Ala of People

TT-iffilEl HF..LTR OF PEOPLE TI XT( QJ( Tii1( S ? ALA I V S P, I A S A ACKNOWLEDGEMENTS The- current Locality Profile Working Group (Carolyn Wilson, Ginia Gouman, Alexius Pepper, Ryan Thompson, Clare Pascoe, Nikki Douglas, Angela Bensemann, Ruth Richards, Clare Baxendale, Helen Watson, Tor Wainwright and Jesse Kokaua) would like to acknowledge those who have contributed over the past three or four years: Chris Clarke, Alex Watt, Ron Craft, Toni Foster, Gail Tipà, Jane Docherty, Christine Theissen, Nigel Dickson, Diana Rothstein, Kirsten Coppell, Brian Cox, Jo-ann Eggers, Phil Hider, Katie Pascoe, Wendy Black. We would also like to acknowledge the work of all who commented on earlier drafts of this document, both colleagues throughout the country and residents of the Southern region. Z. CONTENTS FOREWORD 1 INTRODUCTION 2 THE SOUTHERN REGION AND ITS PEOPLE 4 THE LOCALITIES 4 The localities defined The five Christchurch city localities THE PEOPLE 6 Where people live Changes in the size of the population Age groups Ethnic groups Economic status Families GEOGRAPHICAL ACCESS TO HEALTH SERVICES 17 LIFESTYLE AND ENVIRONMENT 19 LIFESTYLE 19 Smoking Alcohol consumption Diet Obesity Exercise ENVIRONMENTAL HEALTH 22 Water quality Air quality Food safety Waste disposal and hazardous substances Workplace health and safety Road safety Violence Communicable diseases HEALTH, ILL-HEALTH AND DISABILITY 25 LIFE EXPECTANCY AND DEATHS 26 Life expectancy Death rates HOSPITAL ADMISSIONS 28 First admissions and total admissions Causes of admission to hospital Locality differences in admissions Acute admissions Length of stay Where people go for hospital treatment USE OF GENERAL PRACTICE SERVICES 33 Visits to the family doctor The use of medicines DISABILITY 34 Physical and sensory disability Intellectual disability MENTAL ILLNESS AND ALCOHOL AND DRUG ABUSE 38 OVERALL MEASURES OF HEALTH AND HEALTH NEED 41 Peoples view of their own health Socio-ecorfomic measures of health need Womation, Centz UQJA Ministry of. Health Wellingt3n HEALTH DIFFERENCES WITHIN THE COMMUNITY 44 Socio-economic differences Maori health Pacific Islands and other communities Mens and womens health Rural and urban health differences KEY HEALTH ISSUES FOR EACH AGE GROUP 48 CHILDREN (0-14 YEARS) 48 Main causes of death and hospital admission Low birth-weight babies Birth defects and disabilities Sudden Infant Death Syndrome (cot death) Immunisation and infectious diseases Respiratory illness Hearing problems Motor vehicle crash deaths and injuries Child abuse and family violence Dental health TEENAGERS AND YOUNG ADULTS (15-24 YEARS) 56 Main causes of death and hospital admission Motor vehicle crashes Suicide Teenage pregnancy and termination of pregnancy Sexual health Smoking Alcohol and drug abuse Mental ill-health ADULTS FROM YOUTH TO MID-LIFE (25-44 YEARS) 60 Main causes of death and hospital admission Childbirth Abortion and infertility Diabetes Mental ill-health MID-LIFE ADULTS (45-64 YEARS) 62 Main causes of death and hospital admission Coronary heart disease Cancer Adverse effects of chronic conditions THE ELDERLY (65 YEARS AND OVER) 67 Main causes of death and hospital admission Disability and independence Stroke Hip fractures Pneumonia, influenza and chronic respiratory disorder Dementia Multiple illnesses CONCLUSION 70 APPENDICES APPENDIX A - CHRISTCHURCH LOCALITIES 71 APPENDIX B - PREGNANCIES, BIRTHS AND TERMINATIONS 73 APPENDIX C - TABLES AND SOURCES OF FIGURES IN THE TEXT 80 REFERENCES 113 health Funding Authority • . South Office 229 Moray Place 28 September 1998 P0 Box 5849 DUNEDIN New Zealand • ./ Telephone 03 477 4222 Facsimile 03 474 0080 Please find en4 a copy of The Health of People in the South, a health status profile of the West Coast, Canterbury, Otago and Southland regions. This document was compiled over the past two years by staff of the Southern Regional Health Authority (now Health Funding Authority). In 1996 the SR}TA presented thirteen draft locality profiles to the public for comment. Feedback from this consultation was incorporated into this overall regional profile, which retains considerable dçtail about each locality and puts it into a regional and national context. Information on census data, deaths and hospital admissions etc have been updated for this regional profile. This profile also contains additional information that was collected for a draft summary paper on key health problems of the region, prepared earlier in 1998 as a background document for primary health care professionals. We hope you will find this profile interesting and useful as a summary of some baseline information about the health of people in the southern region of New Zealand. If you would like further copies, they can be obtained from: Dunedin Office Health Funding Authority P.O.Box 5849 Dunedin Yours sincerely Jesse Kokaua MENTAL HEALTH RESEARCH ANALYST STATISTICIAN "4 North %4r Midland Central South It Mana Ha— A Rob, 0 T, Raki 11 ThthogH..o • FOREWORD Ko te mana hauora S Ko te mana