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Now is the time to take heed of inequitable mortality rates among New Zealand’s children and young people

Child & Youth Mortality Review Committee
22 September 2021

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Mortality rates of Aotearoa New Zealand children and young people remain inequitably distributed and the lack in reduction of these rates is unacceptable.

These are the findings of the Child and Youth Mortality Review Committee (the CYMRC) in its 15th data report released today, which analyses the deaths of children and young people aged between 28 days and 24 years from 2015 and 2019.

CYMRC co-chair Dr Alayne Mikahere-Hall says over this five-year reporting period 2,666 pēpi (babies), tamariki (children) and rangatahi (young people) died.

Many of these deaths are preventable. The most common individual causes of these deaths were suicide, transport incidents, cancers and sudden unexpected death in infancy (SUDI).

Dr Mikahere-Hall says, ‘It is unacceptable in this day and age that Māori pēpi are six times more likely to die from SUDI compared with non-Māori, non-Pacific pēpi and Pacific pēpi are eight times more likely to die.

‘While strong progress was made in reducing mortality rates of pēpi, tamariki and rangatahi in the past, that momentum has been lost and mortality rates have remained stagnant over the past five years. We find this unacceptable.’

CYMRC co-chair Dr Matthew Reid says the current health and disability system reforms and the establishment of the new Māori Health Authority present real opportunities to address the structural changes that are needed, not only within the health system but in our society more generally.

‘This data report drives home the importance and urgency of doing more to reduce child and youth mortality. Now is the time to reduce these shocking statistics in a redesigned health system and build a greater understanding of the inequitable outcomes experienced by pēpi, tamariki and rangatahi in Aotearoa New Zealand. Government’s commitment to the reformed health system with a mandated priority to address inequities is timely.  This will help to reenergise the system to focus more strongly on preventing such deaths and to support positive pro-equity approaches in line with our recommendations.

‘We know there are pockets of excellence across Aotearoa New Zealand where particularly Māori and Pacific-led health services are making a real difference and we urge the incoming new health agencies to support and spread these and similar innovations.

‘We need improved interventions in health and across government and society that are appropriate for Māori and Pacific pēpi, tamariki and rangatahi to help address the inequity.’

Dr Mikahere-Hall says higher priority must be placed on reducing these shameful statistics.

Mortality rates are also highest in areas of high socioeconomic deprivation, with those in the New Zealand Deprivation Index decile 10 (the group with the highest deprivation) three times more likely to die than those in decile 1 (the group with the lowest deprivation). The combined effect of these findings is that Māori and Pacific communities have a large burden of mortality.

‘Every pēpi deserves the very best start in life. This data report represents the lives of 2,666 pēpi, tamariki and rangatahi that have died far too young. We call on all government policy makers, funders and service providers to examine the structural differences that interrupt quality of life,’ says Dr Mikahere-Hall.

If any of the issues in this report are personal for you and you want to talk to someone, please contact any of the agencies and services below.

  • Pīrangi koe ki te kōrero? Need to Talk? 1737 call or text 
  • Skylight – | For those facing loss, trauma and grief
  • Le Va – | To support Pacific families and communities
  • | To support Māori individuals, whānau, iwi, hapū and communities to unleash their full potential and have the best possible health and wellbeing outcomes
  • SPARX – an online self-help tool that teaches young people the key skills needed to help combat depression and anxiety
  • Wheturangitia – | Information for families and whānau experiencing the death a baby or child
  • Youthline – 0800 376 633 | free text 234 |
  • Kidsline (for children up to 14 years) – 0800 543 754 (0800 KIDSLINE) | 4–6.00 pm weekdays

You can also talk to your GP or another local health professional, friends, whānau or someone you trust.

Notes to the editor:

The Child and Youth Mortality Review Committee (CYMRC) is a statutory committee accountable to the Health Quality & Safety Commission. The CYMRC reviews and reports on deaths with the aim of reducing the deaths of pēpi, tamariki and rangatahi aged between 28 days and 24 years, and improve the quality of health, disability and other social services delivered to them.

