Introduction

The Child Poverty Monitor is a partnership between the J R McKenzie Trust, the Office of the Children’s Commissioner, and the New Zealand Child and Youth Epidemiology Service (NZCYES) at the University of Otago.

The ninth annual Child Poverty Monitor technical report begins with the voices of tamariki. Their voices remind all readers about the world to which we aspire, a society where every child is valued and enjoys their right to thrive and achieve their potential.1,2 Taitamariki are acutely aware of the barriers that stop them from enjoying their right to a good life. Poverty, racism and discrimination can mean that whānau and children struggle to meet everyday needs and miss out on opportunities that most in Aotearoa take for granted.3 In reflecting on what makes a good life, children and young people talk about the importance of strong family relationships, with supported parents, in a community that loves and accepts them.

The technical report presents the most recent child poverty statistics with commentary on how well Government targets are being met for different groups of children. Analysis by Dr Bryan Perry is presented to demonstrate how household circumstances are associated with low income and material hardship. The wider social and economic context is considered in a section including data about financial assistance to eligible households, barriers to good work, housing, and food security. Child poverty related indicators in health include access to primary care, as well as deaths and hospitalisations of children and immunisation coverage. Use of physical punishment, care and protection notifications and fatal and non-fatal injury as a result of assault, neglect or maltreatment are indicators of child safety. Attendance at school and educational achievement are also presented in this section.

There is a lag between collection of data in national surveys and publication of the results. The child poverty statistics are based on data collection for the 2019/20 Household Economic Survey that concluded in March 2020 before the first nationwide lockdown. Health data are presented to the end of the 2020 calendar year, and do not reflect the surge in hospitalisations in 2021 with a high number of hospitalisations due to respiratory syncytial virus (RSV) infections.4 The national peak rate of RSV hospitalisations in 2021 was three times as high as the average peaks in the previous five years.4

Expanded data collection in the household economic survey allows disaggregation of child poverty statistics by ethnicity and by disability status of the child and members of the child’s household. These analyses reveal inequity in the outcomes of measures to reduce child poverty. European children have met the population level targets for proportions living in low-income households or in households experiencing material hardship. Implementation of policies that overcome systemic disadvantage are needed to extend this achievement to all children and their households, including tamariki Māori, Pacific children and disabled children.

Health data show the remarkable and significant fall in hospitalisation rates for potentially avoidable hospitalisations associated with closed borders in Aotearoa and a six-week period of restricted movement during the initial response to the global COVID-19 pandemic. Child health services have, however reported increased hospitalisation rates for eating disorders following the lockdown period5 and there was evidence of increased psychological distress during the pandemic response.6

In 2020 and 2021 vaccination rates have declined for all children. Māori and Pacific children have faced additional barriers to vaccination, which leaves these communities vulnerable not just to COVID-19 but to the common vaccine-preventable diseases of childhood when borders open and restrictions are eased.

Infant mortality statistics show starkly the opportunity to achieve equity in outcomes by reducing sudden unexpected death in infancy rates for pepi Māori and Pacific infants. Support for whānau to access basic health services and transport to reach those services, appropriate and engaging health resources, adequate housing and safe places for infants to sleep, sufficient heating and financial resources, and effective smoking cessation interventions are essential to enable survival and wellbeing from the first days of life.55

The foundations for Aotearoa to be the best place in the world to be a child have been set in place with the commitment of Parliament to the Child Poverty Reduction Act 20189 and the setting of Government targets. No child should be left behind as Aotearoa moves to meet these targets. Maori, Pacific and disabled children face a history of barriers caused by racism, colonialism and ableism that get in the way of them living their best lives. This is the time to be ambitious for all mokopuna, not just some, and meet child poverty targets for all children.

Voices of mokopuna

What children and young people say about poverty

The Office of the Children’s Commissioner engaged with over 6000 children and young people across Aotearoa New Zealand to inform advice to the Prime Minister about 2018’s ten-year Child and Youth Wellbeing Strategy. The most common theme identified in postcards to the Prime Minister was that “everyone should have their basic needs met”. One mokopuna quoted “To have the basics plus a little bit more”. Children understood what it means to struggle daily, and that having enough is important for wellbeing.

“Knowing that there’s money coming keeps you well mentally.” Young person in state care from Dunedin

“I think that it is incredibly important that families have enough money to be able to pay for basic things like food, clothing, bills and other necessities. When children go to school hungry or without enough warm clothing it impacts their ability to learn, communicate and participate in class. Without being able to do these basic things, it can impact their future career, and most importantly their wellbeing.” 15-year-old New Zealand European girl

Mokopuna understand the effects poverty can have on whānau, and they have empathy towards those they see impacted by poverty.

They also see loving, supportive families/whānau/aiga as core to being able to live a good life.

“For me the good life means you have enough things to live, love and be loved.” 16-year-old recent immigrant

“Money may not be the key to happiness, but it is the key to living and I know many people who struggle.” 17-year-old girl, European.

“I think the Prime Minister should make public transport for kids free so then kids can look forward to going to school instead of staying home cause they don't have any money to get to school. Also, I think that the government should give out free food to all school students, so they don't have to worry about food and get hungry at school.” 14-year-old Tongan boy

“It means that all my needs are met and that I am able to have access to some of my wants. It also means that I have people who can care for me and that I can explore my interests and passions.” 15-year-old non-binary gender

Some children personally feel let down by a system that tolerates children being in poverty.

“Not being able to afford things - like sports or activities. People try to help us to make it easier but it's shameful.” Child from Gisborne

“Sometimes you can’t afford what you need. Can’t afford experiences - camps and school trips, education, food - like if you have bad health because you can only afford the bad stuff, you’re never gonna get healthy.” Young person from Whangārei

Mokopuna have clear views on what it takes for a child and their family to have a good life.

“A better environment for the whānau/parents creates a positive and better environment for our children.” Young person from Gisborne

“If the parents are good then the kids are good.” Rangatahi from Rotorua

In other engagements with tamariki, both in and out of school, the Office of the Children’s Commissioner heard about experiences of racism and discrimination. Barriers to living your best life are experienced by some children and young people more than others. They told us about how racism, ableism and other barriers impact on their lives.

“This is a great thing that you are doing [to reduce poverty] but things like racism and discrimination are things that you cannot control. But if it were, a good life would be free of discrimination and full of love and acceptance for our community.” Gender diverse Māori 14-year-old

“The racist bastards that call us brown kids pieces of poo and baa baa blacksheeps - schools need to get this stuff improved.” Primary school student, Māori / New Zealand European / Pacific People

“If everyone could speak Māori, things would be easier, and we’d have less problems. Pākehā and Māori should be taught.” Student in kura kaupapa, Māori

“At other schools we’re judged like ‘typical Māori girl’. We were labelled at other schools. [They] already decided who we were. Like ‘oh there’s a brown girl, she is going to beat us up. Stay away from them [Māori]’. Makes us mad and feel down.” Student from teen parent unit, Māori

“People like the government say bad things about us, but I don’t care cause I know my whānau.” Māori young person in community centre for 12- to 17-year-olds - Housing New Zealand site

“The negative statistics are always reminders of how we fail… why do we constantly get reminded of how we fail?” Student in alternative education, Māori

Children can feel judged, for being from a low-income household.

“I’m always hungry. It’s shame as to say you don’t have kai, so I just act full. The kidscan [free lunch] would be good but you have to sign up and everybody knows. So nah.” Student in alternative education, Māori

Disabled children experience stigma, bullying and discrimination.

“Online bullying is the worst.” – Disabled young person from Wellington

“A way to make our community better for me would be, say, a way to identify us people with [a disability] to everyone, so we don’t have to explain ourselves every time we do something that is, like, odd.” – Disabled young person from Wellington.

“If you were a young disabled person in a wheelchair and there wasn’t a ramp at the front of a building, [you would have to] go around the back entrance just to get in. As much as you have the accessibility it’s almost dehumanising to be forced to go through that back entrance.” – Disabled young person from Auckland

Money is a perceived barrier to accessing education, particularly if you are in care or in households receiving benefits:

“Many people I have lived with [in state care] aren’t able to go [to school/courses] because they can’t pay the fees… I live with Mum but the uniform is too expensive and we got no money from CYFs [State child care and protection agency]. We had to borrow off WINZ and have to pay it back. Some children and young people don’t have enough money to buy uniforms or just won’t go to school because of this. Education should be free, so everyone has the equal opportunity to go to school. Money shouldn’t be a barrier.” Secondary school student, Māori

The Child and Youth Wellbeing Strategy along with the Child Poverty Reduction Act are key mechanisms to ensure all children and young people in Aotearoa New Zealand can enjoy their best life. It is vital that systemic barriers are broken down, so that all children are catered for in the strategy, particularly disabled children, and those who are Māori and Pacific. These children are currently least well served by systems and processes. The best way to ensure systems work for all children and young people is to ask them, devolve decision-making to communities, and for everyone to be committed to upholding the rights of all children.

Key points

Ending child poverty

At a national level there has been progress toward the child poverty reduction targets set by Government as required in the Child Poverty Reduction Act 2018. Disaggregating data by ethnicity shows that we need strong decisive action to give all children and young people the opportunity to thrive. Progress toward Government targets has not been equitable between groups of children. In the 2019/20 Household Economic Survey year, for children aged under 18 years:

Disabled children, and children living in a household with at least one disabled person, were left behind in progress toward the child poverty reduction targets. In the 2019/20 Household Economic Survey year, for children aged under 18 years:

These income measures do not yet reflect the impact of the COVID-19 pandemic and effects related to the national response in Aotearoa.

Health

Access to primary care

Government initiatives have significantly reduced barriers that prevent children accessing primary care when they have a medical problem needing attention.

Sudden unexpected death in infancy

Rates of sudden unexpected death in infancy (SUDI) in Aotearoa decreased significantly from 2.6 deaths per 1,000 live births in 1990–1991 (312 deaths over 2 years) to 0.64 deaths per 1,000 live births in 2012–2013 (78 deaths over 2 years). The SUDI rate has been stable from 2012–2013 to 2018. Inequity in the SUDI rates persists by ethnicity and social and material deprivation:

Vaccine preventable diseases

From 2016–2020 there were over 5,000 potentially avoidable hospitalisations for vaccine preventable diseases. Two-thirds of these hospitalisations (3,300) were children aged under five years. Influenza accounted for almost 60% of hospitalisations for vaccine-preventable diseases, mostly in 2018–2019. Influenza vaccine is recommended and funded for children with specific health conditions. Other common hospitalisations for vaccine-preventable diseases included those for measles and whooping cough (pertussis), which are included in the national immunisation schedule for all children. Hospitalisation rates for chickenpox (varicella) declined after this vaccine was added to the immunisation schedule in 2017.

Some children were better protected than others from vaccine-preventable illness serious enough to need hospital treatment:

Pandemic response measures in 2020 were associated with a dramatic decline in all vaccine-preventable disease hospitalisation rates. All population groups experienced this decline in hospitalisation rates although the relative differences between population groups persisted.

During 2020–2021 vaccination rates declined to below 90% at all key ages (ages 8 months, 2 years, 5 years). This decline affected all ethnic groups except Asian children. In the pandemic context, Māori and Pacific children faced additional barriers to vaccination.

At age 8 months in 2020/21 the overall vaccination rate fell to 88% for all children and to

Children in Aotearoa are now less protected from vaccine-preventable disease than they were before the COVID-19 pandemic. They are vulnerable not just to COVID-19 but to the common vaccine-preventable diseases of childhood when borders open and restrictions are eased. Catching up on routine childhood immunisations is essential alongside COVID-19 vaccine rollout to 5–12-year-olds.

A place to call home

Healthy homes protect children and their whānau from communicable disease transmission and other health problems. Policies and decisions by many Governments have locked Māori and Pacific peoples disproportionately in persistent cycles of low-income. This constrains choices available to whānau and aiga within the housing market and options for their children to live and grow in a safe place.

In the 2018 Census one in 20 children aged under 18 years (5%, around 45,400 children) lived in homes that were always damp and 7% of children (66,800) lived in homes that always had mould larger than A4 size paper.

Children need adequate shelter, space, and privacy within their homes, taking account of the number of people living there. Reducing household crowding is an important intervention to reduce the high rates of hospitalisation for infectious diseases among children in Aotearoa.

In each census year since 1991 there have consistently been 16% or 17% of New Zealand children aged under 15 years living in crowded households, including around 5% of children living in severely crowded households. At the same time the proportion of children living in households with two or more spare bedrooms increased. There is marked inequity in access to space to thrive. For 0–14-year-olds in the 2018 Census:

Food security

When children and whānau are sure they can get enough healthy and safe food to meet their daily requirements they are free to enjoy better health and to learn well at school.

The 2019/20 New Zealand Health Survey found that around one in five children (19.9%) were living in households where food ran out sometimes or often due to lack of money. The proportion of households that often ran out of food had not changed very much since the question was first asked in 2012/13 (consistently around 4–5% of children).

Some groups of children experience greater barriers than others to food security. In the 2019/20 NZ Health Survey:

The household experience of food insecurity does not always translate directly to the experience of individual children. Adult caregivers may shield children from the full effects of food insecurity in the household.

Ending child poverty

Adequate income

Adequate disposable household income enables children and their families to afford participation in society and provide the nurturing and enriching relationships that are critical to children’s growth and development.7,8,9

Disposable income (also called net income or after-tax income) is calculated as the sum of taxable and non-taxable income, working for families’ tax credits, and total rebates, less ACC earner’s levy and tax payable. Disposable income is equivalised using the modified Organisation for Economic Co-operation and Development (OECD) equivalence scale which adjusts for the number of children (aged under 14 years) and adults (aged 14 and over) in the household.10,11 Equivalised household disposable income is an indicator of the money that is available to children and their whānau for day-to-day requirements and saving for larger cost items. Income poverty (having low disposable income) is understood as existing on a continuum of less to more severe.12 The severity of resource restriction experienced by children can be identified through calculating thresholds for low incomes (incomes less than 40%, less than 50%, and less than 60% of the equivalised disposable median income).12 Housing costs, which include mortgage and rent payments, are not discretionary as all households need somewhere to live. Disposable income measures in Aotearoa are presented before housing costs are deducted (BHC) and after housing costs are deducted (AHC).