takata "The health of the people is the strength of the people" This is a document about people in the southern region - Canterbury, West Coast, Otago and Southland - and some measures of their health. We have written it for everyone who has an interest in health. The south is unique in that quite a large proportion of its population is scattered sparsely over a vast geographic area. Many small rural communities are often faced with barriers of distance, terrain and weather in getting to health services. The Health Funding Authority has to meet the challenge of ensuring these communities get the basic services they need and have good access to more specialised services in the larger centres. Some indicators, for example child road deaths, show the south to be better than the rest of the country but nevertheless they are still high by international standards and should therefore be seen as unacceptable. Rates of ill-health and premature death from most causes are clearly higher than average in low income and disadvantaged groups and areas. Peoples health is shown to be closely linked to their socio-economic situation, which reinforces the importance of the Health Funding Authority working inter-sectorally with other agencies to address issues such as housing, employment, income, education and road safety. Maori also show much higher than average rates of ill-health and premature death from many causes. This is linked both to socio-economic disadvantage experienced by Maori and to the cultural barriers that prevent easy access to health services. This highlights the importance of the Health Funding Authority working with Maori to develop effective ways of redressing this health imbalance. Lack of response to illness prevention and health promotion campaigns by those who most need it is a matter of concern. Low income people and Maori, the groups most at risk of illness and premature death, tend to use GPs and screening services less than they need to, and are admitted to hospital more often than average and with more severe illnesses. It is crucial that the Health Funding Authority work with these groups to find effective ways of making sure they get the primary health and preventive services they need. Like the statement "ko te mana hauora, ko te mana takata, this document is uniquely for and by people of the south. We would like to present this document to the Health Funding Authority and people of the southern region with hopes that they will make good use of it. No reira He mihi aroha tenei kia koutou katoa. Tena koutou, tena koutou, tena koutou katoa. E noho mai ra Elizabethcdkinningham Kath Fox General Manager, Maori Health Southern Regional Director, Health Funding Authority Disclaimer In spite of the best efforts to obtain accuracy of the information in this report, the Health Funding Authority cannot guarantee that the information supplied contains-no errors. INTRODUCTION lop, S The purpose of this report - this document pulls together data from many sources to give an overview of the health of people in the south of New Zealand, comparing local areas within the region to the region as a whole and to New Zealand. This report is intended for a wide variety of readers - health professionals, planners, policy makers, organisations providing health and disability services, trainees and students, researchers, community groups, non-government organisations and local and national politicians. Why do a health status profile? - it is essential to know what changes are occurring over time in the ill-health and levels of disability of people in the community, because this enables us to plan for health and disability support services, and to evaluate whether they are having any effect. Knowing how levels of ill-health and disability vary among people of different ages, gender, ethnic and social background is important to be able to make sure that services are reaching those in most need of them. A health status profile is one part of a basic planning tool-kit. Because it covers such a broad range of topics it necessarily skims the surface of each, giving an overview to set them in context. The next steps would be to look at what services are available to meet these identified needs, how people are using these services, whether there is a better way of tackling the greatest health needs within a set funding level, and how priorities should be set among them. These are all different exercises that are beyond the scope of this report. However, we hope that the data presented here will provide a baseline for further analyses and discussion. A traditional view of health - how people define their own health, and how different communities define and value different aspects of health, varies considerably. How health is defined in this paper has been coloured by the type of data that is available. Traditional indicators of health, such as death rates, hospital admissions and common public health measures have been used.

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