27 Sep 2021

Momentum slows in reducing child mortality rates; significant inequity found

2:17 pm on 27 September 2021

Efforts to reduce the number of children and young people dying appear to have stagnated.

Mourning man on funeral with red rose standing at casket or coffin

In the case of sudden infant death, Māori babies are six times more likely to die than non-Māori. Pacific babies were eight times more likely to die, the committee found. Photo: 123RF

That is the finding of the government's Child and Mortality Review Committee, which analysed 2666 children aged between 28 days and 24 years, who died between 2015 and 2019.

The committee, which is part of the Health Quality and Safety Commission, also found the mortality rates reflect a significant inequity, with Māori and Pacific children far more likely to die.

The committee's co-chair, Matthew Reid, said child mortality had been steadily reducing - but this appears to have stopped.

"Strong progress was made in the past, that momentum has been lost.

"In recent times we've just seen that mortality rates have not been reducing as much as they did earlier on. We've described it as stagnant."

Dr Reid, who is also a public health officer in Canterbury, said they also found significant inequity.

"It is disappointing, particularly the extent of inequity that particularly tamariki and rangatahi Māori and Pacific are quite a lot more likely to die and people in circumstances of poverty as well," he said.

"People living in the poorest areas are three times more likely to die."

In the case of sudden infant death, or SUDI, they found that Māori babies are six times more likely to die than non-Māori. Pacific babies were eight times more likely to die.

All of the commission's findings came as no surprise to Owen Sinclair, who is one of only seven Māori paediatricians in the country.

Based in Waitākere, he said the stagnation - and particularly the disparity - was clear.

"It just fills my heart with sadness. They're reporting well known figures," Dr Sinclair said.

"Tamariki, just Māori in general, just exist out of view from the rest of the health system. They're not getting better, and I think that's the thing that makes me angry: the health system is just observing this."

Deprivation, poverty among risk factors

Dr Reid said the most common causes of death were suicide, transport incidents, cancers and sudden infant death (SUDI).

He said while it was complicated to zero in precisely on causes, many of the deaths were avoidable.

"Well we know that mortality is multi-causal, there's not sort of a single factor that causes deaths," he said.

"But for sure, deprivation and poverty are serious risk factors that feed into a bunch of others, and we think that those are the biggest things that are contributing."

Dr Reid said he hoped the introduction of the Māori Health Authority, as well as wider reforms of the health system, would help address the stagnation.

Dr Sinclair said while he had reservations about whether the authority would deliver the structural change needed, something has to be done.

"These are tamariki, these are children of whānau and family. Some of these could be our biggest and brightest, and we're just wasting children's lives based on their ethnicity and where they're born," he said.

"I think we all bear the responsibility for that."

Dr Sinclair said the stagnation can't be tolerated, and far more priority is needed.

Many deaths preventable - Henare

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Peeni Henare Photo: RNZ / Samuel Rillstone

In a statement, Associate Health Minister Peeni Henare said the findings were unacceptable.

"I echo the words of the committee chair - many of these deaths are preventable," Henare said.

Focusing on deaths among the very young, he added, "it's unacceptable that pēpi Māori are six times more likely to die from SUDI compared with non-Māori."

He added that an evaluation of the National SUDI Prevention Programme is underway.

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