Child Poverty Reduction Act

In December 2018, Parliament passed the Child Poverty Reduction Act 201813 which seeks to “help achieve a significant and sustained reduction in child poverty in New Zealand” through encouraging government and society to focus on child poverty reduction, facilitating political accountability to achieve published targets, and requiring transparent reporting. The Act mandates ten primary and supplementary child poverty measures which are reported by Stats NZ.13 Data are available to monitor progress on nine of these measures. The definition for a poverty persistence measure must be decided and reported on for the financial year beginning on 1 July 2025.

Low income measures specified in the Child Poverty Reduction Act are listed below (primary measures in bold):

· Percentage of children living in households with less than 50 percent of the median equivalised disposable household income for the 2017/18 base financial year after housing costs are deducted

· Percentage of children living in households with less than 50 percent of the median equivalised disposable household income before housing costs are deducted (contemporary financial year)

· Percentage of children living in households with less than 60 percent of the median equivalised disposable household income without deducting housing costs (contemporary financial year)

· Percentage of children living in households with less than 60 percent of the median equivalised disposable household income after housing costs are deducted (contemporary financial year)

· Percentage of children living in households with less than 50 percent of the median equivalised disposable household income after housing costs are deducted (contemporary financial year)

· Percentage of children living in households with less than 40% of the median equivalised disposable household income after housing costs are deducted (contemporary financial year)

Fixed-line measures, using the base financial year, compare income in a given year to the median income in the 2017/18 reference year, adjusted for inflation.11 A base financial year measure is most useful for examining short to medium term change. Improvement is considered to have occurred when household incomes rise in real terms between years, irrespective of what happens to the incomes of other households. The base financial year measure indicates if real incomes of households are increasing or decreasing.11

Most of the mandatory low-income measures use a contemporary median (financial year) poverty threshold which compares incomes in a given year to the median income for all households in the same year. Contemporary median measures (sometimes called moving-line measures) are most useful for assessing longer-term change. Improvement in poverty rates is considered to have occurred when the incomes of low-income households move closer to the median, irrespective of whether the incomes change in real terms.11,12

In 2019 the Government set three-year and ten-year targets to reduce the proportion of children living in households with equivalised income less than 50% of the contemporary median before housing costs, and less than 50% of the base financial year (2017/18) median after housing costs.14 Further three-year targets for the 2023/24 year were set in June 2021.15 All targets are shown in Table 1.

Table 1. New Zealand Government low-income targets set under the Child Poverty Reduction Act 2018.

Primary measure

Intermediate
(3-year) target rates16

Second intermediate (3‑year) target rate15

Long-term
(10-year) target rates16

Low-income: less than 50% of median equivalised DHI (without deducting housing costs) for financial year [Before housing costs, BHC 50% moving line]

10.5% of children in the 2020/21 financial year

10% of children in the 2023/24 financial year

5% of children in the 2027/28 financial year

Low-income: less than 50% of median equivalised DHI (after deducting housing costs) for base financial year [after housing costs, 50% fixed line]

18.8% of children in the 2020/21 financial year

15% of children in the 2023/24 financial year

10% of children in the 2027/28 financial year

Source: New Zealand Gazette15,16

The United Nations Global Goals for Sustainable Development (SDGs) were adopted by Aotearoa New Zealand and other nations in 2015. Governments must reduce the proportion of children in poverty, in all its dimensions, by at least half by 2030 (Goal 1.2).17 These goals are used in this report for the supplementary child poverty indicators

This section of the Child Poverty Monitor presents information on children living in households with low disposable incomes, using the equivalised income of the household that includes the child, as reported by the official measures of child poverty produced by Stats NZ Child Poverty Statistics18 and as reported in the Household Incomes in New Zealand12 and Child Poverty in New Zealand19 reports produced by the Ministry of Social Development.

Data sources and methods

Indicators

*Children in households below 50% of median income poverty threshold before housing costs (BHC)

Children in households below 60% of median income poverty threshold before housing costs (BHC)

Children in households below 40% of median income poverty threshold after housing costs (AHC)

Children in households below 50% of median income poverty threshold after housing costs (AHC)

Children in households below 60% of median income poverty threshold after housing costs (AHC)

* This indicator is presented by current financial year (contemporary median) and by base financial year (fixed-line)

Definitions

Children are persons aged under 18 years.

A household is one person who usually resides alone or two or more people who usually reside together and share facilities (e.g. eating, cooking, bathroom and toilet, living area).

A child is a member of a household if they live there for four or more nights per week, or spend equal time in this and another household and were present during the survey week.

Equivalised household income is the household disposable income for the previous twelve months adjusted for household size and composition.

Disposable income is calculated for each household as the: sum of taxable income, non-taxable income, working for families’ tax credits, and total rebates, less ACC earner’s levy and tax payable.

Contemporary median poverty measures are set relative to the median income for the same year. This gives a low-income threshold that rises and falls with changes in contemporary median incomes. This type of measure is also called a moving-line or relative approach. Improvement is considered to have occurred when a poor household moves closer to the median irrespective of whether income in real terms has increased or decreased.12

Base financial year poverty measures are anchored in a reference year (in this report, the reference year is 2017/18), adjusted for inflation, and kept at a constant value in real terms over other years. This type of measure is also called a constant value or anchored approach. Because it is considered most useful for examining short to medium term change, it is necessary to re-set the reference year to continue to calculate realistic rates of poverty where there have been considerable changes in New Zealand’s economy, adjusted using the consumer price index. Improvement is considered to have occurred when household income rises in real terms irrespective of what is happening to the incomes of other households.

Households are low-income where they have an income <60% of the contemporary median income

Data source

Stats NZ Child Poverty Statistics

New Zealand Household Economic Survey (NZHES) via Perry (2021).19

Additional information

The median is a more stable measure of household incomes than the mean. A few households with a very high income will shift the mean upwards, and the number of very-high-income households varies from year to year.

All dates are for year ended June 30. Data collection finished in March 2020 due to the COVID-19 pandemic so the sample size is smaller for the 2019/20 survey than for other years.

The 2009 financial year is the first year for which data are available using the 2017/18 base financial year (fixed-line measure). Data for the contemporary median measures are available from 2007 (Table 2).

Table 2.        Children in low-income households, by selected poverty thresholds, Aotearoa 2006/07–2019/20

Year

Before housing costs (BHC)

After housing costs (AHC)

Children in low-income households

<50% contemporary median

<60% contemporary median

<40% contemporary median

<50% contemporary median

<60% contemporary median

<50% fixed-line median*

n

%

n

%

n

%

n

%

n

%

n

%

2006/07

150,800

14.0

256,800

23.9

163,900

15.3

240,500

22.4

314,200

29.3

2007/08

155,900

14.5

251,800

23.4

155,900

14.5

257,800

23.9

355,200

33.0

2008/09

150,600

14.0

239,500

22.2

165,200

15.3

256,300

23.8

338,700

31.4

328,600

30.5

2009/10

152,500

14.1

242,400

22.4

160,400

14.8

237,400

21.9

321,900

29.7

291,100

26.9

2010/11

161,900

14.9

253,400

23.3

175,500

16.1

238,000

21.9

328,100

30.2

335,300

30.9

2011/12

160,900

14.8

252,800

23.3

176,800

16.3

240,700

22.2

314,300

28.9

315,600

29.1

2012/13

169,000

15.6

255,500

23.6

169,000

15.6

237,600

21.9

318,300

29.3

292,300

26.9

2013/14

157,500

14.5

253,900

23.4

171,700

15.8

248,800

23.0

317,800

29.3

295,900

27.3

2014/15

177,200

16.3

267,900

24.6

168,200

15.5

258,500

23.8

331,200

30.5

295,600

27.2

2015/16

168,300

15.4

254,400

23.3

177,600

16.2

244,200

22.3

325,700

29.8

265,400

24.3

2016/17

156,300

14.2

243,300

22.1

178,000

16.1

235,600

21.4

313,600

28.4

247,500

22.4

2017/18

183,400

16.5

281,200

25.3

174,300

15.7

253,800

22.8

341,100

30.6

253,800

22.8

2018/19

153,200

13.5

250,300

22.1

156,100

13.8

227,900

20.1

313,200

27.7

207,700

18.3

2019/20

157,800

13.8

254,800

22.3

159,700

14.0

229,600

20.1

318,900

27.9

210,500

18.4

Source: Stats NZ Child Poverty Statistics. Years ended June; *Fixed-line measure is anchored to 2017/18 median household income; n rounded to nearest 100.

There has been an overall decline in the proportion of children living in households with equivalised disposable income less than 50% of the fixed-line median income after housing costs since 2008/09. The rate of decline in this measure will need to continue in order to achieve the 2023/24 Government target (Figure 1). In 2019/20 there were an estimated 210,500 children (18 children in every 100) living in households with equivalised disposable income below 50% of the 2017/18 base financial year after housing costs. Note that data collection stopped in March 2020 due to the COVID-19 pandemic and these results do not reflect the impact of the national response to the pandemic.

The proportion of children living in households with equivalised disposable income less than 50% of the contemporary (moving-line) median income before housing costs rate has shown year-to-year fluctuation but little overall change since 2006/07. There will need to be a significant decline in this proportion to meet the 2020/21 and 2023/24 Government targets.

Figure 1.       Children in low-income households (<50% contemporary median income before and after housing costs), New Zealand 2006/7–2019/20 with extrapolations to Government targets

Figure 2 shows the impact of housing costs on the proportion of children living in households with equivalised disposable income less than 50% and less than 60% of the contemporary (moving-line) median income. The effect of housing costs on the proportion of children living in income-poor households has been consistent since around 2012 (Table 2, Figure 2). Before housing costs were deducted, an estimated 254,800 children (22.3%, more than one in four children) lived in households with an equivalised disposable income less than 60% of the contemporary median household income in 2019/20 (Table 2, Figure 2). The impact of housing costs meant that an additional 64,100 children lived in a low-income household (less than 60% of the contemporary median) after housing costs were deducted (Table 2, Figure 2). This is equivalent to an additional 5.6% of children living in households experiencing income poverty (less than 60% contemporary median) due to the impact of housing costs on disposable household income.

A similar pattern is seen for children living in households with equivalised disposable income less than 50% of the contemporary median income. Using this measure, an additional 71,800 children lived in a household with an income less than 50% of the contemporary median after housing costs were deducted (Table 2, Figure 2). This increased the proportion of children living in low-income households (<50% contemporary median) from 13.8% to 20.1%.

Figure 2.       Children in low-income households (less than 50% and less than 60% of the contemporary median income) before and after housing costs, New Zealand 2006/07-2019/20

Figure 3 compares base financial year (fixed line) low-income measures with financial year (contemporary median) measures for the proportion of children in low-income households using a less than 50% of the median equivalised disposable income threshold. The base financial year for the fixed-line measure is 2017/18.

Without consideration of the income changes experienced by other households, disposable incomes in some low-income households with children have increased in real dollar terms between 2010/11 to 2019/20 with a decline of the proportion of children in low-income households (Table 2, Figure 3).

When taking into account income changes experienced by all households, the disposable incomes in low-income households have remained relatively stable compared to the (contemporary) median household income for each year, with a slight decline in the proportion 0–17 year olds living in low-income households(Table 2, Figure 3).

Figure 3.       Children in low-income households (income less than 50% of the contemporary and fixed-line median household income) after housing costs (AHC), New Zealand 2006/07-2019/20

For every 100 children in 2019/20, an estimated 14 children lived in a household with an equivalised disposable income less than 40% of the median household income for that year, after housing costs; 18 children lived in a household with income less than 50% of the median, and 28 children lived in a household with income less than 60% of the median (Table 2). In numerical terms, after taking housing costs into consideration, as shown in Table 2 and Figure 4, there were approximately:

· 159,700 children (14.0%) living in a very-low-income household (equivalised disposable income less than 40% of the contemporary median)

· 210,500 children (18.4%) living in a low-income household (equivalised disposable income less than 50% of the contemporary median)

· 318,900 children (27.9%) living in a household with equivalised disposable income less than 60% of the contemporary median.

Figure 4.       Children in low-income and very low-income households (income less than 40%, 50% and 60% of the median household income) after housing costs (AHC), by income threshold, New Zealand 2019/20

For most years in the past decade, almost one-third of a million children have lived in a household with an equivalised disposable income less than 60% of the median after housing costs for that year, and almost one in six lived in households experiencing severe income poverty (less than 40% of the median income) (Table 2, Figure 5). Since 2010/11, there has been a slight decline in the proportion of children living in low‑income households using the contemporary median measures (Figure 5). There was a fall in the proportion of children in households with low incomes, using a contemporary measure, between 2018 and 2019 although this was not statistically significant. Data collection for the 2019/20 year stopped in March 2020 due to the COVID-19 pandemic and so the sample size was smaller for that year.18 The impact of the pandemic and of the Government response is not reflected in the current data.

Figure 5.       Children in low-income and very low-income households (<40% <50% and <60% contemporary median after housing costs), New Zealand 2006/07–2019/20

The United Nations (UN) global goals for sustainable development (SDGs) include reducing all forms of poverty to at least half of the values as at 2015.17 Figure 6 applies the SDG targets to contemporary median thresholds for child poverty, after housing costs,. Which are supplementary measures set out in the Child Poverty Reduction Act 2018.13

Government will need to implement effective policies to reduce the proportion of children living in low-income and very-low-income households in order to achieve the 2030 SDG targets for child poverty reduction (Figure 6).

