13 May 2011

Health inequities are largely to blame for the striking ethnic disparities in the rates of rheumatic fever in this country, says the New Zealand Medical Association (NZMA), with differential access to the determinants of health, such as income and housing, leading to differences in the rate of this and many other preventable diseases.

The editorial “Reducing a striking health inequality” published in today’s New Zealand Medical Journal (attached) states that Maori are 20 times and Pacific people 37 times more likely to be admitted to hospital with first time acute rheumatic fever than people of European or other ethnicity. 

The editorial also cites differential access to health care and quality of care as reasons for the disparity.

Despite the success of most developed countries and some developing countries in reducing rheumatic fever rates, the numbers of cases in New Zealand remains high and in recent years there has even been an increase. 

“Rates of rheumatic fever are unacceptable and will not be reduced unless we urgently look at how we address social factors that influence health inequity, such as overcrowded housing, inadequate nutrition, and so on,” says NZMA health equity subcommittee Chair Dr Don Simmers.

“The NZMA has called for a whole of government approach so that government departments and agencies work together to address these issues. It is also important that public health agencies, universities and health professionals are also involved. Some progress has been made but we need a stronger and more rapid response,” says Dr Simmers.

Dr Simmers stresses that if the social determinants of health inequity are addressed then the incidence of many other preventable childhood diseases will also be lowered. 

He agrees with the editorial’s recommendation that leadership and funding is required from Government to achieve this goal.

The NZMA published its health equity position statement in March and among its recommendations is the need to focus on our most vulnerable populations, including children, Maori and Pacific people.