Most New Zealand children and young people are healthy and grow up to become healthy adults. However, there are health imbalances within the child and youth population, primarily associated with family socio-economic status and ethnicity.
For much of the 20th century New Zealand was proud of its child health record. Infant mortality, a major health indicator, was the lowest in the world in the early decades and the second-lowest in 1951. Improvements in living standards, smaller families, free and subsidised public health care, family income support and post-Second World War prosperity contributed to this record.
However, New Zealand slipped relative to other rich countries in the 1960s. In the 1970s New Zealand was still in the top third for most child health indicators, but had fallen within this group. By the early 2000s it had dropped to the bottom third. Various broad explanations have been offered, including poor parenting education and skills, fragmented health services, market-led reform of the New Zealand economy in the late 1980s and 1990s, income inequality, changes in welfare policy and internationally low government spending on children.
Government spending on children increases with age in New Zealand and across Organisation for Economic Co-operation and Development (OECD) countries. Spending on children aged 0–5 years mainly takes the form of cash benefits to parents, tax breaks and childcare. Spending on children aged 6–11 is mainly on eduction and to lesser extent cash payments and tax breaks. For those aged 12–17 public expenditure is overwhelmingly on education. New Zealand per capita government spending on children is in the mid-range for OECD countries.
This does not always mean that the health of children got worse overall. Rates for different indicators improved, but to a lesser extent than in other countries, which caught up with and then surpassed New Zealand.
New Zealand did not fare so well internationally in the early 21st century. An OECD report published in 2009 on child health in the 30 OECD countries found that New Zealand had:
- the highest youth (15–19 years) suicide rate
- the second-lowest immunisation rate for measles and the fifth-lowest for whooping cough
- the 10th-highest infant (0–364 days) mortality rate
- the seventh-highest child (0–19 years) mortality rate.
Overall, New Zealand was ranked 29 out of 30 for child health and safety.
New Zealand’s youth suicide rate at 15.6 per 100,000 of those aged 15 to 19 years from 2009 to 2013 was the highest among 41 countries in the European Union and the OECD – countries defined as 'rich countries' by the United Nations Children's Fund. However, across these countries, suicide was the leading cause of death for those in this age group accounting for 17.6% of all deaths.
Health researchers say that a cautionary approach should be taken when making international comparisons of suicide rates. The level of proof required to classify a death as suicide varies between countries. In New Zealand the investigation process is very thorough and the number of unclassified deaths is low. By comparison, there may be undercounting of suicides in other countries. The stigma attached to suicide may affect the way deaths are classified.
Death and hospitalisation rates
The causes of death for children and young people differ depending on age. In the 2010s sudden unexpected death in infancy was the most common cause of death in post-neonatal babies (29–364 days). Medical conditions like cancer were the leading cause of death in children (1–14 years) and car accidents were also a significant cause. For young people (15–24 years) the leading cause of death is intentional injury (suicide and assault).
Injury and poisoning combined were the most common cause of acute hospitalisation of both children and young people. Other significant causes for children were gastroenteritis and respiratory diseases, and for young people abdominal and pelvic pain and mental-health issues.
Māori and Pacific children and young people had the highest rates of mortality followed by those of European and other ethnicities. Asian children and young people had the lowest rates of mortality. Male children and young people were more likely to die before they turned 25 and much more likely to die as a result of intentional injury (69%) or unintentional injury (76%).