Figure 6. Children in low-income and very low-income households (<40% <50% and <60% contemporary median after housing costs) extrapolated to UN Sustainable Development Goal targets, New Zealand 2006/07–2029/30

A longer-term perspective

A long-run time series from the Ministry of Social Development12 (using older methodology for calculating income poverty) shows that the proportion of children living in low- and very-low-income households increased in the early 1990s at all income-threshold levels (Figure 7). At this time there was high unemployment, a fall in the average wage, a reduction in the level of benefits, and introduction of market rents for social housing with increasing numbers of households with very low incomes.12 The Working for Families package made a tangible difference to income distribution from 2004–2007, along with improving employment levels including increased employment for women, increasing average wages, and income-related rents for social housing.12 “The 2004 to 2007 period was the only one in the 25 years to 2007 in which the incomes of low- to middle-income households grew more quickly than those of households above the median.”12(page 78)

The impact of housing costs on the proportion of children living in low-income households increased from the early 1990s, with an increase in the gap between the before and after housing costs trajectories. (Figure 8). Some of this widening gap was influenced by policy decisions to introduce market rents for social housing.12 Since 2000/01 costs for families living in social housing have been capped at 25% of household income. As shown in Figure 8, the gap between low-income measures before and after housing costs narrowed in the years soon after this policy decision, and then widened from 2007/08. Perry12 notes that policy settings for the accommodation supplement did not change from 2005 to 2017, and that housing costs increased relative to BHC incomes, especially for low-income households. This graph is unchanged from the 2018/20 Child Poverty Monitor, as it is not yet clear whether or not this can continue as an unbroken time series after 2018, given the changes to the Household Economic Survey and methodology for calculating household poverty thresholds from 2018/19.19

Figure 7.       Children in low-income and very-low-income households (income less than 60%, 50% and 40% of the contemporary median household income after housing costs, Aotearoa 1981/82–2017/18

Figure 8.       Children in low-income households (income less than 60% of the contemporary median household income) before and after housing costs, New Zealand 1981/82–2017/18


Essentials for a good life

Day-to-day living conditions in which children live, learn, grow, and play affect health and wellbeing.20,17 Access to essential items is associated with equitable opportunities for children and young people to thrive and reach their potential.20 Material hardship at household level in Aotearoa is monitored using a 17-item index (DEP-17) that determines whether households experience enforced lack of essentials due to cost, a high level of economising in order to afford essentials, insufficient funds to pay for essential services or high levels of financial stress and vulnerability. An enforced lack is where a household misses out on an item in the DEP-17 index because of cost.21 Material hardship is defined where a household experiences enforced lack of six or more essentials. Severe material hardship is when a household experiences enforced lack of nine or more essentials on DEP-17.22

The New Zealand Government has set intermediate and long-term targets for reduction of material hardship, as shown in Table 3.

Internationally, the Sustainable Development Goals require that material hardship, unacceptably low material wellbeing,12 be reduced by at least half between 2015 and 2030 (Goal 1.2) as a dimension of poverty.

This section of the Child Poverty Monitor presents information on children aged 0–17 years living in households experiencing material hardship using data gathered in the New Zealand Household Economic Surveys (NZHES) and analysed using DEP-17. The most recent data are from the 2019 NZHES year (ending June 2019).

Table 3. New Zealand Government material hardship target set under the Child Poverty Reduction Act 2018.

Primary measure

Intermediate (3-year) target

Second intermediate (3 year target)

Long-term (10-year) target

Material hardship

10.3% of children in the 2020/21 financial year

9% of children in the 2023/24 financial year

6% of children in the 2027/28 financial year

Source: New Zealand Gazette15,16

Data sources and methods

Indicator

Children in households experiencing material hardship

Children in households experiencing severe material hardship

Definitions

Children are persons aged under 18 years.

A household is one person who usually resides alone or two or more people who usually reside together and share facilities (e.g. eating, cooking, bathroom and toilet, living area).

A child is a member of a household if they live there for four or more nights per week, or spend equal time in this and another household and were present during the survey week.

Material hardship is unacceptably low material wellbeing.12 Experienced by children, material hardship is living in households who were lacking basic/essential child-specific items because of cost. Where a household does not have the opportunity to have or do an essential because of cost, it is considered an enforced lack.

The material hardship threshold is an enforced lack of six or more (≥6) DEP-17 items.21

The severe material hardship threshold is an enforced lack of nine or more (≥9) DEP-17 items.21

Data sources

Stats NZ Child Poverty Statistics18, Perry report: Child Poverty in New Zealand.19

Additional information

DEP-17 is an index of material hardship or deprivation, particularly suited to capturing the living standards of those at the low end of the material living standards continuum.23

 

DEP-17 items   

Enforced lack of essentials (because of cost)        

     Do not have a meal with meat, fish or chicken (or vegetarian equivalent) at least each 2nd day

     Do not have two pairs of shoes in good repair and suitable for everyday use

     Do not have suitable clothes for important or special occasions

     Do not give presents for family and friends on special occasions

     Do not have home contents insurance

Economised, cut back or delayed purchases ‘a lot’ because money was needed for other essentials    

     Went without fresh fruit and vegetables

     Bought cheaper cuts of meat or bought less than would have liked

     Postponed visits to the doctor

     Postponed visits to the dentist

     Did without or cut back on trips to the shops or other local places

     Put up with being cold (to keep costs down)

     Delayed repairing or replacing broken or damaged appliances

Restrictions

     Feel ‘very limited’ by money available when thinking about purchasing  clothes or shoes for self

     Could not pay an unexpected and unavoidable bill of $500 within a month without borrowing

Financial stress and vulnerability

     In arrears more than once in last 12 months, because of shortage of cash at the time, not through forgetting:

              Rates, electricity, water

              Vehicle registration, insurance or warrant of fitness

     Borrowed from friends or family more than once in last 12 months to cover everyday living expenses

Source: Stats NZ21

In 2019/20 almost 130,000 children in New Zealand were in households that experienced unacceptably low material wellbeing, having to go without six or more of the essential items in DEP-17 (Figure 9). This represented 11.3% of all children. Essential lacks (due to cost) included in the DEP-17 index include postponing a visit to the doctor, putting up with feeling cold, not having two pairs of good shoes, going without fresh fruit or vegetables, or inability to pay the electricity or gas bills on time.

In the same year, 4.5% of children (approximately 51,600) experienced severe material hardship, having to go without nine or more essentials due to cost (Figure 9).

Figure 9. Children in households experiencing material hardship, by hardship threshold, New Zealand 2019/20

From 2014/15 to 2019/20 there was an overall decline in the percentage of children in households experiencing material hardship and severe material hardship, with an estimated 60,800 fewer children living in households missing out on six or more essentials in 2019/20 compared with 2014/15 (Figure 10). The lower rate of material hardship in 2015/16 needs to be interpreted with caution, noting that in the household economic survey ending June 2016 there were fewer than expected sole parent households and households with children receiving financial assistance.22

Figure 10. Children in households experiencing material hardship, by hardship threshold, New Zealand 2012/13-2019/20

In 2019/20 the percentage of children in material hardship was 1.3% above the 2020/21 target and 5.3% from the 2027/28 target (Figure 11). In the case of severe material hardship, where there is no Government target, Figure 11 shows that the percentage of children living in households with enforced lack of nine or more essentials in DEP-17 in 2019/20 was about half of the percentage in 2014/15. The effect of the COVID-19 pandemic and response on material hardship numbers will be see in the 2020/21 Household Economic Survey which will be reported in 2022.

Figure 11. Children in households experiencing material hardship, by hardship threshold, extrapolated to NZ Government and UN Sustainable Development Goal targets, Zealand 2012/13–2029/30


 

Combined measures of income and access to essentials

Children in households that experience low income and material hardship have the greater restrictions on day-to-day activities than either households that are income-poor but not in material hardship, or households that experience material hardship but do not meet a low-income threshold.19

In 2019/20 there were an estimated 75,500 children (6.6%) living in households with equivalised incomes less than 60% of the contemporary median household income after housing costs and who also experienced an enforced lack of six or more of essentials in the DEP-17 index There was an overall decline in the percentage of children in households experiencing both material hardship and income poverty from 2012/13 to 2019/20, with an estimated 38,300 fewer children in these circumstances in 2019/20 compared with 2012/13 (Figure 12). This overall decline will need to be sustained in order to at least meet the UN Sustainable Development Goal target of halving this measure of poverty for New Zealand children by 2030 (Figure 13).

The combined measure specified in the Child Poverty Reduction Act is:

· Percentage of children living in households with less than 60% of the median equivalised disposable household income after housing costs are deducted and experiencing material hardship

Figure 12.     Children in households with both low income and material hardship, New Zealand 2012/13–2019/20

Figure 13.     Children in households with both low income and material hardship extrapolated to UN Sustainable Development Goal target, New Zealand 2012/13–2029/30

Leave no child behind

In looking at overall progress toward the Government targets it is possible to overlook inequity in outcomes between groups of children. The 2019/20 Child Poverty Statistics presented data for disabled children, non-disabled children, children living in households with at least one disabled person and children living in households with no disabled people. Data by ethnicity are available in the Child Poverty Statistics for 2018/19 and 2019/20.18

This indicator presents information from the Child Poverty Statistics dataset on progress toward Government targets for the three current primary measures of child poverty. Stats NZ uses total response ethnicity data, in which children who identify with more than one ethnic group will be counted in both groups. Percentages may therefore add to more than 100%.

As seen earlier in this section, in 2019/20 overall 13.8% of under-18-year-olds were living in households with equivalised disposable income before housing costs below 50% of the contemporary median, and 18.4% were living in households with equivalised disposable income after housing costs below 50% of the fixed-line median (anchored to the 2017/18 financial year). These figures were on track to meet, or had already met, the Government’s 2020/21 targets.

When disaggregated by ethnicity it is evident that the combination of historical and recent policies have advantaged European children (Figure 14). Interventions to date have left Māori and Pacific children behind with 17.1% of Māori children living in households with equivalised disposable income before housing costs below 50% of the contemporary median (2020/21 target is 10.5%) and 19.1% of Pacific children in this category. The 2020/21 Government target is for 18.8% of children to be living in households with equivalised disposable income after housing costs below 50% of the fixed-line median; in 2019/20 this figure was 21.1% for Māori children and 21.0% for Pacific children.

The difference was even greater for material hardship, with European 0–17 year olds already well below the target of 10.3% of children living in households experiencing material hardship whereas 19.5% of Maori and 26.1% of Pacific children were living in households experiencing significant restrictions or deprivations of essential items (Figure 14).

Figure 14.  Children in low-income households, and children in households experiencing material hardship, by ethnicity, Aotearoa 2019/20

On all primary measures a higher proportion of disabled children, and children living in a household with at least one disabled person, experienced household-level low income and material hardship compared with non-disabled children and children living in households where no member was disabled (Figure 15). Children aged 2–4 years are disabled if they have serious difficulty with at least one of the following: seeing (even with glasses), hearing (even with hearing aids), walking, manual dexterity, communicating, learning, playing or controlling their own behaviour. For older children further difficulties are added including difficulty feeding or dressing themselves, remembering or concentrating, accepting change, making friends, anxiety, or depression. Adults aged over 18 years are disabled if they have at least one of the difficulties already mentioned or have difficulties with upper body strength or manual dexterity. Children aged under 2 years are not assessed for disability.18

One in five disabled children live in households experiencing material hardship, which is more than double the rate for non-disabled children (Figure 15).24

Figure 15.  Children in low-income households, and children in households experiencing material hardship, by disability status, Aotearoa 2019/20

Strong policy and practice initiatives are needed for every child in Aotearoa to have the resources that they need to thrive. In 2018/19 and 2019/20 the proportion of European children living below the less than 50% of the fixed-line median equivalised household income after housing costs was already below the 2020/21 target (Figure 16).

Figure 16. European children in low-income households extrapolated to Government targets Aotearoa 2018/19 extrapolated to 2027/28

Māori children (Figure 17)and Pacific children (Figure 18) are on track to meet the 2020/21 fixed-line target (<50% median AHC).

Policy and practice resulted in no change from 2018/19 to 2019/20 in the percentages of Māori children or of Pacific children living in households with equivalised disposable income below 50% of the contemporary median before housing costs.

Data for disabled children were provided for the first time in the 2019/20 child poverty statistics. As shown in Figure 19, the proportions of disabled children living in low income households is well above the 2020/21 Government target.

Figure 17. Māori children in low-income households extrapolated to Government targets Aotearoa 2018/19 extrapolated to 2027/28

Figure 18. Pacific children in low-income households extrapolated to Government targets Aotearoa 2018/19 extrapolated to 2027/28

Figure 19. Disabled children in low-income households extrapolated to Government targets Aotearoa 2018/19 extrapolated to 2027/28

Household levels of material hardship for Māori children, Pacific children, and disabled children are all well above the 2020/21 targets (Figure 20, Figure 21, Figure 22). Material hardship reflects the day-to-day living conditions of the households in which children live. A household experiencing material hardship has enforced lacks of essentials due to cost, a high level of economising in order to afford essentials, insufficient funds to pay for essential services or high levels of financial stress and vulnerability. Material hardship is defined as six or more enforced lacks or deprivations measured with the 17-item DEP-17 index. All 17 items are considered essential and are enjoyed by almost all households.

Figure 20. Māori children in households experiencing material hardship against government targets Aotearoa 2018/19 extrapolated to 2027/28

Figure 21. Pacific children in households experiencing material hardship, extrapolated to NZ Government targets, Aotearoa 2018/19 extrapolated to 2027/28

Figure 22. Disabled children in households experiencing material hardship, extrapolated to NZ Government target, Aotearoa 2018/19 extrapolated to 2027/28


 

How low income affects population groups

This section reports on low-income rates for children by ethnicity, disability status, neighbourhood-level social and material deprivation, and different household contexts, and on low -income rates by ethnicity. The original analysis was contained in the Child Poverty in New Zealand report from the Ministry of Social Development.19 In these analyses households with equivalised disposable income less that 70% of the medial income after housing costs are included as a low-income group. Eighteen percent of 0–17-year-olds in households in the AHC income band between 60%–70% of the median income are in households experiencing material hardship.(19 page 42) In ethnicity analyses this section uses prioritised ethnicity, a system in which each child is counted only once and thus percentages add to 100%.

