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Midcentral District Health Board and Whanganui District Health Board Health Needs Assessment 2015

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Midcentral District Health Board and Whanganui District Health Board Health Needs Assessment 2015 MidCentral District Health Board and Whanganui District Health Board Health Needs Assessment 2015 CONTENTS MIDCENTRAL DISTRICT HEALTH BOARD AND WHANGANUI DISTRICT HEALTH BOARD HEALTH NEEDS ASSESSMENT 2015 1 EXECUTIVE SUMMARY 4 1. INTRODUCTION 16 2. DEMOGRAPHIC PATTERNS (AND OTHER MATERIAL FROM 2013 CENSUS) 18 3. ALL CAUSE MORTALITY ANALYSIS 34 SUMMARY 34 INTRODUCTION 35 ALL CAUSE MORTALITY PATTERNS BY ETHNICITY 36 ALL CAUSE MORTALITY PATTERNS BY TERRITORIAL AUTHORITY 39 ALL CAUSE MORTALITY FOR SOCIO-ECONOMICALLY DISADVANTAGED AREAS 40 WHAT ARE THE CAUSES OF MORTALITY? 42 4. MAJOR CAUSES OF MORTALITY ANALYSIS 46 SUMMARY 46 INTRODUCTION 47 BY DISTRICT HEALTH BOARD OVERALL AND ETHNICITY 47 DISEASE MORTALITY PATTERNS BY TERRITORIAL AUTHORITY 53 SOCIO-ECONOMICALLY DISADVANTAGED AREAS 56 1 5. DISEASE GROUP BREAKDOWN 59 SUMMARY 59 INTRODUCTION 59 CIRCULATORY DISEASE 60 CANCERS 60 RESPIRATORY DISEASE 61 EXTERNAL CAUSES (ACCIDENTS AND INJURIES) 62 6. SOCIO-ECONOMIC DISADVANTAGE AND HEALTH 63 SUMMARY 63 INTRODUCTION 64 RECOGNISING HOUSEHOLDS WHO ARE SOCIO-ECONOMICALLY DISADVANTAGED 64 7. AMENABLE MORTALITY 67 SUMMARY 67 INTRODUCTION 68 WHAT IS AMENABLE MORTALITY? 68 AMENABLE MORTALITY FOR MIDCENTRAL AND WHANGANUI DISTRICT HEALTH BOARDS 69 AMENABLE MORTALITY BY ETHNICITY 70 AMENABLE MORTALITY BY TERRITORIAL AUTHORITY 70 AMENABLE MORTALITY BY NZDEP2001 9 AND 10 AREAS 71 WHAT SORT OF CONDITIONS MAKE UP AMENABLE MORTALITY? 72 8. SUICIDE 77 2 SUMMARY 77 MIDCENTRAL’S MENTION IN SUICIDE FACTS 2011 AS HAVING SUICIDE RATES HIGHER THAN NEW ZEALAND’S 78 APPENDIX ONE: CAUSES OF MORTALITY RANKED LISTS (2008 TO 2010) 81 APPENDIX TWO: MORTALITY RATES AND NUMBERS TABLES 91 ALL CAUSE MORTALITY 92 AMENABLE MORTALITY 95 CIRCULATORY DISEASE MORTALITY 98 CANCER MORTALITY 102 RESPIRATORY DISEASE MORTALITY 105 EXTERNAL CAUSES (INJURIES AND ACCIDENTS) 108 APPENDIX THREE: YEARLY AGE ADJUSTED RATES GRAPHS 111 ALL CAUSE MORTALITY 111 CIRCULATORY DISEASE 113 CANCER 114 RESPIRATORY DISEASE 116 EXTERNAL CAUSES 117 AMENABLE MORTALITY 119 APPENDIX: AMENABLE MORTALITY ICD-10 CODES 121 APPENDIX FIVE: SOURCES OF DATA 123 REFERENCES 124 3 Executive Summary Introduction This section attempts to summarise the main take-home messages of the health needs assessment report - not in terms of the order in which the chapters are organized - but in terms of what a health planner would like to know when planning services. Often, this involves pulling together information from different chapters. Most of the information is expressed in a question and answer form. The questions focus on what a health planner would like to know about the health status of MidCentral District Health Board and Whanganui District Health Board populations. There are also some explanations of the logic behind the design of this report. This report uses mortality patterns to comment on population health-status, to identify people experiencing health disadvantage, and to suggest which conditions have the greatest impact on population health. The lower the mortality rate, the better the health status of the population. How does the health status of MidCentral and Whanganui DHB residents compare to New Zealand overall? In general, the health statuses of MidCentral DHB and Whanganui DHB’s residents are worse than New Zealand overall. The health status of MidCentral’s residents is slightly worse than New Zealand overall; the health status of Whanganui residents is more markedly worse. This is based on comparing their age adjusted mortality rates. 4 The reason for this is both MidCentral and Whanganui district health boards have higher proportions of people who are known to have poorer health status than other New Zealanders. They are: people who are experiencing socio-economic disadvantage, Maori, and older people. Older people are at higher risk of long term illnesses (like diabetes, high blood pressure, heart disease, stroke and their effects). Whanganui District Health Board has especially high proportions of people experiencing socio-economic disadvantage, and Maori residents – higher than both MidCentral DHB and New Zealand. In general, is the health status of MidCentral and Whanganui District Health Board residents improving? In general, the health statuses of MidCentral and New Zealand residents have been improving over time. This is suggested by reducing mortality rates between 2004 and 2010. This trend is less apparent for Whanganui DHB residents, whose mortality rates have appeared more static over the same time period. If we wanted to improve the health status of our populations, what conditions should we prioritise for attention? Based on the causes of mortality, the