Rate of teenage pregnancies falling

Dr Caroline McElnay. Photo / Paul Taylor

Teenage pregnancies have more than halved in Hawke's Bay, as the health gap closes.

The Tackling Health Inequities report, presented to the Hawke's Bay District Health Board yesterday, said social and economic changes were needed for health equity to be achieved, but the situation was improving.

It outlined overall progress towards regional health equity, following last year's Health Equity in Hawke's Bay report.

The greatest challenges lay where behavioural, social and economic change was needed.

Dr Caroline McElnay

It was the first report specifically identifying regional inequities and highlighted poor Maori-health statistics including: Maori men living eight years fewer than pakeha men, and 25 per cent dying before 50 compared with 5 per cent of pakeha. Maori were six times more likely to die from lung cancer and one in two Maori adults were obese compared with one in three for all Hawke's Bay adults.

The region was doing worse than the national average in hazardous drinking, teen pregnancy, death rates, mental disorders, smoking, GP access, dental visits and injury from assaults.

However, the report's author, Hawke's Bay DHB director of population health Dr Caroline McElnay, told the board 13 of the 18 indicators reviewed show an improvement in equity. Areas of greatest improvement were due to "effective, appropriate and targeted health services" but the greatest challenges lay where behavioural, social and economic change was needed.

The rate for deaths avoided through timely healthcare would be the same for both Maori and pakeha in the next two years under the current trend but it would take 50 years to achieve the same life expectancy under the current trend.

Maori teenage pregnancies have historically been four times higher but the overall number of teen pregnancies has fallen. In 2014-15, there were 33 births to girls aged 13-17 and 20 abortions for a conception rate of 9.2 per 1000 - a decrease from 2007-2008 when there were 28 conceptions per 1000. Most teenage pregnancies in under 18-year-olds were unplanned and about 40 per cent ended in abortion.

While teen motherhood was a positive experience for many, it was linked to "poor outcomes" for the baby's health, the mother's emotional wellbeing and education, and it was associated with increased likelihood of long-term poverty.

While the overall health trend was improving, some indicators were worsening: hospital admissions for children with viral chest infections, obesity of 4-year-olds, smoking during pregnancy and violent crime.

"The powerful impact of social, economic and behaviour on the indicators showing less or no progress reminds us of the ongoing need to address the underlying causes of health inequity," Dr McElnay said.

She thanked board member Heather Skipworth for a survey of Iron Maori participants, which showed behaviour change was possible when people were supported appropriately.