30 March 2012

Urgent action is required to improve child health in New Zealand and ensuring the wellbeing of our youngest citizens is an ethical issue for our nation, says NZMA Chair Dr Paul Ockelford. 

“It is time to ask ourselves some tough questions. How much do we invest in our children? What more could we be doing to safeguard our children’s health, well-being and future prospects?”

An article in today’s New Zealand Medical Journal finds that New Zealand’s investment in children is low by OECD standards and reports have highlighted that socioeconomic factors have had a major impact on child health with many preventable diseases, such as infectious and respiratory diseases, prevalent in our most vulnerable communities and leading to increasing rates of hospital admissions.

“The article references numerous studies that demonstrate the strong correlation between social determinants, such as damp, overcrowded housing and poor nutrition, and ill health. There is overwhelming evidence of the causes, but thankfully also comprehensive evidence about what we can do to reduce health inequities,” says Dr Ockelford.

“Every child must be given the best start in life and we must create an environment for them that will enable them to develop healthy lives, thrive and to have a sense of belonging. This includes providing high quality maternity services, parenting programmes and early childhood education.”

“We know that failing to prevent ill health in childhood will lead to life long consequences in adulthood, such as cardiovascular disease and mental illness.“

Some progress is being made to rectify our poor health and safety outcomes, with initiatives such as the Green Paper on Vulnerable Children and programmes to boost immunisation rates and eradicate rheumatic fever.

“The NZMA would like to see further progress through a whole of government, whole of society approach, as we have strongly advocated for in our health equity position statement. We all need to be part of the solution. Doctors for example have a responsibility to advocate not only for individual patients but also for better population health.”

Dr Ockelford concurs with the article’s view that there are significant opportunities for positive change. 
“There is a growing awareness and willingness to address child health disparities and we now have a clearer understanding of the multifaceted actions we need to take to make a significant difference. A child focussed approach at the centre of all government policy, and within our communities, must be the foundation for these actions and will lead to a more cohesive and equitable society.”

“Policies and programmes need to be effectively coordinated and integrated across the policy sphere, including in areas such as education, housing and employment,  and must be driven by a strong evidence base.”

Dr Ockelford said the NZMA supports a range of recommendations in its health equity position statement, and is a strong proponent of proportionate universalism which means making services available for all but offered in proportion to need. “In practice for example, at the antenatal stage, children and families would be identified at birth with their needs assessed early on, and those most disadvantaged would be allocated more resources and services in response to these needs.”

The authors make 10 evidence-based recommendations to achieve optimal child health but stress that a comprehensive approach is needed, rather than “cherry-picking of individual recommendations.”

Recommendations include: resource effective community-led development initiatives to improve child wellbeing and reduce inequities; develop a National Children’s Action Plan; establish indicators for child health and well-being; and continue and broaden the programmes which improve home heating and insulation.

“We need a child-centred society that values and invests in its most vulnerable citizens. This is by far the best investment we can make to help ensure a productive, resilient, inclusive society. The time to act is now,” says Dr Ockelford.