Ethnicity

Table 4. Children in low-income households, by prioritised ethnicity and low-income threshold, New Zealand 2018–‍2019

HES 2018-19

Low-income rates

Composition

 AHC

what % of this group is in a low-income household, using the different thresholds?

what % of all those in low-income households (using a given threshold) are in this group / cell?

 

%

Low-income threshold as % of median

<40%

<50%

<60%

<70%

<40%

<50%

<60%

<70%

ALL

Prioritised ethnicity

 

 

 

 

 

 

 

 

 

NZ Māori

15

25

33

45

34

35

33

34

26

Pacific peoples

12

24

36

48

9

11

12

12

9

European

8

13

19

27

33

32

34

35

47

Asian

15

21

28

36

19

16

15

15

14

Other

21

31

41

45

6

6

6

5

4

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019. Low-income thresholds are % of 2019-2020 median after housing costs. Ethnicity is prioritised. Percentages may not sum to exactly 100% due to rounding.

Figure 23. Children in low-income households, by prioritised ethnicity and low-income threshold, New Zealand 2018–2019

The proportion of European children who live in low-income households is lower than the proportion in other ethnic groups across all four thresholds (Table 4, Figure 23). The proportion of Asian children is higher than the proportion of European children who live in low-income households. The proportion of Māori and of Pacific children living in low-income households is higher than for other ethnic groups across all low-income thresholds.

Māori and European children each make up around a third of children in the <50% and <60% low-income categories (Figure 24). Compared to their proportions in the total child population Māori are over-represented in the low-income categories, Pacific and Asian children are slightly over-represented, and European children are under-represented (Figure 24).

Figure 24. Composition of selected low-income categories for children, by prioritised ethnicity, New Zealand 2018–2019

 

 

Source: Perry (2021), derived from Stats NZ Household Economic Survey. 2018–2019. Ethnicity is prioritised. Percentages may not sum to exactly 100% due to rounding

Disability

Table 5. Children in low-income households, by disability status and low-income threshold, New Zealand 2019/20

HES 2018-19

Low-income rates

Composition 

 AHC

what % of this group is in a low-income household, using the different thresholds?

what % of all those in low-income households (using a given threshold) are in this group / cell?

%

Low-income threshold as % of median

<40%

<50%

<60%

<40%

<50%

<60%

ALL

Disability status

 

 

 

 

 

 

 

Disabled children

15.3

25.2

32.8

12.4

14.1

13.2

11.1

Non-disabled children

13.6

19.3

27.1

87.6

85.9

86.8

88.9

Children in a disabled household

15.5

23.8

32.6

33.4

35.5

35.1

29.8

Children in a non-disabled household

13.3

18.5

25.8

66.6

64.5

64.9

70.2

Source: StatsNZ. Low-income thresholds are % of 2019/20 median after housing costs. Differences in the way disabled people are defined means that this data is not comparable with disability rates from the 2013 disability survey. Children under 2 years old are not assessed for disability. Children  aged 2 to 4 years are disabled if they have serious difficulty with at least one of the following: seeing (even with glasses), hearing (even with hearing aids), walking, manual dexterity, communicating, learning, playing or controlling their own behaviour. People aged 5 to 17 years are disabled if they have serious difficulty with at least one of the following: seeing (even with glasses), hearing (even with hearing aids), walking, feeding or dressing themselves, communicating, learning, remembering, concentrating, accepting change, controlling their own behaviour, making friends, anxiety, or depression. People aged 18 or over are disabled if they have serious difficulty with at least one of the following: seeing (even with glasses), hearing (even with hearing aids), walking, remembering or concentrating, washing or dressing, communicating, upper body strength, manual dexterity, anxiety, or depression. A disabled household is one that includes at least one disabled person. Percentages may not sum to exactly 100% due to rounding..

Figure 25. Children in low-income households, by disability status and low-income threshold, New Zealand 2019/20

Around 11% of all New Zealand children have a disability, and around thirty percent live in a household where someone, not necessarily a child, has a disability (Table 5, Figure 25). At the <40%, <50% and <60% AHC thresholds, disabled children have higher rates of being in low-income households than non-disabled children, and children living in disabled households have higher rates than children in non-disabled households.

Neighbourhood deprivation

Table 6. Children in low-income households, by NZDep quintile and low-income threshold, New Zealand 2018–2019

 HES 2018-19

Percentage of children

Composition

 AHC

what % of this group is in a low-income household, using the different thresholds?

what % of all those in low-income households (using a given threshold) are in this group / cell?

%

Low-income threshold as % of median

<40%

<50%

<60%

<70%

<40%

<50%

<60%

<70%

ALL

NZDep Quintile

 

 

 

 

 

 

 

 

 

Q1(least deprived)

6

11

16

21

9

11

11

11

19

Q2

9

12

18

25

15

13

13

14

20

Q3

10

16

23

34

18

17

18

20

21

Q4

14

22

32

41

22

21

22

22

19

Q5 (most deprived)

19

31

42

53

36

37

35

33

22

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019. Low-income thresholds are % of 2019-2020 median after housing costs. Percentages may not sum to exactly 100% due to rounding.

Figure 26. Children in low-income households, by NZDep quintile and low-income threshold, New Zealand
2018–‍‍2019

Table 6 and Figure 26 present the percentage of children living in low-income households by the NZDep quintile of their household (a measure of the average level of deprivation in their neighbourhood). The percentage of children living in low-income households increases with increasing NZDep quintile. Even in the most deprived quintile, fewer than half of children are in low-income households (at the <50% and <60% thresholds).

Compared to the total New Zealand child population, which has children evenly distributed across the five deprivation quintiles, the <50% and <60% low-income (after housing costs) categories have higher proportions of children living in the highest deprivation quintile, and lower proportions living in the three least deprived quintiles (Figure 27).

Figure 27. Composition of selected low-income categories for children, by NZDep quintile of household, New Zealand 2018–2019

 

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019. Percentages may not sum to exactly 100% due to rounding

Household type

Table 7. Children in who are in low-income households (AHC), by household type and low-income threshold, New Zealand 2018–2019

 HES 2018-19

Low-income (AHC) rates

Composition

 

what % of this group is in a low-income household, using the different thresholds?

what % of all children in low-income households (using a given threshold) are in this household type / cell?

% of total child population

Low-income threshold as % of median (AHC)

<40%

<50%

<60%

<70%

<40%

<50%

<60%

<70%

ALL

Household type

 

 

 

2 parent households

9

14

21

30

50

52

55

58

69

Other family households

7

12

19

27

10

11

12

13

17

Single parent households

34

51

64

74

39

37

32

28

14

Other households

s

s

s

s

1

1

1

1

1

 

 

 

 

 

 

 

 

 

 

All children (0-17 years)

12

19

27

36

100

100

100

100

100

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019. Low-income thresholds are percentages of the 2019–2020 median household income after housing costs (AHC). Households are those with dependent children. Other family households are those with dependent children and adults other than just one or two parents. Percentages may not sum to exactly 100% due to rounding. s= rates suppressed due to small numbers.

Figure 28. Children in who are in low-income households (AHC), by household type and low-income threshold, New Zealand 2018–2019

Table 7 and Figure 28 indicate that the percentage of children in sole parent households who experience low household income is much higher than the percentage of children in two parent or other family households who do so. Nevertheless, as shown in Figure 29, the majority of children living in low-income households live in two parent or other family households, because there are many more children living in these types of households.

Figure 29. Composition of selected low household income categories, by household type, New Zealand 2018–2019


Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019. Low-income thresholds are % of 2019-2020 medians after housing costs. Other family households are those with dependent children and adults other than just one or two parents. Other households have some 0-17s, but no dependent children. Percentages may not sum to exactly 100% due to rounding.

Number of children

Table 8. Children in who are in low-income households (after housing costs), by number of children in household and low-income threshold, New Zealand 2018–2019

 HES 2018-19

Low-income (AHC) rates

Composition

 

what % of this group is in a low-income household, using the different thresholds?

what % of all those in low-income households (using a given threshold) are in this group / cell?

% of all children

Low-income threshold as % of median (AHC)

<40%

<50%

<60%

<70%

<40%

<50%

<60%

<70%

ALL

Number of dependent children in household

 

 

 

 

 

 

 

 

 

1

10

15

20

27

18

17

17

17

22

2

10

16

22

31

37

36

35

37

42

3

14

21

30

39

26

24

25

24

22

4+

16

33

47

61

18

22

22

22

13

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019. Low-income thresholds are % of 2019-2020 medians after housing costs. Households are those with dependent children. Percentages may not sum to exactly 100% due to rounding.

Figure 30. Children in low-income households (after housing costs), by number of children in household and low-income threshold, New Zealand 2018–2019

Table 8 and Figure 30, indicate that, while there is little difference between children in one and two child households in the percentage who experience low household income, this percentage is higher for children in three child households and higher again for children in households with four or more children. At the 60% (AHC) threshold, almost half of all children in households with four or more children live in low-income households. Only 13% of New Zealand children live in households with four or more children (Figure 31).

Figure 31. Composition of selected children's low-income categories (after housing costs), by number of children in household, New Zealand 2018–2019

  

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019. Low-income thresholds are % of 2019-2020 medians after housing costs. Households are those with dependent children. Percentages may not sum to exactly 100% due to rounding.

Household tenure

Table 9. Children in low-income households, by tenure of household and low-income threshold, New Zealand 2018–‍2019

 HES 2018-19

Percentage of children

Composition

 AHC

what % of this group is in a low-income household, using the different thresholds?

what % of all those in low-income households (using a given threshold) are in this group / cell?

%

Low-income threshold as % of median

<40%

<50%

<60%

<70%

<40%

<50%

<60%

<70%

ALL

All children (0-17 years)

12

19

27

36

100

100

100

100

100

Tenure of household

 

 

 

 

 

 

 

 

 

Owned with mortgage

7

11

17

24

27

28

30

32

47

Owned no mortgage

6

8

12

19

5

5

5

6

11

Private rental (all)

20

29

39

50

54

50

47

45

32

 Private rental (no AS)

10

16

24

34

14

14

15

16

17

 Private rental (with AS)

30

43

56

67

39

35

32

29

15

Social rental

18

41

59

73

11

15

15

14

7

Other

12

16

22

27

3

3

2

2

3

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019. Low-income thresholds are % of 2019-2020 median after housing costs. Owned includes owned by a family trust. AS = Accommodation supplement. Around 3% of all children belong to the "Other" category.

Figure 32. Children in low-income households, by tenure of household and low-income threshold, New Zealand 2018–‍2019

Table 9 and Figure 32 show that a much higher proportion of children who live in households in rented accommodation experience low household income than children who live in households that own the home they live in. When the private rental category is broken down according to whether or not the household is receiving the accommodation supplement, it can be seen that low-income rates are much higher for children in private rental households that receive the accommodation supplement than in those that do not. Rates of very low income (< 40% of the AHC median) for children in privately renting households receiving the accommodation supplement are considerably higher than those for children in social housing households (30% vs. 18%).

Of the children living in low-income households (at both the 50% and 60% thresholds) around half live in households renting privately, around a third in owned housing, and around 15% in social housing (Table 9, Figure 33). Among all New Zealand children, the largest housing tenure category is owned with a mortgage (47% of all children), followed by private rental (32%, 15% with an accommodation supplement and 17% without).

Figure 33. Composition of selected low-income categories for children, by household tenure, New Zealand 2018–2019

 

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019. Owned includes owned by family trust. .AS = Accommodation supplement.  Percentages may not sum to exactly 100% due to rounding.

Labour market status

Table 10. Children in low-income households (AHC), by labour market status of household and low-income threshold, New Zealand 2018–2019

 HES 2018-19

Low-income rates

Composition

 AHC

what % of this group is in a low-income household, using the different thresholds?

what % of all those in low-income households (using a given threshold) are in this group / cell?

%

Low-income threshold as % of median

<40%

<50%

<60%

<70%

<40%

<50%

<60%

<70

ALL

Labour market status of household

 

 

 

 

 

 

 

 

 

Workless

45

63

76

86

40

35

30

25

11

Part time work only

30

49

65

74

13

13

13

11

5

No FT worker (may have PT)

40

58

72

82

53

48

42

36

16

At least one full time worker

6

11

18

27

36

42

49

56

72

Some work (excluding SE)

7

13

21

30

49

56

61

66

78

Self-employed

10

14

20

25

10

9

9

8

12

 Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Low-income thresholds are % of 2019/20 median after housing costs. FT = full time; PT= part time; SE = self-employed. Some categories are combinations of other categories: No FT = WL + PT; some work = PT + FT. Percentages may not sum to exactly 100% due to rounding.

Figure 34. Children in low-income households (AHC), by labour market status of household and low-income threshold, New Zealand 2018–2019

Table 10 and Figure 34 indicate that a high percentage of children in households that are workless or have only part time work are in low-income households. At the 60% (AHC) threshold, just over three quarters of all children in workless households are in low-income households. Note that some categories presented are combinations of other categories. Low income rates for the “at least one full time worker” and “some work” categories are very similar because, as can be seen from the “all children” section of Figure 35, very few of those in the “some work” category are “part time only”.

Figure 35 indicates that the majority of children in low-income households belong to households where someone is in paid work. Almost half of all children in the <60% (AHC) category, 48%, come from households where at least one person is in fulltime paid work. Although rates of low income are very high for children in workless households, only 11% of all children belong to workless households.

Figure 35. Composition of selected children's low-income categories (after housing costs), by labour market status of household, New Zealand 2018–2019

 

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019 . Low-income thresholds are % of 2019-2020 median after housing costs. Percentages may not sum to exactly 100% due to rounding.

Work intensity of parents

Table 11. Children in low-income households (AHC), by work intensity of parent(s) and low-income threshold, New Zealand 2018–2019

 HES 2018-19

Percentage of children

Composition

what % of this group is in a low-income household, using the different thresholds?

what % of all those in low-income households (using a given threshold) are in this group / cell?