conditions we should prioritise for attention are: 1. circulatory system disease (heart disease and diseases of the blood vessels), 2. cancers, 3. respiratory diseases, and 4. accidents and injuries. Circulatory system diseases were responsible for 35% to 40% of all deaths; cancers for around 30% of deaths; respiratory diseases around 9% to 10% of deaths, and accidents and injuries around 6% to 8% of all deaths. The main causes of circulatory system deaths were ischaemic heart disease (like angina and heart attacks) and stroke. Circulatory system diseases include strokes because the actual cause of a stroke originates in the blood vessels supplying the brain. The main causes of cancer deaths were: prostate cancer, breast cancer, colorectal cancer, blood-related cancers (like lymphomas, and leukaemias), malignant melanoma, and cancer of the pancreas. The main causes of respiratory deaths were: chronic obstructive pulmonary disease (COPD – emphysema and chronic bronchitis), lung infections, and interstitial lung disease (disease affecting the lung tissue between the air sacs). The main causes of deaths from accidents and injuries were: motor vehicle accidents, falls, and intentional self-harm (suicide). Drowning was also a prominent cause for MidCentral residents. 5 For Whanganui DHB, circulatory system diseases and respiratory system diseases appear to be areas where more attention is warranted. Although Whanganui DHB’s circulatory system diseases mortality has been falling over time, their rates are significantly higher than New Zealand. The number of Whanganui DHB circulatory system deaths was 26% higher compared to New Zealand when looking at 2006 to 2010 data combined together (age adjusted). Whanganui DHB’s respiratory mortality rates were higher than both MidCentral DHB and New Zealand and appeared to be increasing over recent years. Whanganui DHB’s respiratory mortality numbers were 28% higher than expected, compared to New Zealand. MidCentral’s respiratory mortality numbers were more-or-less as expected, compared to New Zealand. For both MidCentral and Whanganui District Health Boards, deaths from accidents and injuries were higher than expected, compared to New Zealand, by 25% and 27% respectively. This could be an area of attention. Who are the population groups experiencing health status disadvantage within MidCentral and Whanganui District Health Boards? The people experiencing health status disadvantage within both MidCentral DHB and Whanganui DHB are: Maori Pacific people People experiencing socio-economic disadvantage Horowhenua residents The whole of Whanganui DHB could also be added to this list, because of their higher mortality rates (17% higher than expected, compared to New Zealand overall). Whanganui DHB’s population has high proportions of socio-economically disadvantaged people, Maori, and older people – groups who have higher health needs. The whole of Whanganui District Health Board’s population shows health status disadvantage. Maori had statistically significant higher mortality numbers for New Zealand, MidCentral DHB, and Whanganui DHB. When deaths from 2006 to 2010 were accumulated and adjusted for differences in age balances of the populations, New Zealand Maori number of deaths was 90% higher than expected, when compared to New Zealand overall. MidCentral Maori number of deaths was 61% higher than expected, compared to New Zealand overall. Whanganui Maori number of deaths was 142% higher than expected, compared to New Zealand overall. Although both MidCentral DHB and Whanganui DHB have small numbers of Pacific residents, New Zealand data shows they also experience health disadvantage. New Zealand Pacific deaths were 65% higher than expected, when compared to New Zealand overall (2006 to 2010 accumulated data, age adjusted). If the Pacific 6 populations of MidCentral and Whanganui District Health Boards were larger, they would probably show the same disadvantage. People experiencing socio-economic disadvantage have higher mortality rates than generally. Areas with high levels of socio-economic disadvantage (NZDep 9 and 10 deciles) had higher mortality numbers when compared to New Zealand overall. For 2006 to 2010 data combined, the most disadvantaged areas for New Zealand, MidCentral DHB, and Whanganui DHB all had higher than expected number of deaths compared to New Zealand overall (by 24%, 31%, and 29% respectively). The group who could also be added to this list is older people. This is because older people are at higher risk of major illness and disability - including the ones mentioned above. They have higher health needs than other groups. This is important for both MidCentral DHB and Whanganui DHB because they both have higher proportions of older people (people aged 65 years and older) than New Zealand overall (16.5%, 18.2%, and 14.3% respectively). Horowhenua also has higher proportions
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