Te Tuia Well Child supports today’s release of The New Zealand Children’s Social Health Monitor 2010 update.

In New Zealand today, children are more likely than any other age group in our society to live in poverty and suffer the consequences.

There is a well recognised link between poverty and poor health outcomes for children. The last two years have seen rises in unemployment, with rates currently around 6.4percent, and more children reliant on benefit recipients. As of April 2010 around 243,000 children were benefit-reliant, an increase of nearly 33,000 or around 15 percent.

Hospital admissions for medical conditions that occur more frequently in children living in poverty have increased over the past two years, particularly for Maori and Pacific children.

Families whose main source of income is a Government benefit are more likely to be living in severe or significant hardship. As a consequence these families are more likely to: buy cheaper cuts of meat; go without fruit and vegetables; put up with feeling cold to save on heating costs; make do with cramped housing; have children share a bed; postpone a child’s visit to the doctor or dentist; go without a computer or internet access, and limit their child’s involvement in school trips, sports and extracurricular activities.

Economic recessions have affected children’s health in other countries. However, this report also notes the experience of Sweden in the 1990s where, despite a significant rise in children living in low income families, there were no significant increases in childhood hospitalisations for poverty-related illnesses. The authors concluded that the “maintenance of investments in education, social insurance, and universal access to free health care may have mitigated the impacts of the recession on children during this period”.

Today’s report highlights not only the increasing burden placed upon families below the poverty line, but also reinforces the need to find effective strategies that will assist them, even within the current limits of financial expenditure.

Te Tuia Well Child is a consortium of academics and service deliverers interested in child outcomes. Current membership consists of four Universities and includes the:
University of Auckland
• Immunisation Advisory Centre
• Maori SIDS
• Taha (Well Pacific Mother and Infant Service)
• Department of Paediatrics
• Growing up in New Zealand
• School of Nursing
University of Otago
• NZ Child and Youth Epidemiology Service
Auckland University of Technology (AUT)
• Institute of Public Policy
Massey University
• School of Public Health

1. GDP: While New Zealand technically emerged from a recession at the end of the June 2009 quarter (with an increase in GDP of 0.1%), GDP growth since then has been variable (range 0.2-1.0, with the increase in GDP for the most recent (June 2010) quarter being 0.2%).

2. Seasonally Adjusted Unemployment: After being below 4.0% for the majority of 2005-2007, seasonally adjusted unemployment rates rose in 2008-2009, with rates reaching their highest point, at 7.1% in the quarter ending December 2009. Since then rates have fluctuated, falling to 6.0% in the quarter ending March 2010, before rising again to 6.9% in the quarter ending June 2010, and then falling again to 6.4% in the quarter ending September 2010.

3. Youth Unemployment: While young people 15-19 years were not the primary focus of the Monitor, it is concerning to note that on an annual basis, unemployment rates for those aged 15-19 years rose extremely rapidly during (the years ending) September 2008-2010, with unemployment rates in this age group reaching 25.0% in the year ending September 2010.

4. Ethnic Differences in Unemployment: When broken down by ethnicity, both overall unemployment, and absolute increases in unemployment rates were highest for Maori and Pacific peoples during 2008-2010, with unemployment rates in the quarter ending September 2010 being 13.4% for Māori and 13.8% for Pacific peoples, as compared to 8.2% for Asian and 4.7% for European people.

5. Children Reliant on a Benefit Recipient: Even during 2007-2008, when New Zealand’s unemployment rates were at their lowest, nearly one in five (18%) of New Zealand’s children were reliant on a benefit recipient for their family’s income. During April 2008-April 2010, the number of children reliant on benefit recipients increased further, with the number of children reliant on DPB recipients increasing from 158,173 (13.6% of children) in April 2008, to 177,226 (15.1% of children) in April 2010 (19,053 extra children) and the number reliant on unemployment benefits increasing from 5,289 (0.46% of children) in April 2008, to 16,380 (1.4% of children) in April 2010 (11,091 extra children). When all benefit types were taken into account, the total number of children relying on a benefit recipient increased from 211,609 in April 2008 to 243,884 in April 2011 (32,275 extra children), with 20.7% of all New Zealand children being reliant on a benefit recipient at the end of April 2010.

6. Living Standards: While the final results of the 2008 Living Standards Survey are still awaited, the 2004 NZ Living Standards Survey suggested that 58% of families with children who relied on benefits as their main source of family income were living in severe or significant hardship, as compared to 12% of families receiving market income. Living in severe or significant hardship was associated with such things as not having suitable wet weather gear or shoes for children, and postponing doctors or dentists visits because of cost.

7. Long Term Impacts of Low Family Income: Research suggests that children exposed to low family income in the critical first 5 years, in addition to experiencing poorer health (across a range of measures including hospital admissions and mortality from various causes), also have poorer long term outcomes (e.g. leaving school early and without qualifications, being unemployed in later life).

8. Hospital Admissions for Socioeconomically Sensitive Medical Conditions: New Zealand’s children experience a large number of hospital admissions, and a smaller number of deaths each year, from socioeconomically sensitive conditions (i.e. conditions where rates are much higher in economically deprived areas). When trends in hospital admissions for medical conditions with a social gradient (predominantly infectious and respiratory diseases) in children aged 0-14 years were reviewed, rates increased during the early 2000s, reached peak in 2002 and then declined. An upswing in rates was again evident however during 2008-2009 (when compared to 2007 figures, this equated to 2000 additional hospital admissions per year in 2009). When broken down by ethnicity, admissions were consistently higher for Pacific > Māori > European and Asian children. For Pacific children, rates increased during the early 2000s, reached a peak in 2003 and then declined, with an upswing in rates again being evident during 2008-2009. For Māori children, rates were static during the early-mid 2000s, but began to increase after 2007, while for Asian children rates during 2002-2009 remained relatively static. In contrast, for European children rates declined gradually during the mid-late 2000s.

9. Injury Admissions with a Social Gradient, and Injuries Arising from the Assault, Neglect or Maltreatment of Children: In contrast to medical conditions, injury admissions with a social gradient in children aged 0-14 years gradually declined during 2000-2009, while hospital admissions for injuries arising from the assault, neglect or maltreatment of children declined slightly. Deaths from the assault, neglect or maltreatment of children averaged 8 per year during 2000-2007, with little change during this period.

10. Overall Conclusions: Because of the anonymous nature of the data used, it was impossible to prove any direct causal links between rising unemployment, increases in the number of children reliant on benefit recipients, and increasing hospital admissions for socioeconomically sensitive medical conditions. Despite this, the overall picture painted by the 2010 Children’s Social Health Monitor is concerning, with a significant proportion (20%, or one in five) of New Zealand children being reliant on Government Benefits as the primary source of their family’s income, the 2004 Living Standards Survey suggesting that our current social safety nets may inadequately protect these children from severe or significant hardship, and increases in hospital admissions for socioeconomically sensitive medical conditions, which appear to have reversed some of the gains made during the mid-2000s.

ENDS

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