The 15th data report considers equity as a key priority to protect tamariki Māori and Pacific children from preventable mortality. Te Tiriti o Waitangi underlies the health sector’s obligations to Māori. Treaty-based Māori rights are augmented by the broader rights of children and young people to equitable outcomes regardless of their ethnicity. A human rights-based approach to premature mortality reduction requires all those involved to reduce mortality in marginalised children and young people, and to ‘take all appropriate measures to ensure equality and protect children against discrimination’.

Read the report here.

Ko te pikinga o ngā mate o ngā tamariki me ngā rangatahi o Aotearoa he mea tino rerekē, ā, ko te korenga hoki o te hekenga e kore rawa e pai.

Inā rā ngā kitenga o te Komiti Arotake Matenga Tamariki (CYMRC) i tana pūrongo raraunga 15 i whakaputaina i tēnei rā, e tātari ana i ngā matenga o ngā tamariki me ngā rangatahi i waenga i ngā 28 rā me te 24 tau te pakeke mai i ngā tau 2015 me 2019.

I mea mai tētahi o ngā kaihautū o CYMRC a Tākuta Alayne Mikahere-Hall, puta noa i ngā tau tuku pūrongo e rima nei, e 2,666 ngā pēpi, ngā tamariki me ngā rangatahi i mate.

Tokomaha o ēnei matenga e taea te kaupare. Ko ngā matenga pā noa mai o ēnei matenga ko te whakamomori, te aitua ā-waka, mate pukupuku, me te mate ohorere o te pēpi (SUDI).

Ka mea mai a Tākuta Mikahere-Hall, ‘He mea tino kore pai i ēnei rā e ono putu ake te matenga o ngā pēpi Māori i te mate ohorere SUDI i ērā atu o ngā pēpi ehara i te Māori, ehara i te Pasifika. He mea tino kino ake ko te waru putu ake o ngā pēpi Pasifika i mate’.

‘Ahakoa te kaha mahi hei whakaheke i ngā matenga o ngā pēpi, tamariki me ngā rangatahi kua mimiti taua kaha, kā mutu kua ōrite haere ngā matenga i ngā rima tau ka hori ake nei. Mō mātou ake kāore tēnei i te paku pai.’

Tērā atu o ngā kaihautū o CYMRC Tākuta Matthew Reid ka mea mai mā te whakahoutanga o te pūnaha hauora, pūnaha hauā me te whakatū i te Manatū Hauora Māori hou ka tino whai wāhi ki te tirotiro panoni e hiahiatia ana kaua o roto anake o te pūnaha hauora engari o roto hoki o tō tātou pāpori whānui.

‘Ka kōkiri tēnei pūrongo raraunga i te kaha mahi, te tere hoki hei whakaheke i ngā matenga tamariki, matenga rangatahi. Ko āianei te wā hei whakaiti i ēnei raraunga kino mā roto mai i tētahi pūnaha hauora e whakahoungia anōtia me te piki māramatanga mō ngā putanga hauora e pā atu ana ki ngā pēpi, tamariki, rangatahi hoki o Aotearoa. Ko te tautoko a te Kāwanatanga ki te pūnaha hauora hou mā te mana whakahaere kia whakatikaina ngā rerekētanga he mea arotau. Mā tēnei ka whakakahangia anō te pūnaha kia kaha aro atu hei aukati i ngā matenga me te tautoko i ngā tukanga mana taurite ki tā ā mātou tohutohu e kī ai.

‘Mōhio ana mātou kei ētahi wāhi i Aotearoa ngā ratonga hauora tino pai e ārahina ana e te Māori me te Pasifika e kaha te mahi, nā konei ka kaha akiaki hoki i ngā rāngai hauora hou ki te tautoko me tuku whānui i ēnei mahi hou.

