A review of national health surveys in India

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This experience of multiple material restrictions or lacks clusters strongly at the hardship end of the spectrum. Multiple restrictions experienced by children aged years, by decile of household material wellbeing index score, New Zealand Table 3 presents the proportion of children who experience child-specific restrictions and child-relevant general household items, by child MWI decile.

Within this table are 12 selected child-specific items. Over half of New Zealand 6—17 year olds experience no lacks of the selected child-specific items in Table 3. Restrictions experienced by year olds, by household Material Wellbeing Index score, grouped in quintiles of children, New Zealand Received help food, clothes, money from a community organisation more than once in the last 12 months.

Multiple restrictions out of 12 child-specific and 6 general child-relevant household items 18 in all. The Expert Advisory Group on Solutions to Child Poverty identified that measures of severe and persistent poverty were needed to monitor long term implications of experiencing poverty over time.

However, given that the sustainable development goals include reducing all measures of poverty, 2 it is essential that the data available are included in this report, and that improving their reliability is considered a priority for ongoing monitoring of child poverty.

Income poverty and material hardship exist on a continuum from less to more severe. The second and third groups reflect the observation that, although important, household income is only one factor involved in determining household material wellbeing. Households also vary in the budgetary demands related to debt servicing requirements, health- and disability-related costs, transport costs and expectations to assist others outside the immediate household.

In relation to income poverty and material hardship households fall into four categories as listed below:. The last group, where both income poverty and material hardship overlap, is the one where the stress and need is likely to be the greatest.

People whose average income across all seven SoFIE years was below the average low income poverty line. As income was averaged across all seven years, participants may have been above the income poverty line in some years, but still classified as being in persistent poverty.

People whose income was below the income poverty line for the particular survey year. Note that there are no current data for indicators of persistent poverty. The persistent poverty information in this section is based on the analysis of SoFIE data to , as published by Carter and Imlach Gunasekara 9 with some unpublished data provided to Perry by Carter and Imlach Gunasekara. It will be important to review trends in later NZHES surveys to see whether this fall in rates is due to a new trend or statistical variation.

This high rate has not declined significantly since Surveys like NZHES are valuable, providing a repeated snapshot information of a different sample of households each survey. They cannot tell us, for example, how many of the poor in one survey are still among those counted as poor in the next survey. This survey finished in and obtained longitudinal data from the same group of people over seven years. SoFIE confirmed that the risk of higher material hardship increases the longer that households have low income.

People whose average income is below the average poverty line over all of the seven waves are defined as being in persistent income poverty or chronic low income.

This is different to the disposable income benchmarks used in the earlier income poverty section. New Zealand does not have a current longitudinal survey that collects income data from the same households over time. The SoFIE findings do however allow us to look at and interpret cross-sectional rates with an eye to the way that household experience of income poverty changed over time from — In any wave, around half were in both persistent income poverty and current income poverty, the other half being only in current income poverty i.

The people in this more transient group changed a lot over seven waves which is why the number in low income at least once in the seven waves was around double the number in low income at any one time.

Income inequality raises economic as well as social and political concerns, because rising inequality tends to drag down GDP growth. When lower income people are prevented from realising their human capital potential, it is bad not only for them but for the economy as a whole. A population with a high level of inequality may be considered less socially connected than a society with less inequality.

OECD income distribution database http: Calculated by ranking individuals on the equivalised income of their respective households and dividing them into equal-sized groups or percentiles. If the ranking starts with the lowest income then the income at the top of the 10th percentile is denoted P10, the median or top of the 50th percentile is P50 and so on.

Ratios of values at the top of selected percentiles, such as P P20, are often called percentile ratios. Percentile ratios summarise the relative distance between two points in the income distribution: In the case of P P20 ratio this is the relative distance in the income distribution between high household incomes those in the 80th percentile and low household incomes those in the 20th percentile.

The higher the P P20 ratio, the greater the level of inequality; a P The incomes of households in higher income deciles rose more quickly than incomes for households in lower deciles, both in proportion and in absolute terms between and This led to a greater gap between those on "higher" and those on "lower" incomes Figure P20 ratio gives an indication of the degree of dispersion, or gap between "higher" and "lower" equivalised household incomes.

The ratio includes a range of incomes for most of the population. It also avoids the volatility associated with the top and bottom ten percent of incomes that would be included if the full spread of the distribution was included.

