Child Health Inequity & High-Burden Diseases Worsening

Cure Kids’ State of Child Health in Aotearoa New Zealand report to be released today reveals the inequitable and worsening burden of diseases, including respiratory conditions, and rheumatic fever and heart disease for our tamariki. And, for the first time, the report makes the case for prioritising mental health concerns because of their growing impact on our tamariki and rangatahi.

Delivered by Cure Kids, Aotearoa New Zealand’s largest funder of child health research outside of the government, the report highlights key priorities for urgent action to improve the health and wellbeing of our tamariki.

Cure Kids CEO Frances Soutter says the report, which is the result of extensive research and collaboration with the Paediatric Society of New Zealand, the Royal Australasian College of Physicians, and the New Zealand Child and Youth Epidemiology Service, identifies a number of concerning trends in child health.

“New Zealand continues to face significant challenges in the area of child health, with many children suffering from preventable illnesses and health conditions. Not only have rates of hospital admissions remained unacceptably high over two decades, but the burden of disease is inequitable,” she says.

The report analyses the most up-to-date national data, from 2000 to the end of 2021, which show the growing inequity in child health in New Zealand; Māori children, Pasifika children, and children living in areas with greatest socioeconomic deprivation are disproportionately affected.

“These health issues cause crises for children and their whānau, requiring visits to hospital, time away from school and significant disruption to families. In the long term, this burden of disease causes chronic conditions which persist into adulthood, with significant social and economic impacts for Aotearoa New Zealand,” says Frances.

Four major classes of health issues which impact the lives of infants, children, and young people in Aotearoa were analysed. Across the health areas examined, including respiratory conditions, rheumatic fever, skin infections and mental health, the report found:

Respiratory conditions

Respiratory conditions are responsible for about a third of all acute hospitalisations for children

Three quarters of these hospitalisations for respiratory conditions are for preschool children

Rates of disease are inequitable: rates of hospitalisations for respiratory conditions are twice as high for children who live with serious socioeconomic deprivation

Bronchiectasis, which is irreversible damage to the lungs, caused by respiratory infections and inflammation, is six times higher for children who live with serious socioeconomic deprivation

The hospitalisation rate for respiratory conditions in children has continued to increase since 2000, despite temporary reductions due to pandemic-response measures.

Acute rheumatic fever and rheumatic heart disease (RHD)

Between 2017 and 2021, Pasifika children were over 100 times more likely to be hospitalised with rheumatic fever than children of European or other ethnicities, while Māori children were 40 times more likely.

Mental health

Hospitalisations for young people with serious mental health concerns almost doubled over the past two decades, while in the last 10 years, psychological distress among young people rose from 5% to almost 25%.

Skin infections

The rate of hospitalisation for Pasifika children with skin infections is three times higher than that for children of European or other ethnicities, and for Māori children it is almost twice as high.

The report cites several key contributing factors, including high rates of child poverty, unhealthy housing conditions, inadequate access to healthcare services in some areas, a lack of funding for vital research into childhood diseases, and complex social pressures affecting mental health.

Frances says Cure Kids aims to galvanise action on these health issues. “The high rates of disease among our tamariki are shocking and demonstrate an urgent need for change. We need help to fund research across these key issues to get ahead of the curve, and we need the government to implement solutions where the evidence is already clear.

“These include targeted investment into the health of children, as well as greater public and private collaboration to find and fund solutions which will generate long-term benefits for the future of our tamariki and rangatahi, as well as for Aotearoa."

Cure Kids Chair of Child Health research and Head of Emergency at Starship, Professor Stuart Dalziel says it is concerning to see Bronchiectasis, presenting for the first time in very young children: “Bronchiectasis is irreversible - patients need support for the rest of their lives to manage ongoing respiratory infections. Not only is this unsustainable for our health system, but for our precious tamariki and rangatahi, and their whānau.”

Cure Kids Chair of Child and Youth Mental Health at the University of Auckland, Professor Terryann Clark (Ngāphui) says to effectively address mental health concerns requires investment in early intervention through mental health services that are evidence-based, co-designed, youth-focused, and culturally informed: “We also need mental health services that incorporate core values in te ao Māori, and likewise in Pacific cultures, which place importance on balanced relationships with culture, spirituality, family, community, and the natural environment.

Professor Terryann Clark says, “To effectively address mental health concerns for children, young people and their whanau - first we need to have quality, accessible services available, but we also have to try and reduce the increasingly high levels of distress amongst our tamariki.

“We also need responsive mental health services that are warm, welcoming and provide the type of care that whanau want and need. We urgently need research that innovates to create new models of care in our communities, clinics and hospitals that deliver the best possible care including Māori, Pacific and other cultures knowledge, preferences and understandings. It is time to do child and youth mental health differently, or we will keep failing our tamariki.”

Health Research Council NZ Fellow, and researcher at the University of Auckland Dr Sainimere Boladuadua says there’s an urgent need to improve access to healthcare for rheumatic fever and rheumatic heart disease. “The data show that our Pasifika and Māori children experience higher rates of hospitalisation for rheumatic fever and rheumatic heart disease than all other children in Aotearoa New Zealand.

Dr Sainimere Boladuadua says “More research is needed to understand more about the risk factors for Rheumatic Fever and Rheumatic Heart Disease, and to use that information to co-design better preventative strategies and treatments that work for communities to enable our children to avoid serious long-term effects on their health.

Read the full report on the State of Child Health in Aotearoa New Zealand for 2022 here.

ENDS

About Cure Kids

Cure Kids is New Zealand’s largest charitable funder of child health research committed to finding better treatments and preventative strategies for a wide range of serious child health conditions. Cure Kids has invested more than $60 million in New Zealand research since it formed over 50 years ago, which has helped to shape and vastly improve the way children who live with serious diseases and health conditions are diagnosed and treated. Cure Kids is currently funding over $19 million in child health research across 70 projects. 

For more information visit: www.curekids.org.nz

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