‘Me mātua whakapai ake ngā wawaotanga hauora, huri i te kāwanatanga me te pāpori e tika ana mō ngā pēpi Māori, Pasifika, ngā tamariki, ngā rangatahi hei āwhina i te tiro rerekētanga.’

Mea mai ana a Tākuta Mikahere-Hall me aronui atu ki te whakaiti i ēnei raraunga tino kino.

He tokomaha hoki ngā matenga i ngā wāhi rawakore ko ērā i te Rārangi Rawakore o Aotearoa taumata 10 (te rōpū tino rawakore) e toru putu ake i ērā o te taumata 1 (te rōpū whairawa). Ko te pānga hiato o ēnei kitenga ko te nuinga o ngā matenga ka noho taumaha ki ngā hapori Māori, hapori Pasifika.

‘Me whānau ora mai ngā pēpi katoa. Kei te kōrerotia tēnei pūrongo raraunga mō te oranga o ngā 2,666 pēpi, tamariki me ngā rangatahi i mate tino wawe ai. Kei te karanga atu mātou ngā kaiwhakarite kaupapa here a te kāwanatanga, ngā Kaituku pūtea, me ngā ratonga kia āta tirotiro i ngā hanga rerekē e kokoti ana i te kounga o te orangatanga,’ tā Tākuta Dr Mikahere-Hall.

O lo o tumau pea le lē tutusa o le vaevaega o le aofai o tamaiti ma tupulaga talavou e maliliu i Aotearoa Niu Sila ma e lē taliaina le leai o se tuuitiitia o lea fuainumera.

O iuga nei o lo o folasia i le Child and Youth Mortality Review Committee (le CYMRC) i le lipoti lona 15na faalauiloa i le asō, o lo o iloilo auiliili ai le maliliu o tamaiti ma tupulaga talavou i le va o tausaga mai le 28 aso le matutua ma le 24 tausaga le matutua mai le 2015 ma le 2019.

Na faaalia e se tasi o taitaifono a le CYMRC, Dr Alayne Mikahere-Hall, mai le lima tausaga na lipotia e 2,666 pepe, tamaiti ma tupulaga talavou na maliliu.

O le tele o i latou nei na maliliu e mafua mai tulaga e mafai ona foia. O mafuaaga sili ona taatele e maliliu ai o le pule i le ola, faalavelave tau taavale, kanesa ma le faafuaseia ona maliliu a o pepe meamea (SUDI).

Na faaalia e Dr Mikahere-Hall, ‘O se tulaga e lē taliaina i nei onapo le faaonoina ona maliliu o pepe Māori mai le SUDI faatusa i pepe e lē o ni pepe Māori, pe lē o ni pepe Pasifika. O le isi mea sili ai ona mata‘utia e faavaluina le maliliu o pepe Pasifika.’

‘A o faia taumafaiga malosi e tuuitiitia ai le aofai o pepe, tamaiti ma tupulaga talavou e maliliu i vaitaimi ua mavae atu, ua mou ese atu lava nei taumafaiga ma ua tumau ai pea ona leai se tulaga lelei i le lima tausaga ua mavae o le aofai o tagata maliliu. O tulaga nei matou te matua‘i lē taliaina.’

Na saunoa le tasi taitaifono a le CYMRC, Dr Matthew Reid o galuega e toefuatai ai le faiga faavae tau soifua maloloina ma tulaga o manaoga faapitoa, atoa ai ma le faavaeina o le pulega fou o le Māori Health Authority ua faaalia ai avanoa e tali atu ai i suiga e moomia i le faiga faavae, e lē gata i totonu lava o le faiga faavae tau soifua maloloina ae faapena foi ia tatou faiga lautele.

