State of Child Health in Aotearoa NZ.

Cure Kids’ third report on the State of Child Health in Aotearoa New Zealand makes the case that we need urgent action on four main priorities for the health of our tamariki and rangatahi.

Cure Kids joined forces with the Paediatric Society of New Zealand, the Royal Australasian College of Physicians, and the New Zealand Child and Youth Epidemiology Service to analyse the data. Based on national data on hospitalisations from 2000 to the end of 2021 for children and young people aged up to 18 years, the group agreed that the priorities should be:

- respiratory conditions,

- rheumatic fever and rheumatic heart disease (RHD),

- skin infections, and

- mental health concerns.

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.

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

- Rates of disease are inequitable: rates of hospitalisations for respiratory conditions are twice as high for children who live with the worst socioeconomic deprivation as for other children.

- 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.

Rheumatic fever and RHD

- Pasifika children are 100 times more likely to be hospitalised with rheumatic fever than children of European or other ethnicities; Māori children are 40 times more likely.

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.

Mental health concerns

- Hospitalisations for young people with serious mental health concerns have doubled over the past two decades,

- Almost a quarter of young people report serious psychological distress — a five-fold increase over the past decade.

The report highlights the need to first understand and identify all the causes of these health conditions, and then to invest in action to reduce these risk factors and prevent these four health conditions. For example, RHD is a complex disease, so more research is needed to understand why some children are so much more vulnerable, and why rates in Aotearoa New Zealand and the Pacific Islands are so high relative to other countries. Cure Kids is funding studies to develop a diagnostic test to detect rheumatic fever, and to trial a vaccine against the bacteria which can trigger acute rheumatic fever. Previous studies supported by Cure Kids have shown that supplements of vitamin D can reduce hospitalisations for respiratory conditions.

The report also points to the importance of improving care for children who are already living with health conditions. For example, Cure Kids is funding several studies on new formulations of antibiotics to prevent acute rheumatic fever (ARF), and on health services for ARF and RHD which are youth-focused and culturally appropriate.  Mental health concerns also require new approaches to care, and Cure Kids is investing in research designed to reduce risk factors for self-harm and suicide, encourage healthy conversations, enhance sleep, and teach young people to recognise and manage their thought patterns to reduce anxiety and depression.

Finally, the health system is stretched, and our hard-working healthcare professionals need new tools, techniques, and treatments in the fight against these health conditions. Cure Kids has funded several studies to find safer and more effective treatments for skin infections such as impetigo.  We are currently funding two studies on new ways to treat and manage asthma, and a trial of an innovative treatment to reduce inflammation in RHD.

The Children’s Commissioner, Judge Frances Eivers, wrote the foreword, focusing on the legal rights of children to health, development, and a decent standard of living. CEO Frances Soutter was interviewed, along with Prof Stuart Dalziel, Dr Sainimere Boladuadua, and Prof Terryann Clark. They emphasised that targeted and coordinated investments into the health of children could generate long-term population-level benefits that far exceed the initial costs. 

In many cases, medical and scientific research has already proven which actions are required to reduce risk factors, to prevent disease, and to diagnose health conditions in time to enable . “There is an urgent need for New Zealand to prioritise implementation of evidence-based measures to detect, prevent, and treat disease as early as possible, and to improve care for children” said Prof Dalziel, Cure Kids Chair of Child Health Research.  

We also need to empower communities which experience the highest risk to implement the strategies to ensure health and wellbeing for their children. “The definition of insanity is doing the same things and expecting something different," said Dr Boladuadua, public health physician, Health Research Council Fellow, and researcher at the University of Auckland, who has led the Cure Kids RHD Prevention & Control Programme in Fiji. “We can co-design high-quality accessible healthcare that works for communities, and helps to avoid the known risk factors for respiratory conditions, rheumatic fever, and RHD.”

Cure Kids CEO Frances Soutter pointed out that “not only have rates of hospital admissions remained unacceptably high over two decades, but the burden of disease is inequitable. 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.”

Cure Kids has made continued investments in research on all four of these health conditions, with partners including the government, other charities, corporates, trusts and foundations, research institutions, and organisations in the healthcare sector. We remain committed to supporting research on the big health issues which impact the lives of our tamariki.