The socio-economic position of a child is a major determinant of health status. In New Zealand Māori and Pacific children suffer more ill health than other ethnic groups.
Children living in deprived circumstances are more likely to have poor health. For example in the early 21st century, those in the most deprived neighbourhoods were 28 times more likely to be hospitalised with rheumatic fever than those in the least deprived neighbourhoods. Their risk for bronchiectasis (a lung disease) was 15.6 times greater and for cot death 10.6 times greater.
Not only do children in low income households have worse health than children in more comfortable material circumstances, but they are likely to have more health problems as adults. The longitudinal study of 1,000 children born in Dunedin in 1972/3 has demonstrated that children's experience of socioeconomic disadvantage can affect their adult health. Compared with those who grew up in high socioeconomic households, 26-year-olds from lower socioeconomic households had poorer dental health, higher levels of blood pressure, higher body mass index scores, lower levels of cardiorespiratory fitness and higher levels of alcohol dependence. This occurred even if their socioeconomic circumstances had improved.
Journalist Lesley Max drew attention to the poor health and welfare status of many New Zealand children in a 1986 Metro magazine article and then in a 1990 book, Children: endangered species? How the needs of New Zealand children are being seriously neglected: a call for action. She founded a social enterprise charity, the Great Potentials Foundation, which runs programmes for children, young people and their families living in adverse circumstances. Max was awarded the New Zealand Order of Merit in 2009 for her services to children.
The link between housing and health is well established. High rates of infectious diseases in children and young people are associated with damp and badly ventilated houses. Crowding (where there are not enough bedrooms for the number of occupants) is a contributing factor to meningococcal disease in children. The risk increases with each additional adult in the house.
While overall crowding has declined since the 1960s, it increased in some parts of the country, such as South Auckland, in the 21st century. In 2013, 22% of children and young people lived in crowded households.
Māori and Pacific health
In the 21st century the health of Māori and Pacific children was worse than that of other ethnic groups. This is a long-standing trend evident over the course of the 20th century and into the 21st century. While rates in important indicators like Māori and Pacific infant mortality improved over the long term, significant gaps between ethnic groups remain.
Pacific children and young people fare worst for many standard health indicators. In the early 21st century they experienced the highest hospitalisation rates by ethnicity for bacterial and skin infections, meningococcal and rheumatic heart disease, gastroenteritis and a range of respiratory diseases. Māori were second highest in these (apart from the rate for gastroenteritis) and highest for deaths and hospitalisation due to unintentional non-traffic injuries and deaths due to traffic injuries.
Differences between hospitalisation rates for Māori and Pacific and non-Māori and non-Pacific for acute upper respiratory tract infections, bronchiolitis among infants and pneumonia among 0–14-year-olds have been largely attributed to disparities in access to warm, dry housing and health food that are a consequence of income inequalities. Māori and Pacific children are more likely than children of other ethnicities to live in households experiencing economic hardship.
Despite these bleak statistics there were some improvements. Meningococcal admissions declined significantly from 2010 for both groups, while Māori tuberculosis and Pacific acute rheumatic-fever admissions declined from 2002. There was a significant decline in hospital admissions for skin infections among Māori aged 0–24 between 2010 and 2014, however, the rates remained twice as high as those for non-Māori and non-Pacific children and youth.
Economic and benefit reforms
Some health researchers argue there is a link between economic reforms and social-security benefit cuts in the 1980s and 1990s and the poor health of many New Zealand children. During this period income inequality increased, and by the mid-1990s exceeded the Organisation for Economic Co-operation and Development average.
Researchers believe cuts to benefits in 1991 had a measurable impact on child health. They cite increasing hospitalisation rates due to preventable conditions such as serious skin infections, meningococcal disease, tuberculosis and bronchiolitis between the early 1990s and early 21st century.