OPINION: Poor health outcomes for children preventable – Chief Children’s Commissioner

A Cure Kids’ 2023 State of Child Health Report lays bare the social determinants of health in which children in  our country are born into, which they grow up in, and the wider set of forces and systems shaping the conditions of their daily lives, writes the Chief Children’s Commissioner, Dr Claire Achmad.

What if our children’s worst health problems could be solved by addressing poverty?

The State of Child Health in Aotearoa New Zealand report, released this week by Cure Kids, shows this to be true.

The report uses the latest national hospital data to shine a spotlight on the growing depth of need in child health in this country. It clearly shows that Māori and Pacific children, and those living in areas with greatest socioeconomic deprivation, are disproportionately affected by poor health. When we cross-reference this data to official child poverty figures, the overlap is stark.

The report highlights five particular child health problems that need urgent attention in Aotearoa New Zealand: respiratory conditions, rheumatic fever and rheumatic heart disease, skin infections, dental disease and mental health concerns.

It shows that children who live in the most deprived socioeconomic areas have double the rate of hospitalisations for respiratory conditions compared with others, and tooth decay hospitalisations are particularly high too. Hospitalisations for young people with serious mental health concerns almost doubled over the past two decades, while in the last 10 years, psychological distress among young people rose from 5% to almost 25%. We know that health issues contribute to stress, and in some cases, crises, for whānau. They require visits to hospital, time away from school and cause significant family disruptions.

These are health problems that shouldn’t be so prevalent in our small, relatively rich nation. We need to take urgent action to prevent them.

Making change for children and young people suffering from these illnesses will require intentional policy decisions and collaborative efforts across party lines. Solutions need to be based on deeply partnered ways of working with iwi, kaupapa Māori, Pacific and community-based health services, and continued and new investment into child health research and practice.

I’m pleased that the Government is already committed to extending a focus on the crucial first 2000 days, which provide the foundational building blocks for childhood and lifetime health and wellbeing. As highlighted by this report, it’s crucial that a focus on preventing respiratory conditions, rheumatic fever and skin conditions must be a part of this early childhood focus.

However, given the fact that many of the child health challenges presented in the State of Child Health are entirely preventable, much more action is needed.

The report shows through hard data that contributing factors to these illnesses are poor housing conditions, inadequate access to healthcare services in some areas, and complex social pressures affecting our children and young peoples’ mental health.

The needs this report lays bare the social determinants of health - the non-medical factors that influence health outcomes.

These are the conditions in which children in our country are born into, which they grow up in, and the wider set of forces and systems shaping the conditions of their daily lives.

The avoidable and unfair nature of the health burdens experienced by far too many children in our country – as shown in this report – are a further call to action to strengthen child poverty reduction efforts.

It’s both shocking and encouraging that these diseases are entirely preventable. Shocking, because they simply shouldn’t be part of the experience of childhood here. Encouraging, because we know that with the right prevention efforts, these child health problems can be turned around.

Our country can do so much better than this, and we must.

This report demonstrates an urgent need for intentional, cross-partisan support to end child poverty, and I continue to call on the Government to make this a priority. The evidence and data presented this week by Cure Kids shows us that this is now urgent.

As the independent advocate working for and with children and young people, I get to witness the boundless potential of children and youth up close on a regular basis, when I have the privilege of showing up in their places and spaces, where I listen – really listen – to what they have to say.

They tell me about their aspirations and dreams, they share their insights and knowledge, and their ideas and solutions for better childhoods, for better communities, for a better country. They tell me that they want thriving health – but that for too many, there are barriers getting in the way.

Childhood is a relatively short period, but it sets the foundations for the rest of our life. Children born today will most likely still be alive in 2100, so it is crucial that we choose to take an intergenerational view when investing in their health and wellbeing.

Please join me in calling for ending child poverty to be a project of national significance, so that all children can grow up in good health and go on to live their best lives.

(Dr Claire Achmad is Kaikōmihana Matua – Chief Children’s Commissioner at Mana Mokopuna – Children and Young People’s Commission.)