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Child health shames us again

Child health shames us again

Child health advocate Dr Nikki Turner is calling for a renewed focus on child health following a damning report into the state of our nation’s child health released today by the Paediatric Society of New Zealand. The report describes, amongst other statistics, that New Zealand’s hospital admission rates for childhood skin infections have increased to the point where they are double those in Australia and United States of America. Hospital admission rates in general are much higher for those children living in the most deprived households in New Zealand.

Other major areas for concern facing children who live below our poverty line are bronchiolitis, exposure to household smoking and abuse, both sexual and physical. The trend that is emerging is that New Zealand children living in poverty are significantly more likely to suffer from these issues than those living above the poverty line.

Dr Turner, speaking on behalf of Kia Mataara Well Health, a child health coalition based at the University of Auckland, says that we can turn our shameful statistics around. “We know how to do it. Instead we wring our hands every time another child pays the awful price for living in poverty. We need to significantly redistribute our health resources so that funding goes where it’s needed,” she says.

The links between poor health outcomes and poverty are very well documented. (Graham, Leversha et al. 2001; Easton and Ballantyne 2002; Poulton, Caspi et al. 2002; Case, Fertig et al. 2005; Shaw, Blakely et al. 2005) For example, bronchiolitis, an acute viral infection of the lungs, is easily passed around poorer households which may not have good insulation, ventilation and too few bathrooms and bedrooms for the number of people in the house. Cellulitis or serious skin infections are common in over-crowded homes, low access to washing machines and a diet which may be lacking fresh fruits and vegetables.

It is also estimated that some 40% of year 10 students live in households where one or more person smokes. This figure gets even worse with poorer households where it is estimated that over 60% of year 10 students who attend decile 1 -2 schools report living with parents who smoke. It is estimated that parents who smoke around their children result in 500 hospital admissions for babies under 2yrs, 15,000 episodes of childhood asthma, 27,000 GP consultations and 1,500 glue ear operations every year.

Dr Turner says that New Zealand can become the best in the world for child health indicators. “It is possible, but it requires focus and a will to change. New Zealand used to be child-focused and have good child health outcomes. We can do it again, but we need real commitment from all levels of our society. We challenge all of New Zealand society to put genuine focus and resourcing back into caring for our kids,” she says.

Firstly, New Zealand needs to look at the economics of why we allow too many children to grow up in poverty in this country. Children continue to be much more likely to be living in economic hardship than adults, and they suffer the health outcomes as a consequence. The Working for Families package is significantly helping many low income children, but not all. The economy is currently in good shape; if the promised tax cuts are delivered we should focus them to those on low incomes, to support our children as a priority.

Secondly we can do better at working together: Combining strategies across all sectors and agencies is effective. The UK has shown improvements in child outcomes with top-level commitment to their children with strategy and funding across all sectors – education, welfare, health, housing and local government etc
Ref Opportunity for all Eight Annual Report 2006 Strategy Document DWP, UK http://www.dwp.gov.uk/ofa/reports/2006/pdf/StrategyandIndicators-FullReport.pdf

Thirdly, there are many health and education specific initiatives known to help improve children’s health. These include good access to primary health care, resourcing to early childhood programmes, parenting programmes, and home visiting to families who may be in need of help. New Zealand has made a start in these areas, but much more is needed.

However, the report is not all bad news. Gains have been made in some areas such as road traffic injuries and infant mortality. More recently, hospital admissions and deaths from meningococcal disease have fallen markedly, helped by the meningococcal vaccine roll-out. Further, the Government’s introduction of primary care subsidies and increased prescription subsidies have helped to improve day-to-day access to family doctors.

However, while one third of New Zealand’s population is made up of children, and while many more children are living in hardship than other members of our society, our child health statistics will remain a shameful fact of life in this country. While we have some excellent strategies - we need more. We also need a real commitment with resourcing to renew our focus on our children, to have a real impact on their lives.

References:

Case, A., A. Fertig, et al. (2005). "The lasting impact of childhood health and circumstance." Journal of Health Economics 24(2): 365-89.

Graham, D., A. Leversha, et al. (2001). The Top 10 Report. Top 10 issues affecting the health and wellbeing of children and young people in Auckland and Waikato. Hamilton, Waikato District Health Board: 72.

Poulton, R., A. Caspi, et al. (2002). "Association between children's experience of socioeconomic disadvantage and adult health: a life-course study." Lancet 360(9346): 1640-5.

Shaw, C., T. Blakely, et al. (2005). "The contribution of causes of death to socioeconomic inequalities in child mortality: New Zealand 1981-1999." New Zealand Medical Journal 118(1227): U1779.

ENDS

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