The State of Child Health in Aotearoa NZ

Cure Kids’ inaugural State of Child Health Report 2020 sets out three key indicators to benchmark the health of New Zealand children.

Cure Kids has consulted with experts to identify the three areas of dental disease, respiratory conditions, and skin infections as markers of child health in New Zealand. The report reveals that overall, children in New Zealand have relatively high rates of hospitalisation in these three areas compared with similar countries, and these rates are on the increase.

Rates of hospitalisation for these diseases are highest among Māori and Pasifika children and younger children (under 5 years), and are strongly associated with increasing deprivation – disparities that are common themes throughout the report.

The report is inspired by a similar series of annual reports produced in the United Kingdom, and the three health areas were selected based on criteria including the prevalence and burden of disease, public importance (including for Māori), rates of hospitalisation or death, and availability of robust published data for New Zealand.

In 2021, Cure Kids will consult again to add another three health areas, report on progress to improve health in the first three areas, and continue to add as required each year. This data helps Cure Kids prioritise investments in research that helps our scientists and doctors answer the most urgent questions to improve the health of our children.

These reports will demonstrate areas in which evidence-based medicine is improving child health and highlight areas where such vital evidence is lacking. We will focus on the unanswered questions about these health conditions – such as how to diagnose, prevent, and treat diseases, and how to improve care for children.

 

Key findings

  • For dental disease, data showed that less than 60% of children brush their teeth at least twice daily with a fluoride toothpaste, and 40% of 5-year-olds have evidence of tooth decay, with higher rates for Māori and Pasifika children. Hospitalisation for tooth decay is particularly high for children living in areas of high deprivation.
  • The report found that respiratory conditions are the leading cause of acute admissions to hospital for children, with ‘asthma and wheeze’ the most frequent diagnosis. Māori and Pasifika children, and children living in areas of high deprivation have the highest hospitalisation rates for respiratory conditions.
  • For skin infections, ‘cellulitis’ and ‘cutaneous abscesses, furuncles, and carbuncles’ are the most likely causes of hospitalisation for children. Rates of hospitalisation for serious skin infections are highest in Pasifika, Māori, children younger than 5 years, and children living in areas with high socioeconomic deprivation.

 

Recommendations

  • Given the report highlighted persistent inequalities linked to ethnicity and income, Cure Kids and its partnering organisations agree on the obvious need to urgently prioritise equity in health outcomes for all New Zealand children.
  • Measures which are proven to prevent disease should be urgently implemented wherever there is evidence. However, where evidence gaps remain, there is a need for investment in health research.
  • Cure Kids encourages the collaboration of organisations who are active in funding child health research, including the Government, so our resources can work smarter together to improve the health of our children.
  • Cure Kids points to research that shows rates of hospitalisation for common but severe dental, respiratory, and skin conditions can be reduced through early access to primary healthcare, and ongoing culturally appropriate education for parents, children, and healthcare providers.
  • Evidence also supports investment in cost-effective preventive strategies at the national level to reduce risk factors tied to housing conditions, limit tooth decay due to unhealthy foods and drinks, and enable nurse-led school-based clinics and other child-centred services to address skin health.
  • For all three health areas, hospitalisation rates are the best data currently available. However, hospitalisations are only the tip of the iceberg – research is urgently needed to understand earlier stages of disease – when prevention may still be possible. The report highlights gaps in data, and outlines initiatives to fill these data gaps.