%

Low-income threshold as % of median (AHC)

<40%

<50%

<60%

<70%

<40

<50

<60

<70

ALL

Work intensity of parent(s)

 

 

 

 

 

 

 

 

 

2P - both FT

4

6

9

14

7

7

8

9

23

2P - FT PT

5

10

16

26

7

8

9

11

14

2P - FT WL

10

20

34

48

14

17

21

22

16

SP - FT

11

21

33

47

5

5

6

6

5

SP - PT

34

59

77

86

8

8

7

6

3

Other

18

27

34

42

60

55

50

45

39

Source: Perry (2021), derived from Stats NZ HES 2018–2019. Low-income thresholds are % of 2019-2020 medians after housing costs.

2P = two parents; SP = sole parent; FT = full time; PT= part time; WL = workless. The "Other" category contains children in other household types (such as extended family households), children in two parent WL-PT households, and children in households where no parent is in work.

Figure 36. Children in low-income households (AHC), by work intensity of parent(s) and low-income threshold, New Zealand 2018–2019

Table 11 and Figure 36 present information on children in one and two parent households where at least one parent is in paid work. Among these children, low-income rates are highest for children living with a sole parent with only part time work and lowest for children living with two parents who both work fulltime. Low-income rates are similar for children in both types of one fulltime working parent household: two parent households in which one parent has fulltime paid work and the other has no paid work, and fulltime working sole parent households.

Figure 37 indicates that around half of all children in low-income households (in the <50% or <60% AHC categories) have at least one parent working and around 40% have at least one parent working fulltime. That some children experience low income even with two parents working fulltime reflects the very high housing costs faced by some households.

Figure 37. Composition of selected children's low-income categories (after housing costs), by work intensity of parent(s), New Zealand 2018–2019

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019 . Low-income thresholds are % of 2019-2020 median after housing costs. 2P = two parents; SP = sole parent; FT = full time; PT= part time; WL = workless. The "Other" category contains children in other household types (such as extended family households), children in 2 parent households WL - PT, and children in households where no parent is in work. Percentages may not sum to exactly 100% due to rounding.

Income source

Table 12. Children in low-income households, by main source of household income and low-income threshold, New Zealand 2018–2019

 HES 2018-19

Percentage of children

Composition

 AHC

what % of this group is in a low-income household, using the different thresholds?

what % of all those in low-income households (using a given threshold) are in this group / cell?

%

Low-income threshold as % of median

<40%

<50%

<60%

<70%

<40%

<50%

<60%

<70%

ALL

Source of HH income in the 12 months prior to interview

 

 

 

 

 

 

 

 

 

Main source market

6

11

18

27

46

51

59

66

87

Main source government

47

68

81

90

54

49

41

34

13

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019. Low-income thresholds are % of 2019-2020 median after housing costs. Main source of household income is for the 12 months prior to interview.

As can be seen from Table 12, children in households that receive their income from the government are much more likely to be in low-income households than children in households that receive their income from market sources (such as wages and salaries). Sixty-eight percent of children in households with the government as their source of income have incomes below the 50% threshold, compared to 11% of children whose households receive their income from the market. A small proportion of children (13%) live in households with income from government income, which means that in term of composition of low-income households at the <50% threshold, approximately equal numbers of children come from households with incomes from market and from government sources.

Parental education

Table 13. Children in low-income households, by highest educational qualification in household and low-income threshold, New Zealand 2018–2019

 HES 2018-19

Percentage of children

Composition

 AHC

what % of this group is in a low-income household, using the different thresholds?

what % of all those in low-income households (using a given threshold) are in this group / cell?

%

Low-income threshold as % of median

<40%

<50%

<60%

<70%

<40%

<50%

<60%

<70%

ALL

Highest educational qualification in household

 

 

 

 

 

 

 

 

 

No formal qualifications

22

40

52

65

13

15

14

13

7

School qualification

18

27

39

51

29

28

28

28

19

Post-school non-degree qualification

12

20

28

37

33

34

33

33

32

Bachelors or similar

8

12

18

25

15

14

14

15

22

Higher degree

6

9

13

19

10

10

10

11

20

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019. Low-income thresholds are % of 2019-2020 median after housing costs. Percentages may not sum to exactly 100% due to rounding.

Table 13 and Figure 38 indicate that the percentage of children who live in low-income households decreases with increasing levels of household educational qualifications. Although low-income rates are relatively high for children living in households with no formal educational qualifications, only small percentages of children in low-income households in the <50% and <60% AHC median income categories live in households where no-one has any formal educational qualifications (15% and 14%, respectively, Figure 39) Around a quarter of children living in low-income households live in a household where someone has a bachelors or higher level qualification (24% in both the <50% and <60% categories).

Figure 38. Children in low-income households, by highest educational qualification in household and low-income threshold, New Zealand 2018–2019

Figure 39. Composition of selected low-income categories for children, by highest educational qualification in household, New Zealand 2018–2019

 

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018–2019. Percentages may not sum to exactly 100% due to rounding.

How material hardship affects population groups

This section reports on material hardship rates for children by ethnicity, disability status, neighbourhood-level social and material deprivation, and different household contexts. The original analysis was contained in the Child Poverty in New Zealand report from the Ministry of Social Development.19 In ethnicity analyses this section uses prioritised ethnicity, a system in which each child is counted only once and thus percentages add to 100%.  

Ethnicity

Table 14. Children in households experiencing material hardship, by prioritised ethnicity and hardship threshold New Zealand 2018/19

 HES 2018/19

Hardship rates

Composition

 

what % of this group is in material hardship, using the different thresholds?

what % of all children in material hardship (using a given threshold) are in this household type / cell? 

% of total child population

Hardship level

Material hardship

Severe material hardship

Material hardship

Severe material hardship

All

Ethnicity (prioritised)

 

 

 

 

 

Māori

23

11

44

50

26

Pacific peoples

29

14

19

21

8

Asian

6

2

7

4

15

European

7

3

25

21

47

Other

20

6

5

4

4

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Material hardship is a lack of six or more items on the DEP-17 index. Severe hardship is a lack of nine or more. Ethnicity is prioritised. Percentages may not add to exactly 100% due to rounding.

Figure 40. Children in households experiencing material hardship, by prioritised ethnicity and hardship threshold, New Zealand 2018/19

Children of Māori, Pacific or Other ethnicity have much higher rates of material hardship than children of Asian or European ethnicity (Table 14, Figure 40). Although only around a quarter of all New Zealand children are Māori, half of the children in severe material hardship are Māori (Table 14, Figure 41). Pacific children are also over-represented in the hardship categories. Fewer than one in ten New Zealand children are of prioritised Pacific ethnicity, yet one in five children in material hardship or severe material hardship are of prioritised Pacific ethnicity (Table 14, Figure 41).

Figure 41. Composition of material hardship categories for children, by prioritised ethnicity, New Zealand 2018/19

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Material hardship is a lack of six or more items on the DEP-‍17 index. Severe hardship is a lack of nine or more. Ethnicity is prioritised. Percentages may not add to exactly 100% due to rounding.

Disability

Table 15. Children in households experiencing material hardship, by child and household disability status and material hardship threshold, New Zealand, 2018/19

 HES 2018/19

Hardship rates

 

Composition

 

what % of this group is in material hardship, using the different thresholds?

what % of all children in material hardship (using a given threshold) are in this household type / cell?

% of total child population

Hardship level

Material hardship

Severe material hardship

Material hardship

Severe material hardship

All

Disability status

 

 

Disabled children

20.4

8.6

20.1

20.7

11.1

Non-disabled children

10.1

4.1

79.9

79.3

88.9

Children in disabled households

20.4

8.9

53.5

58.5

29.8

Children in non-disabled households

7.5

2.7

46.5

41.5

70.2

Source: Stats NZ. Material hardship is a lack of six or more items on the DEP-17 index. Severe hardship is a lack of nine or more. People aged 5 to 17 are disabled if they have serious difficulty with at least one of the following: seeing (even with glasses), hearing (even with hearing aids), walking, feeding or dressing themselves, communicating, learning, remembering, concentrating, accepting change, controlling their own behaviour, making friends, anxiety, or depression. People aged 2 to 4 are disabled if they have serious difficulty with at least one of the following: seeing (even with glasses), hearing (even with hearing aids), walking, manual dexterity, communicating, learning, playing or controlling their own behaviour. Children under 2 years old are not assessed for disability. People aged 18 or over are disabled if they have serious difficulty with at least one of the following: seeing (even with glasses), hearing (even with hearing aids), walking, remembering or concentrating, washing or dressing, communicating, upper body strength, manual dexterity, anxiety, or depression. A disabled household has at least one person with a disability.

Figure 42. Children in households experiencing material hardship, by child and household disability status and material hardship threshold, New Zealand, 2019–2020

Around 11% of all New Zealand children have a disability and around 30% live in a household where someone, not necessarily a child, has a disability (Table 15). Children with a disability have hardship and severe material hardship rates more than twice those of non-disabled children (Table 15, Figure 42). Children who live in a household where someone has a disability have hardship and material hardship rates roughly three times those of children living in a household here no-one has a disability. (Table 15, Figure 42). Children with a disability make up 20% of all children in hardship and 21% of children living in severe material hardship (Table 15). Fifty-three percent of children living in material hardship are in a households where someone has a disability and 58% of children in severe material hardship are living in a household where someone has a disability (Table 15).

Neighbourhood deprivation

Table 16. Children in households experiencing material hardship, by NZDep quintile and hardship threshold, New Zealand 2018/19

 HES 2018/19

Hardship rates

Composition

 

what % of this group is in material hardship, using the different thresholds?

what % of all children in material hardship (using a given threshold) are in this household type / cell?

% of total child population

Hardship level

Material hardship

Severe material hardship

Material hardship

Severe material hardship

All

NZDep Quintile

 

 

 

 

 

Q1 (least deprived 20%)

4

1

6

3

19

Q2

6

2

9

7

20

Q3

9

3

14

12

21

Q4

14

5

20

15

19

Q5 (most deprived 20%)

31

17

51

64

22

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Material hardship is a lack of six or more items on the DEP-17 index. Severe hardship is a lack of nine or more. Percentages may not add to exactly 100% due to rounding.

Figure 43. Children in households experiencing material hardship, by NZDep quintile and hardship threshold, New Zealand 2018/19

Rates of children’s material hardship and severe material hardship increase with increasing NZDep quintile (Table 16, Figure 43). There are large increases in hardship rates from quintile four to quintile five (the most deprived quintile): rates of material hardship double (from 14% to 31%) and rates of severe material hardship triple (from 5% to 17%). Half of the children in material hardship living quintile five areas as do two thirds of the children in severe material hardship (Figure 44).

Figure 44. Composition of material hardship categories for children, by NZDep quintile, New Zealand 2018/19

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Percentages may not add to exactly 100% due to rounding.

 

Household type

Table 17. Children in households experiencing material hardship, by household type and hardship threshold, New Zealand
2018/19

 HES 2018/19

Hardship rates

Composition 

 

what % of this group is in material hardship, using the different thresholds?

what % of all children in material hardship (using a given threshold) are in this household type / cell?

% of total child population

Hardship level

Material hardship

Severe material hardship

Material hardship

Severe material hardship

All

Household type

 

 

 

 

 

Two parent households

9

3

46

37

69

Single parent households

32

17

34

41

14

Other family households

16

8

19

22

16

Other households

s

s

1

0

1

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Material hardship is a lack of six or more items on the DEP-17 index. Severe hardship is a lack of nine or more. Other family households are those with dependent children and adults other than just one or two parents. Percentages may not sum to exactly 100% due to rounding. s= rates suppressed due to small numbers.

Figure 45. Children in households experiencing material hardship, by household type and hardship threshold, New Zealand 2018/19

Material hardship rates are much higher for children in single parent households than in two parent households or other family households (Table 17, Figure 45). Around one third of children in sole parent households are in material hardship, and around one sixth are in severe material hardship (Table 17, Figure 45). However, the majority of children in material hardship and severe material hardship come from two parent or other family households (Figure 46).

Figure 46. Composition of material hardship categories for children, by household type, New Zealand 2018/19

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Other family households are those with dependant children and adults other than just one or two parents. Percentages may not add to exactly 100% due to rounding.

Number of children

Table 18. Children in households experiencing material hardship, by number of children in household and hardship threshold, New Zealand 2018/19

 HES 2018/19

Hardship rates

Composition 

 

what % of this group is in material hardship, using the different thresholds? 

what % of all children in material hardship (using a given threshold) are in this household type / cell?

% of total child population

Hardship level

Material hardship

Severe material hardship

Material hardship

Severe material hardship

All

Number of children in household

 

 

 

 

 

1

11

5

17

18

22

2

10

4

33

30

43

3

13

6

23

24

23

4+

27

13

26

28

12

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Material hardship is a lack of six or more items on the DEP-17 index. Severe hardship is a lack of nine or more. Percentages may not add to exactly 100% due to rounding.

Figure 47. Children in households experiencing material hardship, by number of children in household and hardship threshold, New Zealand 2018/19

Children in households with four or more children have more than double the rates of material hardship and severe material hardship of children in households with one, two or three children (Table 18, Figure 47). Only a relatively small percentage of all children come from households with four or more children and around three-quarters of children in material hardship and severe material hardship come from households with fewer than four children (Table 18, Figure 48).

Figure 48. Composition of material hardship categories for children, by number of children in household, New Zealand 2018/19

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Material hardship is a lack of six or more items on the DEP-17 index. Severe hardship is a lack of nine or more Percentages may not add to exactly 100% due to rounding.

Household tenure

Table 19 Children in households experiencing material hardship, by tenure of household, receipt of accommodation supplement and hardship threshold, New Zealand 2018/19

 HES 2018/19

Hardship rates

Composition

 

what % of this group is in material hardship, using the different thresholds?

what % of all children in material hardship (using a given threshold) are in this household type / cell?