In New Zealand the most rapid rises in income inequality occurred between and Between and income inequality fell after introduction of the Working for Families WFF package. These changes were most noticeable for income inequality after housing costs Figure Real equivalised household incomes after housing costs, by income decile New Zealand — Ratio of 80th percentile to 20th percentile P P20 ratio of equivalised disposable housing income before and after housing costs, New Zealand — Income inequality comparisons between countries can be made using the Gini coefficient and the Palma ratio.

The Gini coefficient takes the incomes of all individuals into account and gives a summary of the income differences between each person in the population and every other person in the population. The Gini scores in this report range from 0 to Gini co-efficient x ; a score closer to indicates higher inequality and a score nearer zero indicates greater equality lower inequality within the country concerned.

The Palma ratio correlates well with the Gini co-efficient and is much easier to explain. The use of non-income measures provides a useful way of assessing relative material wellbeing. The European Union EU has developed and adopted an official measure of material hardship deprivation using non-income measures, which provides a robust way to make comparisons between countries. The comparative New Zealand data cannot be presented until the EU publishes a full range of official and updated figures based on the EU item deprivation index EU International comparisons of income poverty estimate the proportion of children in each country living in households below an agreed low-income threshold.

This type of comparison is not presented in detail in this report, because this approach can lead to incongruities when making comparisons between in rich countries with very different median income levels. In this section, international comparisons of income inequality and distribution are derived mainly from the Organisation for Economic Co-operation and Development OECD Income Distribution Database 13 and the Eurostat for the EU database, with reference to other additional sources taken from Perry In New Zealand had a Gini score of New Zealand has very similar ranking using the Palma ratio Figure Gini score, by country, whole population OECD members Palma ratio, by country whole population OECD members In May , the EU formally adopted the item deprivation index EU as its official measure of social and material deprivation.

Although comparative New Zealand data cannot be presented until the EU publishes a full range of official and updated figures, in the meantime it is possible to present data from the Living Standards Survey to give some international comparisons, using the earlier EU-SILC European Union statistics on income and living conditions index.

The hardship or deprivation risk ratio summarises the extent to which a specific group is over- or under- represented in material hardship categories compared with the whole population. A hardship risk ratio greater than one means that children are over-represented in hardship statistics. The reason for this high risk ratio is that New Zealanders aged 65 and older have low rates of material hardship, pulling down the population rate more than for other countries.

When both the risk ratio and the actual rates of material hardship are considered, New Zealand 0—17 year olds experienced both above median material hardship rates and an above median risk ratio. Children aged 0—17 years in households by degree of material hardship, EU members cf. Material hardship risk ratio for 0—17 year olds compared with total population 20 European countries cf. New Zealand , Income is not distributed evenly across a population, even after taxes and transfers are taken into account.

Table 4 further shows that the household income distribution in New Zealand, the UK, Canada and Australia is broadly similar; Finland and Norway show less dispersed income distribution. International comparison of the shares of total income by quintile of equivalised disposable household income, selected countries c. Perry 7 derived from national statistics compilations: New Zealand Household Economic Survey.

However it must be remembered that these rankings do not necessarily reflect the actual day-to-day living conditions experienced by children in these countries. The 17 sustainable development goals of the United Nations Agenda for sustainable development officially came into force in January New Zealand is one of the signatories to this Agenda, and is expected to take ownership and establish national frameworks for the achievement of all 17 Goals.

The first goal is to end poverty in all its forms, everywhere, with a specific target to reduce at least by half the proportion of men, women and children of all ages living in poverty in all its dimensions by This section of the report shows the changes required for New Zealand to halve the rates of 0—17 year olds living in low-income households and in households experiencing material hardship, using the measures presented in the Child Poverty Monitor and a baseline.

The extrapolation indicates that New Zealand needs continued sustained reductions in relation to this measure to meet the target. Sustained efforts to reduce rates of material hardship are also required to reduce these measurements to half of the benchmark by It is essential that measures taken to meet the target address the most severe income poverty within this group.

Children aged 0—17 years in households living in material hardship, by hardship level, New Zealand — and extrapolated to A rise in the unemployment rate is a key marker of an economic downturn in a community, with effects on a wide range of outcomes for all children and young people in a community, not only for those directly affected by job loss within their own household.

Gross domestic product and average hourly earnings have both increased in New Zealand since , with a steeper increase in GDP compared with the benefits received by workers. Base series from Lattimore and Eaqub 21 and supporting web page —Q1. GDP production chain volume seasonally adjusted total Q2—Q2.