‘Ua faamaonia mai le lipoti lenei le tāua ma le vave moomia o le faia o galuega e tuuitiitia ai tulaga e maliliu ai tamaiti ma tupulaga talavou. O le taimi lenei ua tatau ona tuuitiitia ai nei faamaumauga faafuainumera ogaoga i se faiga faavae tau soifua maloloina ua toe faatulaga ma lalaga a‘e ai se malamalama sili i taunuuga lē tutusa o aafia ai pepe, tamaiti ma tupulaga talavou i totonu o Aotearoa Niu Sila.’ Ua sauni le Malo e toefuatai le faiga faavae tau soifua maloloina ma ave le faamuamua e talanoaina ai tulaga lē tutusa. O le a mafai ona toe faamalosia atili le faiga faavae e taula‘i atili i faiga e foia ai tagata ua maliliu faapenei ma lagolagoina faiga e maua ai faiga e laugatasia ai tagata e ogatasi ma a tatou fautuaga.

‘Matou te iloa e iai vaega o atagia ai faiga silisili ona lelei i Aotearoa Niu Sila atoa o lo o taimua ai auaunaga tau soifua maloloina o faafoeina mo tagata Māori ma tagata Pasifika ma o iloga ai suiga lelei, ma e matou te fautuaina pulega fou tau soifua maloloina e lagolago ma faalauiloa nei atinae fou ma isi atinae tai tutusa.

Peitai, e tumau pea le moomia ona iloa mafuaaga o afaina ai le soifua maloloina.‘E moomia ona tatou faaleleia faiga e foia ma togafitia ai faaletonu tau soifua maloloina ma faatino faiga nei e faigamalo uma ma le atunuu ma ia talafeagai nei faiga mo pepe, tamaiti ma tupulaga talavou Māori ma le Pasifika e tali atu ai i tulaga lē tutusa.’

Saunoa Dr Mikahere-Hall e tatau ona faasili le faamuamua i le tuuitiitia o nei faamaumauga faafuainumera matagā.

E pito sili ona maualuga le aofai o tagata maliliu i vaega o le atunuu e maualalo ai avanoa e siitia ai tulaga tau tamaoaiga ma agafesootai, ma ua faailoa mai o tagata o lo o faamauina i le New Zealand Deprivation Index decile 10 (o tagata pito sili ona maualuga le faamativaina) e faatoluina le ono maliliu pe a faatusa i tagata o faamauina i le decile 1 (o tagata pito sili ona maualalo le faamativaina). O le tuufaatasi o nei iuga ua faailoa ai e sili atu ona pa‘ū le mamafa o le avega o tagata e maliliu i tagata Māori ma tagata Pasifika.

‘E tatau i pepe uma ona maua le amataga pito sili ona lelei e ola ai. Ua faaalia mai i le lipoti o le 2,666 o pepe, tamaiti, ma tupulaga na maliliu laiti. Matou te talosagaina i latou o galulue mo le malo e saunia taiala, o i latou o maua mai ai fesoasoani tupe ma faalapotopotoga o saunia auaunaga, ina ia suesue i tulaga o lo o eseese ai faiga faavae ua faalavelavea ai le maua o tulaga lelei mo le soifuaga,’ o le saunoaga lea a Dr Mikahere-Hall.

ʻOku kei hokohoko atu pē ʻa e ‘ikai ke potupotu tatau ʻa e tuʻunga ‘o e lahi ‘a e mate (mortality rates) ‘a e fānau mo e toʻutupu ‘o Aotearoa Nuʻu Silá ni pea ʻoku taʻefeʻunga ‘a e ʻikai ko ia ke malava ‘o holoki ki lalo ‘a e ngaahi tuʻunga ko ení.

Ko e ngaahi ola eni mei he lipooti hono 15 ‘a e Kōmiti ki hono Vakaiʻi ‘o e Tuʻunga ‘o e Mate ‘a e Fānaú mo e Toʻutupú (Child and Youth Mortality Review Committee – CYMRC) ‘a ia ‘oku tuku atu ‘i he ‘ahó ni ‘o fakaikiiki atu ai ‘a e mate ‘a e fānau mo e to‘utupú ‘i he vahaʻa ‘o e taʻu motuʻa ‘aho ʻe 28 ki he taʻu 24 meí he 2015 mo e 2019.

