2  Poor outcomes in New Zealand: Selected case studies

New Zealand has a young population compared with other OECD countries. Almost a quarter of the population is under 15 years of age, though this proportion is projected to decline steadily over the next fifty years. In many respects, the well-being of the child population has continued to improve in recent years (eg, infant mortality rates have halved since 1980). On the other hand, specific aspects of New Zealand children’s and young people’s well-being may be a cause for concern both in themselves and for what they indicate about later life outcomes.

Youth suicide, low educational attainment, youth inactivity and teenage pregnancy are areas in which New Zealand performs notably less well than other comparable countries, where there are seemingly important implications for overall social well-being (ie, problems affecting either a large number of people or a smaller number intensely or generating costs for society) and which appear to be amenable, at least in part, to public policy intervention.

While the information presented in this paper provides an indication of some areas of concern about adverse outcomes in New Zealand, it does not provide a thorough indication of the extent of the problem or who is most affected. A crucial step for the design of policy is an assessment of the size and distribution of all the direct and indirect costs of any problem. This will provide an initial assessment, at least of the scope for improvements in outcomes that could be achieved with effective interventions.

Some child outcomes in New Zealand are the subject of intense concern, but it is not clear, despite appearances, whether this country faces any more of a problem in general terms than other comparable countries in ensuring that its children can grow up into competent, happy, productive adults.

Other features of the family and household circumstances (such as lone parenthood) of New Zealand children are distinctive and potentially problematic, but the extent to which they should be priorities in themselves for policy action is more debatable.

2.1  Youth suicide

New Zealand has the highest rate of youth (15 to 24 years) suicide in the OECD, with higher rates among Maori than non-Maori (Figure 1).[4][5] Youth suicide rates have risen, especially for males, over the last two decades (Figure 2). Youth suicide is a serious negative indicator of young people’s well-being worthy of attention in its own right, although the number of deaths involved is small as a percentage of the number of young people.

Figure 1 – Youth suicide rates (ages 15 to 24 years) in OECD countries, both genders combined, latest available years

Source: Calculated from information in World Health Organisation (2001)

Figure 2 – Youth suicide rates (ages 15 to 24 years), by gender, 1978 to 1998

Source: New Zealand Health Information Service (2001).

The main causes of death for children and young adults are accidents – particularly motor vehicle accidents – and suicides. Suicides are responsible for a third of deaths of young people. The most common method of suicide was hanging, which accounted for over half of youth suicides in 1998.

Suicides are uncommon during school-age years. The number of suicides rises during the teenage years reaching a sharp peak at age 20 for males, followed by a steady decline over the life course. Female suicides rise to a local maximum at around 19 years but do not markedly decline until much later in life (New Zealand Health Information Service 2001).

In most industrialised countries, the risk of suicide increases with age, but this is not the case in New Zealand (Skegg 1997). At the time Pritchard (1992) studied youth suicide in New Zealand and Australia, these countries were unique in having youth suicide rates higher than all-age suicide rates.

A total of 7.5% of participants in the CHDS had attempted suicide by the time they reached 21, and more than a quarter had had suicidal thoughts (Fergusson, Horwood and Woodward 2000). Mental health disorders, especially depression, were the most important predictors of suicide attempts. Adverse life events, and being raised in a family with low socio-economic status, were also associated with increased rates of suicide attempts, even when other confounding and intervening factors were taken into account (Fergusson et al 2000).

Suggested explanations for rising youth suicide rates in industrialised countries have included a higher prevalence of depression in recent generations of young people, increased use and misuse of alcohol and psychoactive drugs, changes in family structure, and changing circumstances in society as a whole. There are no clear explanations for New Zealand’s very high youth suicide rates, but psychological aspects of New Zealand youth such as risk-taking and help-seeking behaviour may need to be explored (Skegg 1997).