Children Of The Poor: Nothing Matters More

So Don Brash has repeated himself, and another married mother has turned into a sole parent - though I doubt that Je Lan will be off to Work and Income any time soon. I’ve been thinking about sole parents because, in a roundabout way, they featured prominently in the most important news of the week.

The Paediatrics Society report, Monitoring the Health of New Zealand Children and Young People – Indicator Handbook (read it on www.paediatrics.co.nz) came out on 26 November. It makes it crystal clear that being at the bottom of the heap for health is very closely linked with being at the bottom of the heap for family income.

And as a recent Ministry of Social Development report confirmed (Household incomes in New Zealand: trends in indicators of inequality and hardship 1982 to 2004, on http://www.msd.govt.nz/work-areas/social-research/household-incomes.html) no one is more likely to be down there than the children of sole parents.

The Indicator Handbook highlights these families too:

“In spite of improved economic performance in the 2000s, between 2000 and 2004 the proportion of children in severe or significant hardship rose from 18% to 26%...Poverty remains highest among sole parents, dependent on benefits, and their children who number more than 200,000.” Overall, it says, 43.3% of children in sole parent families and 14.6% of children in two parent families lived below the poverty line in 2003-2004.”

The core benefit for a sole parent with two children “went from 92% percent of the average wage in 1986 to just 65% in 1991. These benefit cuts have had significant impact on children.” But since then things have got even worse: “Not linking benefits to wage levels also meant the core benefit / wage relation was eroded even further, to 62% by 1999, and then to 58% in 2004.”

So successive governments have made sure that the benefit which was originally brought in to keep sole parents’ children out of poverty now puts them at very high risk of being in poverty. Only 7.9% of children living in the most affluent areas had a sole parent, compared with 46.2% of children living in the most deprived areas.

What about the government’s flagship anti-child-poverty programme, “Working for Families”? As the Child Poverty Action Group have repeatedly pointed out, and are currently taking a legal case to prove, it discriminates against the poorest children, driving their families further into hardship. (See exactly why on
http://www.cpag.org.nz/campaigns/Child_Tax_Credit_IWP.html)

Why does any of this matter, and why should anyone else care? From start to finish, the Indicator Handbook shows exactly why.

As we’ve known for two centuries, poor children have poor health. Parts of the report read like something out of Dickens.

“The associations between substandard housing and poor health have been known for several centuries, with reports from as early as the 1830s attributing high rates of infectious disease to overcrowded, damp, and poorly ventilated housing. In New Zealand, crowding is strongly correlated with meningococcal disease, while overseas reports also demonstrate correlations with a number of infectious diseases and mental health issues.”

In 2001, 42.5% of children in the most deprived areas lived in crowded households, compared with just 2.7% of children in the most affluent areas. By 2006 - after five supposedly prosperous years – fewer children in the most affluent areas (2.3%) lived in crowded households. But more children in the most deprived areas – 43.6% - lived in crowded households.

Crowding may mean more than sharing a bedroom. In 40% of those families defined as living in severe hardship, children had to share a bed.

With a deadly inevitably, Dickensian health statistics follow. The formal language hides the sheer misery behind them. Skin infections, for example:

“In New Zealand during 1990-2006, there were large increases in the number of children and young people admitted to hospital with serious bacterial infections. In absolute terms, the majority of these increases were attributable to the large rise in admissions for serious skin infections. Admissions for all other serious bacterial infections either remained static or increased, with the exception of meningococcal disease and meningitis, which both exhibited a downward trend during the early-mid 2000s…During 2002-2006, the most common reason for admission was skin infection, accounting for 78.8% of admissions in this category.”

And tuberculosis:

“…a clear resurgence in TB in children was evident during 1992-2001…In New Zealand during the late 1990s-early 2000s, hospital admissions for TB gradually increased, although data for 2004-2006 suggest that admission rates may be beginning to taper off…TB admissions were highest amongst young people in their late teens and early twenties, those living in the most deprived areas, females and those of non-European ethnic origin.”

And rheumatic fever (the report helpfully spells it out: “usually occurs in school-age children and may affect the brain, heart, joints, skin or subcutaneous tissue…Recurrent episodes…may result in the development of rheumatic heart disease…”):

“While New Zealand’s rheumatic fever rates have declined significantly during the past 30 years, they still remain higher than those of many other developed countries. Risk factors include age (school age children), ethnicity (Pacific>> Māori>> European), socioeconomic disadvantage and overcrowding…during the past 10 years, hospital admissions due to acute rheumatic fever and rheumatic heart disease have remained relatively static.”

After all that, here’s the killer fact:

Overall, during 2006, a total of 23,541 babies (39.1% of all births) were born into the most deprived areas.

So if nothing changes, almost 4 out of every 10 new-born children will be at high risk of poor health from day one. And this is after a really good run of around seven or eight years of prosperity, plus heavily increased spending on health care.

The report does not, of course, have the answers. But it does give a few clues.

For a start, we need to find out exactly what’s happening to children’s health – and keep on finding out. We are not doing this now. The report’s authors have done the best they could with the information available. But “adequate data sources were available for only a fraction of the issues that those working in the health sector considered important to child and youth health.”

Still, what we do know is bad enough: “the information currently available is of sufficient quality to suggest that urgent measures are necessary if we are to reduce the large disparities in health outcomes experienced by New Zealand’s children and young people.”

The report makes it very clear that the health of children depends on far more than individual parents and the health system.

“The health and well being of our children and young people reflects the outcomes of very complex ecological interactions with their environment.”

This is why “coordinated action will be required at all levels, from those responsible for higher level Government policies, through to those working with children and young people on a day to day basis.”

Nothing matters more. The reason should be obvious:

“Outcomes for the current generation of children and young people will determine the future success or failure of the community and society as a whole.”

Either we get this right – or at least a whole lot better – or we’re stuffed.

- Anne Else is a Wellington writer and social commentator. Her occasional column will typically appear on a Monday. You can subscribe to receive Letter From Elsewhere by email when it appears via the Free My Scoop News-By-Email Service

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