ʻOku pehē ʻe he taha ʻo e ongo sea ‘o e CYMRC Dr Alayne Mikahere-Hall, ‘i he taʻu ʻe nima ko eni ‘o e lipootí, kuo mate ai ha pēpē, fānau iiki mo ha fānau to‘utupu ‘e toko 2,666.

Ko e lahi ‘o e ngaahi mate ko ení ‘oku ala taʻofi. Ko e lahi taha ʻo e ngaahi mate ko ení ko e taonakita, ngaahi fakatuʻutāmaki ‘i he fefonongaʻakí, kanisā, mo e mate taʻeʻamanekina ‘i he kei valevalé (SUDI).

Naʻe pehē ʻe Dr Mikahere-Hall, ‘ʻOku taʻefeʻunga ‘i he ngaahi ʻahó ní ke liunga ono ʻa e tuʻunga ‘o e mate ʻa e pēpē valevale Mauli mei he SUDI ʻi hono fakahoa ki he pēpē ‘oku ʻikai Maulí mo ʻikai Pasifikí (non-Māori, non-Pacific). ʻOku to e fuʻu fakaloloma ange ‘a e tuʻunga ‘oku ʻi ai ʻa e pēpē Pasifikí he ‘oku liunga valu ‘a e tuʻunga ‘o e lahi ‘enau maté.’

‘Neongo kuo ʻi ha tuʻunga mālohi ange ‘a e holo ki lalo ‘a e lahi ‘a e mate ‘a e pēpeé, fānau iikí mo e toʻutupú ʻi he kuohilí, kuo mole atu ʻa e tuʻunga fakalakalaka ko iá pea kuo tuʻumaʻu ai ʻa e tuʻunga ʻo e lahi ‘a e maté ʻi he taʻu ‘e nima kuohilí. ‘Oku mau lau eni ko ha tuʻunga taʻefeʻunga.’

‘Oku pehē ‘e he kaungā-sea ‘o e CYMRC ko Dr Matthew Reid ‘oku ‘omai ‘e he fakalelei ‘oku lolotonga fakahoko ki he faʻunga ngāue ki he moʻui leleí mo e faingataʻia fakaesinó (health and disability system reforms) mo hono fokotuʻu ‘o e Maʻu Mafai Pule ki he Moʻui Lelei ʻa e Kakai Maulí (Māori Health Authority) ʻa e ngaahi faingamālie moʻoni ke fakahoko ai ha ngaahi liliu ‘oku fiemaʻu ki he faʻunga ngáué, ʻo ʻikai ngata pē ʻi he faʻunga ngáue ki he moʻui leleí ka ki hotau sōsaietí fakalūkufua foki.

‘ʻOku fakamamafaʻi ʻi he fakamatala ʻoku ʻoatu ʻi he lipooti ko ení ʻa e fiemaʻu mahuʻinga ke fakahoko ha ngāue fakavavevave mo lahi ange ke holoki ʻa e lahi ʻo e mate ʻa e fānau iikí mo e toʻutupú. Ko e taimi eni ke holoki ai ʻa e ngaahi fika fakavalevale ko ení ʻaki hano fokotuʻutuʻu foʻou ʻo ha faʻunga ngāue ki he moʻui leleí pea lahi ange mo e tuʻunga ʻo hono mahinoʻi ʻo e ʻikai ko ia ke potupotu tatau ʻa e ngaahi ola ʻoku aʻusia ʻe he pēpē, fānaú mo e toʻutupú ʻi Aotearoa Nuʻu Silá ni. ‘Oku hoko taimi totonu ‘a e tukupā ‘a e Pule‘angá ki hono fakalelei‘i ‘o e fa‘unga ngāue ki he mo‘ui leleí ‘a ia ‘oku fakamu‘omu‘a ai ‘a e kaveinga ki hono fakalelei‘i ‘o e ‘ikai potupotu tataú. ‘E tokoni eni ke fakaivia ‘a e fa‘ungá ke mālohi ange ‘a ‘ene ngāue ki hono ta‘ofi ‘o e fa‘ahinga mate ko ‘ení pea mo tokonia ‘a e founga ngāue ‘okú ne poupoua ‘a e potupotu tataú ‘o hangē ko ia ‘oku mau fokotu‘u atú.