% of total child population

Hardship level

Material hardship

Severe material hardship

Material hardship

Severe material hardship

All

Tenure of household

 

 

 

 

 

Private rental (with AS)

36

18

41

49

15

Private rental (no AS)

11

4

15

12

17

Owned with mortgage

5

1

18

11

47

Owned no mortgage

3

2

3

4

10

Other

4

1

1

1

3

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Material hardship is a lack of six or more items on the DEP-‍17 index. Severe hardship is a lack of nine or more. AS = accommodation supplement. Percentages may not add to exactly 100% due to rounding.

Figure 49. Children in households experiencing material hardship, by tenure of household, receipt of accommodation supplement and hardship threshold, New Zealand 2018/19

Thirty-two percent of all New Zealand children live in housing that is privately rented (Table 19, Figure 49). Just under half of these children live in households receiving the accommodation supplement (which is available to New Zealand citizens and permanent residents who are renting privately or paying a mortgage and whose cash assets and income are below thresholds which depend on family circumstances and location.25 Thirty-six percent of children living in households receiving the accommodation supplement are in material hardship and 18% are in severe material hardship (Table 19, Figure 49).

The material hardship rates for children living in social housing are higher than those of children living in private rental households receiving the accommodation supplement (44% vs. 36%) but the severe material hardship rates in these two categories are similar (20% vs. 18%) (Table 19, Figure 49). Only seven percent of New Zealand children live in social housing, but these children make up a quarter of the children living in severe material hardship (Figure 50, ).

Figure 50. Composition of material hardship categories for children, by household tenure and receipt of accommodation supplement, New Zealand 2018/19

 

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. AS = accommodation supplement. Percentages may not add to exactly 100% due to rounding.

Labour market status

Table 20. Children in households experiencing material hardship, by labour market status of household and hardship threshold, New Zealand 2018/19

 HES 2018/19

Hardship rates

Composition

 

what % of this group is in material hardship, using the different thresholds

what % of all children in material hardship (using a given threshold) are in this household type / cell?

% of total child population

Hardship level

Material hardship

Severe material hardship

Material hardship

Severe material hardship

All

Labour market status of household

 

 

 

 

Workless

44

25

34

45

10

Part time work only

25

11

10

10

5

At least one full time worker

10

3

54

44

72

Self-employed

2

0

2

1

12

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Material hardship is a lack of six or more items on the DEP-17 index. Severe hardship is a lack of nine or more. Percentages may not add to exactly 100% due to rounding.

Figure 51. Children in households experiencing material hardship, by labour market status of household and hardship threshold, New Zealand 2018/19

The labour market status of a child’s households has a major effect on the chances of that child experiencing material hardship. Material hardship and severe material hardship rates are highest for children in households where no-one is in paid work and lowest in households that receive the majority of their income from self-employment (Table 20, Figure 51). Because relatively few children are in workless households (Figure 52) more than half of children in material hardship come from households with at least one fulltime worker. Of children in severe material hardship, roughly equal proportions come from workless households and households where someone is in full-time work (45% and 44%, respectively).

Figure 52. Composition of material hardship categories for children, by labour market status of household, New Zealand 2018/19

 

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. FT = full time; PT= part time. Percentages may not add to exactly 100% due to rounding.

Work intensity of parents

Table 21. Children in one or two working parent households experiencing material hardship, by work intensity of parent(s) and hardship threshold, New Zealand 2018/19

 HES 2018/19

Hardship rates

Composition

 

what % of this group is in material hardship, using the different thresholds?

what % of all children in material hardship (using a given threshold) are in this household type / cell?

% of total child population

Hardship level

Material hardship

Severe material hardship

Material hardship

Severe material hardship

All

Work intensity of parent(s)

 

 

 

 

2P - both FT

6

1

11

5

23

2P - FT PT

7

2

8

6

15

2P- FT WL

12

4

15

13

17

SP - FT

17

7

6

6

5

SP - PT

28

11

6

5

3

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Material hardship is a lack of six or more items on the DEP-17 index. Severe hardship is a lack of nine or more. 2P = two parents; SP = sole parent; FT = full time; PT= part time; WL = workless. The categories shown do not include children in other household types (e.g. extended family households) and children in households of any type where no one is in work or the household's main source of income is from self-employment. For this reason, percentages in the composition columns do not add to 100%.

Figure 53. Children in one or two working parent households experiencing material hardship, by work intensity of parent(s) and hardship threshold, New Zealand 2018/19

Table 21 and Figure 53 show that rates of material hardship are higher for children in working sole parent households than in any type of two parent working households. Although rates of material hardship are very low for children in households where both parents work fulltime, Figure 54 shows that the number of children in two fulltime working parent households who are in material hardship is about the same as the number in single parent households with either full or part time work who are in material hardship (11% vs. 12% of all children in material hardship). Figure 54 also shows that more than a quarter of children in severe material hardship have either one or two parents working fulltime.

Figure 54. Composition of material hardship categories for children, by work intensity of parent(s), New Zealand 2018/19

 

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19 Material hardship is a lack of six or more items on the DEP-17 index. Severe hardship is a lack of nine or more. 2P = two parents; SP = sole parent; FT = full time; PT= part time; WL = workless. The "other" category comprises children in other household types (such as extended family households), children in households whose main source of income is self-employment and children in households of any type where no one is in work. Percentages may not add to exactly 100% due to rounding.

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Percentages may not add to exactly 100% due to rounding.

Parental education

Table 22. Children in households experiencing material hardship, by highest educational qualification in household and hardship threshold, New Zealand 2018/19

 HES 2018/19

Hardship rates 

Composition

 

what % of this group is in hardship, using the different thresholds?

what % of all children in material hardship (using a given threshold) are in this household type / cell?

% of total child population

Hardship level

Material hardship

Severe material hardship

Material hardship

Severe material hardship

All

Education (highest qualification in household)

No formal qualification

34

17

17

20

7

School qualification

22

10

32

32

19

Post-school non-degree qualification

15

7

35

37

32

Bachelors or similar

6

2

9

8

22

Higher degree

4

1

6

3

20

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Material hardship is a lack of six or more items on the DEP-17 index. Severe hardship is a lack of nine or more. Percentages may not add to exactly 100% due to rounding.

When hardship rates are broken down by the household education level, children in households where no-one has any formal educational qualifications have the highest rates of material hardship and severe material hardship (Table 22, Figure 55). Hardship rates decrease with increasing levels of household educational qualifications. Relatively few (7%) of children live in households with no formal educational qualifications and almost three-quarters live in households with some post-school qualifications (Table 22, Figure 56). This means that, even though hardship rates are lower for children in better-qualified households, roughly half of the children in material hardship and severe material hardship come from households where someone has post-school qualifications of some kind (Table 22, Figure 56).

Figure 55. Children in households experiencing material hardship, by highest educational qualification in household and hardship threshold, New Zealand 2018/19

Figure 56. Composition of material hardship categories for children, by highest educational qualification in household, New Zealand 2018/19

Relationship between material hardship and low income

Not all children who experience material hardship are in low-income households and not all children in low-income households experience material hardship.

Just over 30% of children who are in households with incomes <50% of the median AHC income are in material hardship (Figure 57, Table 23). As household incomes rise, the percentage in hardship in each income category decreases and, for those children in households with greater than median AHC incomes, the hardship rate is only 3%.

Although hardship rates are highest for children in households with incomes below 50% of the AHC median, the majority of children in hardship come from households with incomes greater than 50% of the AHC median and 41% come from households with incomes greater than 60% of the AHC median (Figure 58)

Figure 57. Children in each income band who are in material hardship, HES 2018/19

Figure 58. Composition of material hardship category for children, and composition of total child population, by AHC income band, New Zealand 2018/19

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Material hardship is a lack of six or more items on the DEP-17 index. Percentages may not add to exactly 100% due to rounding.

Table 23. Children in each income band after housing costs (AHC) (children in households in hardship and all children)

HES 2018/19

AHC income band

< 40% AHC

40-50%

50-60%

60-70%

70-100%

Median +

Sum across

Percentage

% of 0-17s in the income band who are in hardship

32

33

25

18

11

3

n/a

% of all 0-17s who are in hardship who come from this income band

28

17

15

12

20

9

100

% of all 0-17s who are in the income band

12

7

8

9

25

40

100

Numbers (000s)

Number of 0-17s in the income band who are in hardship

40

25

20

20

30

15

150

Total number of 0-17s in income band (all children)

130

80

85

100

270

440

1105

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Material hardship is a lack of six or more items on the DEP-17 index.
Low income thresholds are % of 2018/19 median after housing costs.

The children who experience both living in a low-income household and material hardship could be expected to be in a greater depth of poverty than those who experience either low income or material hardship alone.

Figure 59 illustrates the overlap between material hardship and low income (<60% of the AHC median) for children. While 27% of children experience low income and 14% experience material hardship, there is limited overlap between these categories so that only 8% experience both hardship and low income.

Of the children in low-income households (<60% of median AHC), around 30% are in material hardship (as can be calculated from the numbers in Table 23). Of the children in material hardship, around 60% come from low-income households (Figure 58).

Figure 59. Children by income and material hardship categories of their households, New Zealand 2018/19

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Low income is <60% of the 2018–2018 median after housing costs. Material hardship is a lack of six or more items on the DEP-17 index. Percentages may not add to exactly 100% due to rounding.

Figure 60 and Table 24 present the percentages of children living in households that experience various restrictions in different material hardship and low-income categories. In all the categories shown the household being unable to pay an unexpected $500 expense was the most commonly experienced restriction. Restrictions were much more commonly experienced by children in material hardship, regardless of whether or not they also had low income, than by children who had low income alone.

In the neither low income nor material hardship category, the only restriction that was experienced by more than 5% of children was being unable to pay an unexpected $500 expense, which was reported for 14%.

Figure 61 presents child-relevant restrictions for children living in households with the lowest incomes (lowest AHC income quintile) with details of the main source of income. It is notable that households eligible for and receiving Government financial assistance are experience more restrictions in child-relevant general household items, compared with low-income working households. The data demonstrate that children households receiving financial assistance from the Government are ‘missing out’ on basics to a significant extent.

Figure 60. Children in households reporting restrictions, by low income and hardship categories, HES 2018/19

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Low income is <60% of the 2018/19 median after housing costs. Material hardship is a lack of six or more items on the Dep-17 measure. Note that some categories are not mutually exclusive, e.g. "low income" includes all those with low income only plus those who have both a low income and are in material hardship.

 

Table 24. Children aged 0–17 years in households reporting restrictions, by low income and hardship categories, HES 2018/19

HES 2018/19

ALL

neither

low income only

low income

material hardship only

material hardship

both

% of all children who belong to category

100

68

19

27

6

14

8

% of all children in households reporting

 

 

 

 

 

 

 

$500 expense – can’t pay

27

14

32

48

79

84

87

borrowed from fam/friends for basics - more than once in last 12 months

13

4

11

26

51

58

62

not enough income for the basics

13

5

14

26

43

49

53

put up with cold (a lot) through shortage of money

9

3

7

18

43

43

43

use of food banks more than once in last 12 months

5

1

4

12

19

26

32

life satisfaction of ‘dissatisfied / very dissatisfied’

6

3

6

11

19

21

23

Source: Perry (2021), derived from Stats NZ Household Economic Survey 2018/19. Low income is <60% of the 2018/19 median after housing costs. Material hardship is a lack of six or more items on the Dep-17 measure. Note that some categories are not mutually exclusive, e.g. "low income" includes all those with low income only plus those who have both a low income and are in material hardship.

Figure 61. Restrictions of child-relevant items for children aged 6–17 years in the lowest AHC income quintile by main source of income, HES 2018/19

Economic and social context

Adequate financial assistance

The New Zealand Social Security Act includes a Government guarantee of financial and social support so that people have an adequate income and standard of living when needed.26 The Government has a vision of a social security system in which people are treated with and live in dignity and are able to participate meaningfully in their communities.26

The following section uses data from the Ministry of Social Development to review the proportion of children included in recipients of financial assistance.

Data sources and methods

Indicator

Number of 0–17 year olds included in recipients of financial assistance

Data sources

Numerator:            SWIFT database: Number of 0–17 year olds included in recipients of financial assistance

Denominator:         NZCYES Estimated Resident Population

Definitions

Main benefits (up to June 2013) include: Domestic Purposes Benefit (DPB)-Care of Sick and Infirm, DPB- Woman Alone, Emergency Benefit, Independent Youth Benefit, Youth Payment, Young Parent Payment, Unemployment Benefit Training and Unemployment Benefit Training Hardship, Unemployment Benefit Student Hardship, Widow's Benefit.

Main benefits (from June 2014 onwards) include: Jobseeker Support, Sole Parent Support, and Supported Living Payment

Other benefits (from June 2014 onwards) include: Emergency Benefit, Youth Payment, Young Parent Payment, and Jobseeker Support Student Hardship.

Main benefits are income-replacing.

Not-income replacing financial assistance includes but is not limited to: Disability allowance, Unsupported Child's Benefit and Orphan's Benefit and Non-Beneficiary Assistance/Non-Benefit Assistance.27

Non-benefit financial assistance is assistance provided to those who are not beneficiaries, such as accommodation supplements.

Hardship Assistance is the term used to describe emergency grants and one-off payments. The two main types of payment are Special Needs Grants (non-recoverable) and Advance Payments (also known as Recoverable Assistance Payments)

Additional information

All figures are as at June 30. The number of children in recipients of financial assistance as at the end of June provides no information on the number receiving assistance at other times of the year.

The data count children, not clients. An adult client who has more than one child included in their financial assistance will have their financial assistance counted more than once.

Three new benefits were introduced in a welfare reform and implemented from July 2013, which replaced many of the previously existing benefits, and changed the eligibility criteria for financial assistance. The benefits up to data as of June 2013 are not directly comparable to the benefits on and after June 2014. The welfare reform changes have been described at Changes to benefit categories from 15 July 2013 – Ministry of Social Development and Benefit Fact Sheets – Ministry of Social Development.

