Poverty to blame for escalating respiratory illness
Poverty to blame for escalating respiratory illness and unvaccinated children
Child Poverty Action Group (CPAG) applauds the recent spotlight on children’s health by the New Zealand Herald.
"This is a welcome focus, and it is clear that what is needed is a much more strategic multi-sector policy response to supporting good health in children, and ensuring that families have all their needs met," says Professor Innes Asher, paediatrician and CPAG Health Spokesperson.
Poverty has many adverse effects on the health of children, including contributing to very high rates of acute and chronic respiratory illness. The number of people affected by asthma and acute respiratory infections has increased over 2000-2017, especially for Māori and Pasifika. Of the 700,000 people in New Zealand affected, one-third are children.
"Some children who have acute or chronic respiratory infections may experience life-long complications from bronchiectasis, a potentially fatal disease caused by lung scarring and damage," says Professor Asher. "This condition is as damaging for people’s lungs as rheumatic fever is for hearts."
In New Zealand there is a tragically high incidence of bronchiectasis, with rates not normally seen in other high-income countries. The Asthma and Respiratory Foundation NZ reports that every year 123 children are diagnosed, and 116 deaths occur.
"Most people diagnosed with bronchiectasis in New Zealand are babies and children under the age of five, and the link between serious lung disease and poor quality housing through poverty is an important factor," says Professor Asher.
While the regulations required by the new Healthy Homes Guarantee Act will go some of the way toward making homes warmer and drier, a comprehensive Warrant of Fitness would go much further toward ensuring homes are fit for purpose. It would require all rental homes to meet the minimum standards before they can be let. CPAG is pleased to see the Green Party calling upon the Government to do better in this area.
Poverty can also result in children having poor nutrition, through families having little or no money spare for healthy food options. This can impact brain development, and lead to other health complications such as those associated with high rates of childhood obesity.
Not being able to get to the doctor for scheduled vaccinations is another barrier caused by poverty.
Immunisation coverage rates for infants have significantly dropped in the past two years, particularly for infants from severely impoverished households, and particularly tamariki Māori.
"While the rhetoric is around vaccine hesitancy, the reality for these households are more around the multiple challenges when living in severe hardship," says Dr Nikki Turner, CPAG Health Spokesperson and Director of the Immunisation Advisory Centre. "Barriers include access issues such as transport costs; lack of after-hours availability for low-income working families; lack of relationships with general practices due to insecure housing and competing priorities with many other urgent household issues.
"It doesn’t take long for the risk of contracting an illness such as whooping cough, where we are currently in the middle of an outbreak, to become high, which is why it’s so important that vaccinations be done on schedule."
Bringing children to the doctor can become expensive after they turn 13 and can no longer access free primary healthcare and prescriptions. Debt accumulated at the clinic can be another barrier to getting to scheduled appointments on time.
CPAG has advocated for free healthcare for all children until they turn 18, and for a raft of other income-related measures to reduce poverty and ensure that families have sufficient income to meet all their basic needs, including healthcare.
"More broadly, we need healthcare policies to be strengthened for low-income families, including maternal healthcare. Recent initiatives like those by Counties Manukau Health Board, offering support to help families get to their vaccination appointments are to be commended, but families in the greatest hardship urgently need a significant income boost before things are likely to get better," says Dr Turner.
CPAG says that no time should be lost in Government implementing the key recommendations in the Welfare Expert Advisory Group’s report Whakamana Tāngata for lifting very low-income families out of poverty.
For more information on:
- Health priorities CPAG urged a New Zealand Government to adopt prior to the 2017 election, see "Health Priorities for a New Zealand where children can flourish"
- CPAG’s recommendations for family incomes see "What will it take to have a welfare system that is fit for families in the 21st century?".