Estimated de facto population —; Estimated resident population Real GDP is adjusted for changing prices and reflects the extent to which growth in the value of goods and services is due to increased production rather than an increase in the absolute value of the goods and services produced. The production approach to GDP measures the total value of goods and services produced in New Zealand, after deducting the cost of goods and services used in the production process. GDP data were re-expressed in March prices using a constant ratio based on the ratio of the nominal and real values in the March quarter; AHE data were re-expressed in March prices using rebased Consumer Price Index.

While the different data series used to develop a composite AHE data set may have had different underlying methodologies, this is not likely to have a significant effect on the overall pattern of quarterly change in AHE.

The graph axes have been scaled to make it easier to compare the relative changes in each variable over time. Real gross domestic product per capita and real average ordinary time hourly earnings, New Zealand March quarter to June quarter Lattimore and Eaqub 21 and Statistics New Zealand.

The unemployment rate provides a picture of overall economic conditions. It reflects not only total lack of work but also insufficient volume of work. All people in the working-age population who, during the reference week, were without a paid job, available for work, and had either actively sought work in the past four weeks or had a new job to start within the next four weeks.

Number of unemployed people expressed as a percentage of the labour force. Usually resident, non-institutionalised, civilian population of New Zealand aged 15 years and over. Sum of those unemployed, underemployed, and in the potential labour force.

Number of underutilised people expressed as a proportion of those in the extended labour force. People who are in part-time employment who would like to, and are available to, work more hours. People who are not actively seeking work but are available and wanting a job, and people who are actively seeking but not currently available for work, but will be available in the next four weeks. Seasonal adjustment removes the seasonal component present when dealing with quarterly data and makes the underlying behaviour of the series more apparent.

A redesigned HLFS was implemented from the June quarter and will enable more accurate reporting of underutilisation statistics in line with International Labour Organisation recommendations. In June there were , New Zealanders who were officially unemployed 4.

Seasonally adjusted quarterly unemployment numbers and rates, New Zealand March to June Unemployment rates, in absolute terms, differ by age, with the highest rates consistently observed for young people aged 15—19 years.

From to unemployment rates for 15—19 year olds rose more steeply and peaked higher than unemployment rates for other age groups, and have remained much higher than rates for other age groups Figure The underutilisation rate includes persons underemployed and in the potential labour force, as well as those unemployed.

In June there were , New Zealanders seeking additional hours of work, actively seeking work but not available in the next week, or available but not actively seeking work. The underutilisation rate increased following the global financial crisis and remains high Figure Analysis by Statistics New Zealand showed that from — unemployment and underutilisation data followed similar patterns over time with the underutilisation rate much higher than the unemployment rate.

These 15—19 and 20—24 year old age groups had both the highest numbers and rates of underemployment, unemployment, potential labour force, and underutilisation. Unemployment rates by selected age groups, New Zealand — Quarterly unemployment rates by ethnicity, New Zealand March —June Quarterly underutilisation by extended labour force status, New Zealand March to June Children in New Zealand households where the main income is from an income support benefit are more likely than other children to live in income-poor households and to experience material deprivation.

Government policies in areas such as access to and value of income support benefits have a substantial effect on household incomes for families dependent on benefit payments. The following section uses data from the Ministry of Social Development to review the proportion of children who are reliant on a recipient of a benefit.

Number of children aged 0—17 years who were reliant on a recipient of a benefit. All figures refer to the number of children reliant on a recipient of a benefit at the end of June and provide no information on the number receiving assistance at other times of the year. Figures refer to the number of children not the number of benefit recipients; in a household with more than one child each will be included in the count.

Welfare reform in July introduced three new benefits Jobseeker Support, Sole Parent Support, and Supported Living Payment , which replaced many of the previously existing benefits, and changed the obligations to be met by recipients of a benefit. The welfare reform changes have been described at https: The benefits prior to the June reform are not directly comparable with the benefits as at June Prior to , "Other benefits" included: To be eligible for a benefit, clients must have insufficient income from all sources to support themselves and any dependents, and meet specific eligibility criteria.

Information about current eligibility criteria for benefits can be found at http: Children aged 0—17 years who were reliant on a recipient of a benefit recipient, New Zealand as at end of June — For 15—17 year olds the percentage of children reliant on a recipient of sole parent support was lower than the percentage of children reliant on recipients of jobseeker support Figure Children aged 0—17 years who were reliant on a recipient of a benefit, by age and benefit type, New Zealand as at end of June Social inequities are responsible for a high proportion of death and illness among children in both poor and rich countries.