To be eligible for financial assistance, clients must have insufficient income from all sources to support themselves and any dependents, and meet specific eligibility criteria. Information about current eligibility criteria can be found at Check what you might get – Work and Income.

Children included in financial assistance

In the year ending June 2021, over 300,000 children aged under 18 years were living with a recipient of government-provided financial assistance (Figure 62), which was over one-quarter of all children in the age group (Figure 63). Most of these children were included as recipients of income-replacing financial assistance (main benefits) and around one-third were recipients of other assistance such as the orphan/unsupported child benefit or non-beneficiary assistance (Figure 62, Figure 63). The proportion of children included as recipients of main benefits is influenced by factors outside the control of individuals. The overall proportion declined from 26% of children in 2000 to 15% in 2018, with increases from 2008 to 2011 following the global financial crisis and a recent increase in 2020 and 2021 during the global COVID-19 pandemic (Figure 63).

From 2000 to 2021 there has been an overall increase in the proportion of children included in recipients on non-beneficiary assistance (Figure 63).

Figure 62.     Children aged 0–17 years included in recipients of financial assistance, by assistance category, Aotearoa 2021

Figure 63.     Children aged 0–17 years included in recipients of financial assistance, by assistance category, Aotearoa 2000–‍2021

In June 2021, most 0–17 year olds included in income-replacing assistance were living with a recipient of Sole Parent Support (65%), with the remainder living with recipients of Jobseeker Support (25%), Supported Living Payments (9%) or Other Main Benefits (less than 2%). Figure 64 shows that the proportion of children included in sole parent benefits and jobseeker benefits increased from 2019 to 2021. The proportion of children as recipients of supported living payments has been fairly stable at around 1.6% since 2014.

 

Figure 64.     Children aged 0–17 years included in recipients of income-replacing financial assistance, by selected type of assistance, New Zealand 2000–2021

Figure 65 presents the children included in financial assistance as a proportion of all children in that year of age. The percentage of children who were included in recipients of financial assistance reduced with increasing age, from 27% of children aged one year to 17% of children aged 17 years. The percentage of children living with a recipient of Sole Parent Support declined with increasing age from around 15% of 1–4 year olds to fewer than 5% of 16–17 year olds. There was a decrease in the proportion of children living with a recipient of Jobseeker Support from birth to age 13 years. For child recipients of financial assistance aged 14 to 17 years the percentage of children reliant on a recipient of Sole Parent Support was lower than the percentage of children reliant on a recipient of Jobseeker Support (Figure 65). The proportion of children living with a recipient of Non-Beneficiary Assistance increased with increasing age up to 14 years before decreasing for older children.

Figure 65.     Children aged 0–17 years included in recipients of financial assistance, by age and by assistance type, New Zealand as at 30 June 2020

At 30 June 2021 there were 77,886 children aged under 18 years included in recipients of Non-Beneficiary financial assistance. Non-Beneficiary financial assistance is targeted to provide tax credits or supplementary allowances to low-income earners. Children included on this type of assistance lived in households not eligible for income-tested main benefits because one or more adults in the household were employed. The household income was below the income threshold for supplementary assistance such as Accommodation Supplement, Disability Allowance or Child Care Subsidy. In the year ending June 2000, around 4% of all children were included in Non-Beneficiary financial assistance, this percentage increased steeply from 2004 to 2008 to around 7% of all children and has remained stable at that level from 2008 to 2021.

The Unsupported Child’s Benefit or the Orphan’s Benefit is assistance paid to adults who are caring for someone else’s children, when parents cannot care for a child due to family breakdown or serious long-term health conditions, or when parents have died or cannot be found. In these circumstances the child may be included as a recipient of the. These types of non-income-replacing financial assistance are not income-tested; a child could be included in both income-replacing assistance or supported by a caregiver’s working income and also receive an Orphan’s Benefit/ Unsupported Child’s Benefit.28,29 Although these benefits make up a very small proportion of all financial assistance provided by the Government, there has been an increase in the number and percentage of 0–17 year olds included in recipients of orphan’s benefit and unsupported child’s benefit from 7,419 (0.7% of children in this age group) in 2000 to 19,875 (1.8% of children in this age group) in 2021.


Good work

Having one or both parents in paid work greatly reduces the likelihood of a child living in poverty, as shown in other sections of this report. ‘Good’ work means that there is a fair balance of rights and responsibilities with a safe working environment and adequate pay. Unemployment and underutilisation labour statistics provide a picture of the economy and workforce in Aotearoa. The unemployment rate provides a picture of the economy overall, reflecting the conditions of the labour market and the number of people seeking work. The following section is a review of unemployment from 1986–2021 and underutilisation from 2004–‍2021 using data from the Stats NZ Household Labour Force Survey.

Data sources and methods

Indicators

Persons unemployed and unemployment rate

Persons underutilised and underutilisation rate

Data sources

Stats NZ Household Labour Force Survey

 

Unemployment rate

Numerator(s):         The number of people unemployed.

Denominator:         The total number of people in the labour force.

 

Underutilisation rate

Numerator(s):         The number of people underutilised (that is: the sum of the number of people unemployed, under‑employed, and in the potential labour force).

Denominator:         The total number of people in the extended labour force (that is: the sum of the number of people in the labour force and the number of people in the potential labour force).

Definitions

Unemployed: all people in the working-age population who, during the reference week, were without a paid job, available for work, and had either actively sought work in the past four weeks or had a new job to start within the next four weeks.

Actively seeking work: To be actively seeking work, a person must have indicated that they used at least one job search method other than looking at job advertisements.

Working age population: usually resident, non-institutionalised, civilian population of New Zealand aged 15 years and over.

Potential labour force: people who are not actively seeking work but are available and wanting a job, and people who are actively seeking but not currently available for work, but will be available in the next four weeks.

Underemployment: people who are in part-time employment who would like to, and are available to, work more hours.

Underutilised: sum of those unemployed, underemployed, and in the potential labour force.

Extended labour force: people in the labour force, or in the potential labour force.

Additional information

When the seasonal adjustment program is run each quarter, all previously published figures are subject to revision. Seasonal adjustment makes data for adjacent quarters more comparable by smoothing out the effects of any regular seasonal events. This makes the underlying movements in time series more visible. Each quarter, the seasonal adjustment process is applied to the latest and all previous quarters. This means that seasonally adjusted estimates for previously published quarters may change slightly.

For information on the Household Labour Force Survey, see Stats NZ’s DataInfo+ for an overview.

In the June quarter of 2021, there were 116,000 New Zealanders who were officially unemployed, or 4.3% of all people in the labour force. The seasonally adjusted unemployment rate has remained under 6% since September 2013. Looking back over the past 30 years, the highest unemployment rate was 11.2% in the September quarter of 1991 and the lowest was 3.3% in December 2007 (Figure 66).

Figure 66.     Unemployment numbers and rates (seasonally adjusted) by quarter, New Zealand 1986–2021

Unemployment rates differ by age and young people aged 15–19 years consistently have the highest rates. In the year to June 2021, the unemployment rate for young people aged 15–19 years was 19.2% compared to less than 3.5% for adults aged 35 years and over (Figure 67). While the unemployment rate is high for the youngest working-age population, only a small proportion of this age group are in the labour force as most are engaged in education or training.

Figure 67.     Unemployment rates by year, by selected age groups, New Zealand 1987–2021 years ending June

Unemployment rates by ethnicity show consistently higher unemployment rates for Māori and Pacific people however differences between ethnic groups have been generally decreasing from around 2013. In June 2021, the unemployment rate for both Māori and Pacific people was 7.8% compared with 3.1% for the European ethnic group and 3.6% for the Asian ethnic group (Figure 68).

Figure 68.     Unemployment rates by quarter, by ethnicity, New Zealand 2008–2021

The underutilisation rate includes persons underemployed (in part-time employment but would like to work more hours and are available to do so), and in the potential labour force (not actively seeking work but are available and wanting a job, or actively seeking work and, although not currently available, will be available for work in the next four weeks), as well as those people officially unemployed. In June 2021, there were 315,000 New Zealanders in this category (Figure 69).

The underutilisation rate increased following the 2008 global financial crisis but had been falling slowly from around mid-2012 until there was a short-lived upswing in early 2020 with the onset of the coronavirus pandemic (Figure 69). In the second quarter of 2021, the underutilisation rate was 10.5%.

Figure 69.    Underutilisation numbers and rates (seasonally adjusted) by quarter, New Zealand 1986–2021

The underutilisation rate for women has consistently been higher than that for men (Figure 70). The increase in the underutilisation rates during early 2020 was likely driven by the coronavirus pandemic, and it was more pronounced for women than men (Figure 70).

Figure 70.     Underutilisation by quarter, by sex, New Zealand 2004–2021

Figure 71.     Underutilisation by quarter, by extended labour force status and by sex, New Zealand 2007–2021

 

Figure 71 shows the trends in the three components of underutilisation by gender. The numbers of men and women and unemployed have been similar, but there have consistently been more women than men in the potential labour force, and considerably more women than men underemployed. The numbers of men and women underemployed have both have risen overall since 2007, but the number of women underemployed has risen much more steeply.

A 2019 report from the New Zealand Work Research Institute30 used data from the Household Labour Force Survey to gain a more detailed understanding of the underutilised workforce. Their analysis of reasons for underemployment indicated that women were much more likely than men to cite difficulties in finding suitable childcare (4.1% vs. 1.1%) and other family responsibilities (9.3% vs. 2.8%). The most commonly cited reason for unemployment, by both men and women, was lack of available work.


A place to call home

‘A place to call home’ can help to provide children with a sense of belonging and connection to community.9,31-34 Healthy homes keep occupants warm, dry, and breathing good indoor air quality, and also protect them from communicable disease transmission and physical injury, while promoting mental and emotional wellbeing.34,35

Affordable homes

Housing costs impact considerably on the resources available to households, as reflected in before and after housing costs low-income statistics. Households that spend more than 30% of their income on owner-occupied or rental accommodation meet the benchmark for having a high “outgoings-to-income” ratio or OTI.12 Meeting housing costs associated with a high OTI can mean there are not enough resources to meet other basic needs such as food, clothing, heating, transport, medical care and education, especially for low-income households.12

The following section provides information on housing costs for the New Zealand general population and more specifically for households with children. The section focuses on households spending 30% or more of their income on housing costs. The Department of Prime Minister and Cabinet reported that in 2019/20 36.3% of households with children spent more than 30% of their disposable income on housing. These figures were 31.8% for Māori households, 33.6% for Pacific households, 35.2% for disabled children and 32.9% for households with children that included at least one disabled person.36

Data sources and methods

Indicator

Households experiencing a high housing cost outgoings-to-income (OTI) ratio

Definitions

High housing costs: when a household spends more than 30% of their income on owner-occupied or rental accommodation, they meet the benchmark for having a high “outgoings-to-income” ratio or OTI.12

Owned: people who owned their home, partly owned their home, or held it in a family trust.

Rental: people who did not own their home, did not have it in a family trust, and were making rent payments to a private person, trust, or business or were making rent payments to Housing New Zealand Corporation, local authority, or city council, or other state-owned corporation or state-owned enterprise, or government department or ministry.

Housing costs include all mortgage outgoings (principal and interest) together with rent and rates for all household members. Repairs, maintenance, and dwelling insurance are not included. Any housing-related cash assistance from the government is included in household income.12

Income quintiles All household incomes are ranked and then divided into five groups with equal numbers of households. The first income quintile represents the 20% of households with the lowest equivalised income; the fifth income decile comprises the 20% of households with the highest incomes. Income deciles are similar but there are ten groups with equal numbers of households.  

Data source

New Zealand Household Economic Survey (NZHES) via Perry12

Additional information

Variations in housing costs do not necessarily correspond to similar variations in housing quality. This is because many older individuals live in good accommodation with relatively low housing costs, for example, those living in mortgage-free homes, whereas many younger people have a similar standard of accommodation but relatively high accommodation costs12

In the 2017/18 household economic survey (HES), around 42% of low-income households with dependents spent more than $40 per $100 of their income on housing costs and 31% spent more than $50 per $100 of income (Figure 72).

Households with one adult and dependent children more commonly experienced high housing stress and very high housing stress when compared to other households with dependents. Over half (53%) of low-income one-adult households with dependent children spent more than $40 per $100 income on housing costs, and nearly 4 in 10 (37%) experienced very high housing stress in spending more than $50 per $100 income on housing (Figure 72).

Figure 72.     Proportion of low-income households with dependents experiencing high housing cost outgoings-to-income ratios (OTIs), by household type and by high OTI threshold, New Zealand, 2017 and 2018 NZHES years

Housing costs have been increasingly unaffordable in Aotearoa for all households with children, primarily for children who are in low- and middle-income household thresholds.

There was a steep increase in the proportion of low-income households with children (income quintile 1) experiencing high housing costs relative to their income (high OTI) for a decade from the late 1980s before dropping to the lowest point in 2004 and then increasing back to 1998 levels (Figure 73). The gap between the proportion of low-income households with children with high OTIs and the proportion of high-income households with children with high OTIs has widened since 1988 (Figure 74). Children in low-income households have disproportionately seen a much steeper housing stress increase than their high-income peers.

From 2008–2015, over half of the households in the lowest income quintile with children spent more than $30 per $100 income on housing costs (Figure 73). From 2010–2018 over 40% of these lowest-income households with children spent more than $40 per $100 income on housing costs (Figure 74). In 2017–2018 over 30% of households with children in the lowest income quintile spent more than half their income on housing costs.12

Figure 73.     Households with children experiencing high housing cost outgoings-to-income ratios (OTIs), by income quintile, New Zealand 1988–2018 NZHES years

Figure 74.     Households with children experiencing high housing cost outgoings-to-income ratios (OTIs) greater than 40%, by income quintile New Zealand 1988–2018 NZHES years

Among recipients of the Accommodation Supplement (AS), almost all recipients of income-replacement financial assistance and almost all renters experienced high housing costs in 2018 and spent at least $30 on housing for every $100 income (Table 25). In 2018, 52% of AS recipients in each of these categories experienced very high housing stress with housing costs of at least $50 per $100 income.