‘ʻOku mau ʻiloʻi ‘oku ʻi ai ‘a e ngaahi ngāue lelei ʻoku fakahoko ʻi he ngaahi feituʻu siʻi pe ‘i Aoteroa Nuʻu Silá ni ka ‘oku fakatefito pē ia ʻi he ngaahi sēvesi ki he moʻui leleí ʻoku tākiekina ʻe he kakai Maulí mo e Pasifikí ʻo maʻu ai ʻa e ola ʻoku lelei, pea ‘oku mau tapou ki he ngaahi potungāue fo‘ou ki he mo‘ui leleí ‘oku fakahū maí ke nau tokonia mo fakamafola atu ‘a e ngaahi founga fo‘ou ko ení mo ha ngaahi founga tatau mo ia.

Neongo eni ʻoku fiemaʻu ke fakahoko ha ngāue ki he ngaahi palopalema ʻokú ne uesia ʻa e tuʻunga ʻo e moʻui leleí. ‘ʻOku tau fiemaʻu ha ngaahi ngāue ‘oku lelei ange ki he moʻui leleí mo e kotoa ‘o e puleʻangá mo e sosaietí, ʻa ia ‘oku tuha mo e pēpē, fānau iikí mo e toʻutupu Maulí mo e Pasifikí ke tokoni ki hono fakaleleiʻi ‘a e tuʻunga faikehekehé ni.’

ʻOku pehē ‘e Dr Mikahere-Hall ʻoku tonu ia ke fakamuʻomuʻa ʻa hono holoki ki lalo ʻa e ngaahi tuʻunga fika fakamā ko ení.

‘Oku māʻolunga taha ʻa e tuʻunga ʻo e lahi ʻo e maté ʻi he ngaahi ʻēlia ʻoku lahi ai ʻa e masivá (high socioeconomic deprivation), pea ʻoku liunga tolu ai ʻa e tuʻu matuʻutāmaki ʻa e kakai ʻi he tuʻunga fika 10 ʻi hono Fakahokohoko ʻo e Tuʻunga ki he Masivá ‘a Nuʻu Silá ni (New Zealand Deprivation Index decile 10, ko e kulupu eni ʻoku lahi taha ai ‘a e tuʻunga ‘o e masivá) ke nau maté ʻi hono fakahoa kiate kinautolu ‘i he tuʻunga Fakahokohoko fika 1 (ko e kulupu ʻoku siʻisiʻi taha ai ʻa e tuʻunga ʻo e masivá). Ko e ola fakakātoa ʻo e ngaahi meʻá ni ko e lahi ange ‘a e hoko ‘a e maté ‘i he ngaahi komiunitī Maulí mo e Pasifikí.

‘ʻOku tuha mo e pēpē kotoa pē ke nau maʻu ‘a e lelei tahá ʻi he kamata ‘o ʻenau moʻuí. ‘Oku fakamatala atu ‘i he lipooti ko ení ‘a e ngaahi moʻui ʻa e pēpē, fānau iiki mo e toʻutupu ‘e toko 2,666 ʻa ia kuo nau mate kei iiki. ‘Oku mau ui ai ki he kau fokotuʻutuʻu ngāue kotoa pē ʻa e puleʻangá, kau fakapaʻangá mo e ngaahi kautaha ʻoku nau fakahoko ‘a e ngaahi sēvesí ke vakaiʻi ‘a e ngaahi tefitoʻi faikehekehe ‘oku nau uesia ‘a e tuʻunga lelei ‘o e moʻuí,’ ko e lau ia ‘a Dr Mikahere-Hall.

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