Health effects of poverty arise from complex interactions between social and environmental factors such as education, poor quality housing and household crowding.

This section of the Child Poverty Monitor brings together data from several sources, each giving valuable insights into factors in the health, education, housing and social sectors that relate to the conditions in which children are born, live and grow, which affect their capacity to develop and thrive.

The health-related factors infant mortality, medical conditions with a social gradient, assault, neglect and maltreatment are considered in detail along with housing and education. Household crowding is included in this report because it has been linked to several health conditions including communicable diseases such as gastroenteritis, hepatitis A and B, and respiratory infections. The infant mortality rate reflects the effects of economic and social environments on the health of mothers and newborns and can be read as an indicator of national commitment to universal maternal and child health, particularly for poor and marginalised families.

In all developed countries, the rates of death in the first year of life infant mortality rates have been reduced to fewer than 10 infant deaths per thousand live births.

The infant mortality rate for New Zealand was similar to that of the United States, higher than Australia and more than twice the rates in Slovenia, Iceland and Japan Figure International comparison of infant mortality rates, Death of a live born infant prior to days of life includes neonates.

Deaths of live born infants prior to days of life per 1, live births. Sudden unexpected death in infancy SUDI: Death of a live born infant prior to days of life, where the cause of death was sudden infant death syndrome SIDS , accidental suffocation or strangulation in bed, inhalation of gastric contents or food, or ill-defined or unspecified causes.

Sudden infant death syndrome SIDS: Cause of death is the main underlying cause of death. Refer to Appendix 2 for relevant codes. Infant mortality rates fell overall from to , with the majority of the decrease occurring between and and a more gradual decline from to Infant mortality rates were stable from — Between and there were inequities in infant mortality rates by socio-economic deprivation, maternal age, ethnicity and gender as shown in Table 5.

The mortality rate for infants born in areas with the highest scores on the NZDep index of deprivation deciles 9—10 was almost three times higher than the mortality rate for infants born in areas with the lowest NZDep scores deciles 1—2. The mortality rates for infants born to mothers younger than 20 years and aged 20—24 years were 2—3 times higher than the mortality rate for infants born to mothers aged 30—34 years. Most infant deaths occurred in the first 28 days of life, and were caused by serious issues occurring around the time around birth such as congenital anomalies, extreme prematurity and other perinatal conditions.

Sudden unexpected death in infancy SUDI was the most common cause of death for infants aged from 28 days old Table 6. Infant mortality rates in New Zealand, total — and by prioritised ethnicity — Infant deaths by demographic factors, New Zealand — National Mortality Collection; Denominator: Birth Registration Dataset; Rate ratios are unadjusted. Infant mortality by main underlying cause of death, New Zealand — Sudden unexpected death in infancy; SIDS: Sudden infant death syndrome.

These are deaths that occur suddenly and unexpectedly in the first year of life, usually in otherwise healthy infants, and often during sleep.

Collectively these challenges were likely barriers to being able to provide a safe sleep environment for baby or to access appropriate supports.

From to there was a statistically significant fall in the SUDI rate. Between and there were inequities in SUDI rates by socioeconomic deprivation, maternal age, ethnicity, gestational age at birth and gender as shown in Table 7. The SUDI rate for infants living in areas with the highest scores on the NZDep index of deprivation deciles 9—10 was more than seven times higher than infant mortality rates for infants in areas with the lowest NZDep scores deciles 1—2.

The SUDI rate for infants born to mothers aged under 20 years was almost eight times higher than the rate for infants born to mothers aged 30 years or older, and for infants born to mothers aged 20—25 years the SUDI rate was five times the rate for infants born to mothers aged 30 years or older.

National Mortality Collection, Denominator: The New Zealand Child and Youth Epidemiology Service has identified a number of medical conditions and modes of injury where rates of death or hospitalisation are more than one and a half times higher for children living in areas with the highest NZDep index of deprivation scores deciles 9—10 compared with children living in areas with the lowest NZDep scores deciles 1—2 and conditions where there are strong social gradients on the basis of ethnicity see Appendix 3.

These medical conditions and modes of injury are said to have a social gradient. This section reviews deaths and hospitalisations from medical conditions and injuries with a social gradient, including sudden unexpected death in infancy SUDI , using information from the National Mortality Collection and the National Minimum Dataset.

