonly been considered impervious to intervention until the development of recent preventive programmes such as early diagnostic evaluation and genetic counselling. The fourth factor determining health is the range, quality and availability of the health services. This last is the traditional practice field for health professionals. However, health services can come too little and too late in trying to overcome the effects of deficiencies which show themselves as excessive or premature morbidity, disability and death. "Planning for health cannot be described as comprehensive if it is directed solely to health services or even to traditional health concerns." (1 p.290) -2- The comprehensive and general approach is necessary if the planning of health services is to be set in some conceptual framework and meaning given to the interrelationships which were described earlier. This needs to be clearly visible at the various stages of the planning process: o reviewing the health problems and health status of the population; o reviewing the availability, range and distribution of health services; - o developing specific and time related community health and health service performance objectives and priorities, and identifying ways of attaining them; o implementation; and o developing procedures for the periodic review of the plan. It is in response to the-first two steps in this planning process that this handbook has been developed. The profile of a region is analysed with regard to population characteristics, health status and health problems. When this is assessed alongside the health services already provided and the funds allocated, it is hoped that a range of responsive and imaginative alternatives can be proposed and assessed and the most appropriate decisions made. DEVELOPMENT OF THE HANDBOOK This handbook has several origins. Firstly, it derives from information developed for planning purposes in and for Northland itself. This includes various inventories of health services dating from 1976 on., The handbook, however, is more extensive than that because the profile sections also draw upon the broad categories of information included in Dr T Johnstones "Health Status Profile of Northland and Suggestions for Future Studies by Service Development Groups" (1978). Secondly, the handbook stems from the inventories of health services which have been prepared in several district health offices. Thirdly, it originates from requests for assistance in providing a suitable health service contribution to regional planning schemes under the Town and Country Planning Act 1977. The handbook is a practical sequel to the Regional Health Planning Guidelines Circular Memorandum No 1981/81, Circular Letter Hosps. No 1981/80 which were sent to all hospital boards and district health offices in 1981. It is intended to help meet the need for a general information base which can be developed appropriately by service development groups. The handbook is an important but first attempt at providing a general information base for health planning at a regional level. It should be regarded as a working draft subject to modification when actually -3- used in the day to day and long term planning of the health services. It is also expected that information requirements will vary slightly in different parts of the country and that this general data base may need to be adapted to suit these varying needs. Reaction to this handbook will be welcomed and closely monitored. The first handbook has been developed for Northland because of its selection as a pilot scheme for administrative reorganisation. The interest in the handbook project however has been so great that the production of a guide to preparing a handbook will be undertaken shortly and will be widely distributed by the Department in the form of technical planning guidelines. The preparation of handbooks to suit the requirements of any health district, hospital district or local government region could follow the general format being developed as it will not be specific to any area. Given the degree of interest already in different parts of the country in undertaking such an exercise, it would be appreciated if a copy of other handbooks could be sent to the author: J E Hickling, M.S.R.U., Department