National Mortality Collection; Hospitalisations: Deaths excluding neonates with a medical condition or injury with a social gradient as the main underlying cause of death.

Acute and arranged hospitalisations excluding neonates and waiting list cases with a medical condition with a social gradient as the primary diagnosis and hospitalisations with a primary diagnosis of injury with a social gradient excluding neonates and ED cases. Medical conditions with a social gradient: Acute bronchiolitis; acute lower respiratory infection unspecified; acute upper respiratory infections; asthma and wheeze; bronchiectasis; croup, laryngitis, tracheitis, epiglottitis; dermatitis and eczema; epilepsy or status epilepticus; febrile convulsions; gastroenteritis; inguinal hernia; meningitis; meningococcal disease; nutritional deficiencies or anaemias; osteomyelitis; otitis media; pneumonia; rheumatic fever or rheumatic heart disease; skin infections; tuberculosis; urinary tract infection; vaccine preventable diseases; viral infection of unspecified site for codes see Appendix 2.

Injuries with a social gradient: External cause is land transport crashes road traffic; non-traffic ; falls; mechanical forces inanimate; animate ; thermal injury; poisoning; and drowning or submersion for codes see Appendix 2. SUDI rates are traditionally calculated per 1, live births, however in this section of the report the denominator used was children aged 0—14 year olds, so that the relative contribution SUDI makes to mortality in this age group is more readily appreciated.

In the five years from — there were deaths of 0—14 year olds as a result of conditions with a social gradient. Drowning and off-road transport injuries were also frequent causes of death from injuries with a social gradient Table 8. From to there was an overall marked fall in mortality rates for sudden unexpected death in infancy and deaths from injuries with a social gradient, with a less marked fall in the deaths from medical conditions with a social gradient Figure Deaths from conditions with a social gradient in 0—14 year olds excluding neonates , by main underlying cause of death, New Zealand, — National Mortality Collection neonates removed ; Denominator: Deaths from conditions with a social gradient in 0—14 year olds excluding neonates , New Zealand, — There was significant disparity in death rates from conditions with a social gradient by ethnicity, particularly for medical conditions.

Analysis by NZDep confirmed the social gradient for the selected medical conditions and injuries Figure Figure 36 and other similar figures compare the rates in different population groups with the reference REF population group.

An unadjusted rate ratio of one indicates no difference between two groups. A rate ratio of two indicates that the health condition occurs twice as often in the specified group compared with the reference group. The error bars indicate the level of uncertainty in the ratio.

In the five years from — there were , hospitalisations of 0—14 year olds for medical conditions with a social gradient and 44, such hospitalisations for injuries with a social gradient. The most common primary diagnoses for hospitalisations for medical conditions with a social gradient were respiratory and communicable diseases such as asthma, bronchiolitis and gastroenteritis. The hospitalisation rate of 0—14 year olds for medical conditions with a social gradient rose overall from to ; the rise was most marked from to From to hospitalisation rates for selected respiratory and communicable diseases with a social gradient were highest for the youngest children and declined steeply with increasing age Figure There was significant ethnic disparity in hospitalisation rates for medical conditions and injuries with a social gradient.

Hospitalisation rates for conditions with a social gradient were slightly higher for male 0—14 year olds compared with female 0—14 year olds.

National Minimum Dataset neonates removed ; Denominator: Statistics NZ estimated population. Hospitalisations for conditions with a social gradient in 0—14 year olds excluding neonates , New Zealand — Hospitalisations for selected conditions with a social gradient in 0—14 year olds by age, New Zealand — Hospitalisation for medical conditions and injuries with a social gradient, comparison by demographic factors, New Zealand — Child maltreatment is a serious public health issue that is recognised internationally.

The following section reviews deaths and hospitalisations of New Zealand 0—14 year olds that involved injuries due to assault, neglect or maltreatment, using data from the National Minimum Dataset and the National Mortality Collection. Hospitalisations for injuries arising from the assault, neglect, or maltreatment of 0—14 year olds. From — there were children aged 0—14 years who died from injuries arising from assault, neglect, or maltreatment, a stable rate of around nine deaths per million children per year.

Lower rates in —03, —13 and were not statistically different from the rates in other years Figure Data from future years are required to determine whether this is the start of a new trend or year-to-year statistical variation. In the five-years from — there were 28 deaths of 0—14 year olds as a result of assault, neglect or maltreatment.

Sixteen of these deaths were of female and 12 were of male children. Sixteen deaths occurred in the first year of life, seven deaths were of 1—4 year olds and five were of 5—14 year olds.

There was an overall fall in both the number and rate of hospitalisations for injuries arising from assault, neglect or maltreatment of New Zealand children aged 0—14 years from to Figure In the five years from — there were hospitalisations of 0—14 year olds for injuries arising from assault, neglect or maltreatment.

The most common primary diagnoses for these hospitalisations included traumatic subdural haemorrhage in 0—4 year olds, and head injuries at all ages 0—14 years Table Age-specific hospitalisation rates for injuries arising from assault, neglect or maltreatment were highest in the first year of life Figure There was a clear social gradient with increasing hospitalisation rates for children living in areas with higher scores on the NZDep index of deprivation.

Hospitalisation rates were eight times higher for children who lived in areas with the highest NZDep scores compared with children living in areas with the lowest scores. Hospitalisations due to injuries arising from the assault, neglect, or maltreatment of 0—14 year olds, New Zealand — Hospitalisations due to injuries arising from assault, neglect, or maltreatment of 0—14 year olds by age and gender, New Zealand — Nature of injuries arising from injuries arising from the assault, neglect, or maltreatment of hospitalised 0—14 year olds, by age group, New Zealand — Hospitalisations for injuries arising from assault, neglect, or maltreatment of 0—14 year olds, comparison by demographic factors, New Zealand — Addressing quality and affordability of housing is arguably the most important action to mitigate the effects of child poverty in New Zealand.

Put up with feeling cold as a result of being forced to keep costs down to pay for other basics. Statistics New Zealand People who owned their home, partly owned their home, or held it in a family trust. People who did not own their home, did not have it in a family trust, and were making rent payments to a private person, trust, or business. People who did not own their home, did not have it in a family trust, and were making rent payments to Housing New Zealand Corporation, local authority or city council, or other state-owned corporation or state-owned enterprise, or government department or ministry.

Housing costs include all mortgage outgoings principal and interest together with rent and rates for all household members.

Repairs, maintenance and dwelling insurance are not included. Any housing-related cash assistance from the government is included in household income. Variations in housing costs do not necessarily correspond to similar variations in housing quality.

This is because many older individuals live in good accommodation with relatively low housing costs, for example, those living in mortgage-free homes, whereas many in an earlier part of the life cycle have a similar standard of accommodation but relatively high accommodation costs. The NZHES data give a sense of the scale of the issue but are not sufficiently robust for a time series. The NZHES-based crowding rates are derived from a sample not from the total population and are somewhat lower than the Census rates.

Material Wellbeing Index MWI quintiles are calculated by ranking all people by the MWI score of their households and then dividing them into five equal groups quintiles. The MWI quintiles are population-based measures. Home ownership is a significant part of family wealth in New Zealand and enables one generation to pass resources on to the next generation. From to the proportion of people living in owner occupied dwellings fell with a rise in the proportion of people in rental accommodation.

Among people living in rented accommodation, those who have a private sector landlord increased at each Census from to , while at the same time there was a decrease in the percentage of people living in rented accommodation managed by Housing New Zealand Corporation or other social sector housing. Household tenure by ethnicity, individuals in households, New Zealand Census — Total number of people in households. People who did not own their home, did not have it in a family trust, and were making rent payments.

Ethnicity is total response. Rates of mobility are higher for households who rent which can have negative consequences for children in relation to schooling and social interaction. Child poverty rates show a clear gradient across different tenure types. The cost of housing is relatively high in New Zealand.

Individuals aged 0—17 years are more likely than 45—64 year olds and older to live in households with high OTIs. Between and there was an increase in the percentage of individuals living in households with high OTIs across all age groups Figure Housing costs as a proportion of income, accommodation supplement recipients, by household type, New Zealand Household crowding is clearly linked with poorer health outcomes, particularly for children, and there is also some evidence for poorer mental health, educational and social outcomes.

The highest rates of crowding were seen for 0—17 year olds living in Housing New Zealand Corporation HCNZ homes; rates of crowding for 0—17 year olds living in HNZC and private rental homes were higher than rates for their peers in owner-occupied households Figure Household crowding by household tenure and composition, New Zealand — The physical quality of housing is associated with individual and family well-being and the positive health outcomes that accrue from investing in good quality housing.

On average, in the — NZHES years, almost half of the households experiencing major problems with dampness, mould or heating lived in private rental housing, and one-fifth lived in social sector housing.

Problems with dampness, mould, heating, problems keeping homes warm in winter, and frequently putting up with being cold to reduce costs and pay for other basics were more prevalent in households with the lowest incomes after housing costs AHC, Figure Housing quality problems, by household tenure and composition, individuals in households, New Zealand — average.

Major problem with damp and mould in previous 12 months. Major problem with heating or keeping home warm in winter. Housing quality problems, by household income quintile after housing costs and composition, individuals in households, New Zealand — average.

Put up with cold: Housing quality problems, by household material wellbeing index MWI quintile and composition, individuals in households, New Zealand — average. The socioeconomic context in which children and young people live has a significant impact on their educational performance.

The following section presents Ministry of Education data to summarise key measures for educational attainment of school leavers from There are three levels depending on the difficulty of the standards achieved. At each level, students must achieve a certain number of credits, with credits being able to be gained over more than one year.

All schools are assigned a decile ranking based on the socioeconomic status of the areas they serve. These rankings are based on census data from families with school age children in the areas from which the school draws its students.

Census variables used in the ranking procedure include equivalent household income, parent's occupation and educational qualifications, household crowding and income support payments.

Decile ratings are used by the Ministry of Education to allocate targeted funding, as well as for analytical purposes. These data follow a new definition of school leavers from the Ministry of Education's ENROL system utilised from onwards so comparison with previous years is not possible. New Zealand has continued to see an increasing percentage of students leaving school with qualifications. The proportion of school-leavers with NCEA level 1 rose from From — there were improvements in educational outcomes across all ethnic groups, with persisting inequity between ethnic groups.

School socioeconomic deciles were used by the Ministry of Education in the time period of this report for funding purposes. Ranking of deciles is in the opposite direction to that of the NZDep index of deprivation used with health data in this report. Highest educational attainment of school leavers, New Zealand — Educational attainment of school leavers by ethnicity, New Zealand — Educational attainment of school leavers by school socioeconomic quintile, New Zealand This appendix outlines the main New Zealand data sources for non-income measures NIMs that are used in this report to monitor material hardship or material wellbeing.

Table 12 is modified from Perry 6 and provides a brief overview of the deprivation and material wellbeing indices used in his report and in other Ministry of Social Development MSD research. National and international material deprivation and material wellbeing indices. A 13 item material deprivation index used by European researchers for some time and formally adopted by the EU in May to replace EU The short-form SF version uses 25 items.

Unlike indices above, NZDep is not a household- or family-based index. It is based on information from households within a small area, using Census items as described in Appendix 3. A partnership should be adaptable to deliver cost-and-operational efficiencies to meet client needs. Regulatory outsourcing, even for small, targeted projects, is a change-management challenge. Staff may worry about the loss of responsibility, or loss of jobs.

New processes and systems may be met with resistance. To overcome skepticism and fear, all relevant business units need to understand what the vendor is providing, with transparency for roles and responsibilities. The transfer of work can then be mapped. A rushed transition will likely be a troubled one. Transferring simple, downstream publishing activities to a service provider can take three to six months; a complete transfer of regulatory affairs portfolio management can take up to one year.

Even if existing regulatory information management systems or processes are outdated or inefficient, few companies want to deal with a deluge of changes in addition to adopting an outsourced operating model.

Many pharma companies prefer to retain their existing systems but will upgrade to more efficient technology if the benefits are explained and demonstrated rather than dictated.

Ultimately, a successful outsourcing relationship requires support from top management. In successful large-scale strategic partnerships, appropriate motivation should be given to staff based on compliance and cooperation quarterly goals, etc. In this setting, governance and communications between providers and companies work best when function is matched to function, subject matter expert SME to SME, therapeutic area to therapeutic area, and local-regional experts to local-regional experts.

A robust governance structure is vital to cultivating and maintaining a healthy outsourcing relationship. In addition to its operational skillset, the regulatory affairs team overseeing a service provider needs to have management expertise. An effective outsourcing partner should report both strategic and functional metrics upon demand. Functional metrics should include percentage of on-time submissions, percentage of submissions achieving first time quality, and number of submissions completed versus number planned.

Strategic metrics can be measured by a survey targeted to specific stakeholders, which can also elicit new ideas for improving the partnership.

Health Related Questions