Table 25.      Housing costs as a proportion of income, by household type, OTI threshold (30%, 40% and 50%), and selected NZHES year, Accommodation Supplement recipients, New Zealand for month of June

Household type

Group as % of those receiving AS*

Housing costs as a proportion of income

>30%

>40%

>50%

New Zealand

NZHES year

2007

2016

2018

2007

2016

2018

2007

2016

2018

2007

2016

2018

All

100

100

100

87

91

93

59

69

71

34

43

44

Renters

63

66

65

90

94

95

67

76

77

40

51

52

Single adults

45

55

56

90

94

94

65

73

74

40

49

51

One parent, 1 child

19

14

13

86

89

91

60

65

67

33

42

40

One parent, 2+ children

17

14

13

84

88

88

55

62

63

23

32

34

Two parents with children

11

9

10

74

89

92

40

56

58

21

27

27

Beneficiaries

-

67

66

-

93

94

-

74

77

-

48

52

NZ Super/Veterans Pension

9

13

14

81

86

88

48

52

56

23

26

26

Source: Perry (2019)12 derived from MSD Information Analysis Platform (iMSD) AS = accommodation supplement;
NZ Super = NZ Superannuation; children = dependent children. *Categories are not mutually exclusive and thus do not sum to 100%

Healthy homes

It is important that children grow up in homes with good air quality that are free from mould and have amenities most people consider to be essential minimums for modern living, such as cooking facilities, showers or baths, and electricity supplies.

In 2019/20 6.9% of children aged 0–17 years lived in households with major problems with dampness or mould.36 Māori and Pacific children experienced greater barriers to healthy housing: 11.1% of Māori children and 16.9% of Pacific children lived in households with a major problem with damp or mould.36 These results were from a customised data request using household economic survey (HES) data and differ from the total population perspective of the 2018 Census. Results from the 2018/19 HES showed 7.9% of all children, 13.3% of Māori children and 20.3% of Pacific children living in households with major problems with damp and mould.36

This section presents information on the quality of housing in which children live and the basic amenities available in these dwellings, using the 2018 Census findings.

Data sources and methods

Indicators

0–17 year olds living in dwellings that are always and sometimes damp

0–17 year olds living in dwellings that always and sometimes have mould larger than A4 size

0–17 year olds living in dwellings that have less than seven basic amenities available

0–14 year olds living in crowded households

Definitions

A dwelling is any building or structure (or its parts) that is used, or intended to be used, for human habitation (temporarily or permanently). Dwellings include: houses, motels, hotels, prisons, motor homes, huts, and tents. More than one dwelling can be in a building (such as in the case of apartments in apartment buildings).

A household can be one person who lives alone, or two or more people who live together and share facilities (such as for cooking) in a private dwelling.37

A child is a member of a household if they live there for four or more nights per week, or spend equal time in this and another household and were present during the survey week.

Access to basic amenities indicates what basic amenities (e.g. cooking facilities, shower or bath, and electricity) are available inside an occupied private dwelling. The amenities need to be in working order to be counted.

A household is defined as crowded if one or more bedrooms are needed to meet the Canadian National Occupancy Standard (CNOS). Within this group a household is defined as severely crowded if two or more bedrooms are needed to meet CNOS. A household is defined as not crowded if no extra bedrooms are required to meet the Canadian National Occupancy Standard

Data source

Stats NZ Census 2018 (Census 2018).

Additional information

The number of basic amenities available variable is rated as moderate quality.

The dwelling dampness indicator variable is rated as moderate quality.

The dwelling mould indicator variable is rated as moderate quality.

For more information about and data quality details pertaining to individual housing and amenities variables, please refer to the Data quality ratings for 2018 Census variables.38

The Canadian National Occupancy Standard states: There should be no more than two people per bedroom; parents or couples share a room; children aged under five years, either of same or opposite sex, may reasonably share a bedroom; children aged under 18 years of the same sex may reasonably share a bedroom; a child aged five to 17 years should not share a bedroom with one aged under five of the opposite sex; single adults aged 18 years and over and any unpaired children require a separate bedroom.39

Crowding data excludes households where bedroom data was imputed. Data for these people have been included in the not stated category. (Around 2 percent of crowded households had their bedroom count imputed).

Around 400,000 people could not be placed in households and are not included in the crowding calculation.

Indicator: Dwelling dampness

A flat classification with the following categories:

01 Always damp

02 Sometimes damp

03 Not damp

99 Not elsewhere included

Indicator: Dwelling mould

A flat classification with the following categories:

01 Mould over A4 size – always

02 Mould over A4 size – sometimes

03 No mould/mould smaller than A4 size

99 Not elsewhere included

Indicator: Access to basic amenities

A flat classification with the following categories:

0 None of these

1 Cooking facilities

2 Tap water that is safe to drink

3 Kitchen sink

4 Refrigerator

5 Bath or shower

6 Toilet

7 Electricity supply

9 Not elsewhere included

Dry and free from mould

The 2018 Census recorded a total of 282,228 children in Aotearoa who lived in damp housing and 237,543 in housing with mould (Figure 75, Figure 76). Around 25% (just under a quarter of a million) of children lived in houses that were sometimes damp and 18% (170,000 children) in houses that sometimes had mould larger than the size of an A4 sheet of paper (Figure 75, Figure 76). One in twenty children (around 45,400) lived in housing that was always damp (Figure 75, Figure 76). Seven per cent of children (around 66,800) lived in housing that always had mould larger than A4 size (Figure 75, Figure 76).

Figure 75.     Children 0–17 years living in housing of inadequate quality, by dampness and mould indicator, New Zealand, Census 2018

Figure 76.     Children 0–17 years living in housing of inadequate quality, by dampness and mould indicator, New Zealand, Census 2018

 

There is marked inequity by ethnicity in housing quality indicators (Figure 77). For every one hundred Māori children, nearly 35 lived in housing that was sometimes damp and 9 lived in housing that was always damp (Figure 77). Half of all Pacific children were living in damp housing: around 37 in every 100 Pacific children lived in sometimes-damp housing and 12 in every hundred lived in always-damp housing (Figure 77).

Māori and Pacific children also disproportionately lived in housing that had mould larger than A4 size. For every 25 children of Māori ethnicity, nine had mould in their home sometimes and three had mould in their home all the time, while 11 of every 25 Pacific children lived with mould in their home sometimes and four all the time (Figure 78).

Asian and European/Other children saw the lowest proportion living in housing that was always damp (Figure 77) and housing that always had mould (Figure 78), at under 4% and under 6% respectively).

Māori and Pacific peoples are overrepresented in the population of people in Aotearoa locked in poverty and persistent cycles of low-income. This is an important contributor to constraining the choices whānau have available to them in securing a quality dwelling from the housing market so that their children can live and grow in a safe place.

Figure 77.     Children 0–17 years in dwellings that are sometimes and always damp, by dampness indicator and by ethnicity, New Zealand, NZ Census 2018

Figure 78.     Children 0–17 years in dwellings that sometimes and always have mould larger than A4 size, by mould indicator and by ethnicity, New Zealand, NZ Census 2018

When compared to their European/Other peers, Pacific children were nearly four times as likely to live in a home that was always damp and three times as likely to live in a home that was always mouldy (Figure 79). For housing that was always damp, Māori children experienced a rate nearly three times that of European/Other children and, for housing that always had mould, experienced a rate over twice that of European/Other children (Figure 79). Children of Asian ethnicity were significantly less likely than other ethnic groups to live in a home that was always mouldy (Figure 79).

Children aged under 10 years were more likely than their older peers to be living in housing that was always damp; there was no statistical difference by age in relation to living in housing that always had mould.

Figure 79.     Children 0–17 years in dwellings that are always damp and always have mould larger than A4 size, by indicator and by ethnicity, New Zealand, NZ Census 2018

Access to basic amenities

In the 2018 census there were 77,976 under-18 year olds without access to one or more of the seven household amenities considered to be basic for an acceptable standard of living (Figure 80); this represents eight children in every hundred missing out on an amenity such as safe tap water, cooking and washing up facilities, a bath or shower, a toilet, a refrigerator or a supply of electricity (Figure 81).

Figure 80.     Children aged 0–17 years living in dwellings that do not have basic amenities available, by basic amenities threshold, New Zealand Census 2018

Figure 81.     Children aged 0-17 years living in dwellings that have less than seven basic amenities, by ethnicity, New Zealand Census 2018

While all basic amenities should be available to every child and young person to lead a good life, most children and young people going without basic household amenities were in households lacking one amenity (i.e. with access to six out of seven amenities) (Figure 82). A smaller proportion had access to only 4–5 basic household amenities. There were an estimated 4212 under-18 year olds missing out on most of the seven basic amenities (4 per 1,000 with 1-3 amenities available) and an estimated 4833 children living in dwellings with no amenities (5 per 1,000) (Figure 82).

Inadequate access to basic amenities is experienced disproportionately between ethnic groups. When compared to European/Other children, under-18 year olds of Māori ethnicity were nearly two times as likely to have access to less than seven of the basic household amenities (10 out of every 100). Pacific, Asian and MELAA children disproportionately experienced higher rates of being unable to access basic household amenities, with 15 of every 100 Pacific children, 12 out of every 100 Asian children and 12 out of every 100 MELAA children missing out on one or more basic household amenities, compared with five out of every 100 European/Other children who went without (Figure 82).

Pacific, Asian and MELAA children disproportionately experienced higher rates of having no basic amenities available, compared with European/Other children (Figure 82).

Figure 82.     Children aged 0–17 years in dwellings that have less than seven basic amenities available, by basic amenities threshold and by ethnicity, New Zealand Census 2018

Space to thrive

Household crowding occurs when there is no longer adequate shelter, space, and privacy because of the number of people living there.34 Living in a crowded household is associated with additional barriers to wellbeing including lack of enough money for everyday needs, problems with damp or mould, and having to delay a visit to the doctor because of cost.40 Children admitted to hospital with lung infections in New Zealand have a high rate of exposure to known avoidable risk factors included crowded households.41 Reducing household crowding is an important intervention to reduce the high rates of hospitalisation for infectious diseases among New Zealand children and to address the inequitably high rates experienced by Māori and by Pacific children.42

In the 2018 census there were almost 130,000 children aged under 15 years living in crowded households (128,680 children, 16.1 percent). Within this group there were 42,150 children (5.1%) living in severely crowded households with two or more bedrooms needed to meet the standard for a non-crowded household (Figure 83). 

There was inequity for Māori children with over one-fifth of those aged under-15 years living in crowded households (48,730 children, 23.5%). This group includes 9% of Māori children who were living in severely crowded households (17,410 children). The highest levels of household crowding in this age group were experienced by Pacific children, over 40% of whom lived in crowded households. Despite this higher percentage, with the smaller population of Pacific children this equated to 41,230 Pacific children (41.8%) living in crowded households with very high levels of severe crowding experienced by 17,890 Pacific children (18.1%).

In each census year since 1991 there have consistently been 16% or 17% of New Zealand children living in crowded households, including around 5% of children living in severely crowded households (Figure 84). In contrast the proportion of children living in households with two or more spare bedrooms increased in the same time period.

Figure 83. Number of bedrooms spare or needed using the Canadian National Occupancy Standard, 0-14 year olds, New Zealand Census 2018

Figure 84. Number of bedrooms spare or needed using the Canadian National Occupancy Standard, 0–14 year olds, New Zealand Census years 1991-2018


Food security

Children and their families enjoy food security when they have the assured ability to acquire nutritionally adequate and safe foods that meet cultural needs in a socially acceptable way.43 Low food security exists in household situations with limited resources.44 In New Zealand, food insecurity is driven mainly by a lack of sufficient money for food.45 Households reporting low food security spend less on food overall than households with moderate food security, and particularly spend less on fruit, vegetables and cereals and tend to spend less on milk.43,44

The New Zealand Health Survey (NZHS) included a household food security questionnaire in 2012/13, 2014/15 and 2015/16 and 2019/20. Caregiver responses to the survey may not always translate directly to the experience of individual children as caregivers may shield children from the full effects of food insecurity in the household.45

This indicator presents information from the NZHS on 0–14 year olds in households that sometimes or often run out of food.

Data sources and methods

Indicator

Children in households that sometimes or often run out of food

Definition

Child respondents (aged 0–14 years) living in households where food runs out sometimes or often due to lack of money, based on caregiver response to the NZHS

Data source

New Zealand Health Survey (NZHS) via Ministry of Health

Further information

The survey question was: We are interested in whether you run out of basics, like bread, potatoes, etc because you do not have enough money. We are not referring to treats or special foods. Food runs out in our household due to lack of money. How often has this been true for your household over the past year? (1) often (2) sometimes (3) never

All dates are for year ended June 30. Data collection finished in March 2020 due to the COVID-19 pandemic so the sample size is smaller for the 2019/20 survey than for other years.

In 2019/20 the NZHS found that around one in five children were living in households where food ran out sometimes (15.6%) or often (4.3%) due to lack of money. The proportion of children living in households that sometimes ran out of food was marginally lower in 2019/20 than in 2012/13; there was no difference over time in the proportion of children living in households that often ran out of food (Figure 85).

Figure 85. Children in households that sometimes or often run out of food, by survey year, NZ Health Survey 2012/13–‍2019/20

In the 2019/20 NZHS year the prevalence of households with children running out of food was strongly associated with neighbourhood deprivation, as indicated by NZDep2013. Households living in areas with high deprivation scores were more much likely to run out of food compared with those living in neighbourhoods with lower deprivation scores. It was extremely uncommon for households in low deprivation areas to run out of food often, whereas one in ten children living in high deprivation areas lived in households that often ran out of food and almost one-third lived in households that sometimes ran out of food (Figure 86). Inequity by ethnicity is demonstrated by the much lower proportion of European children in households that sometimes or always run out of food, compared with Māori and Pacific children (Figure 86).

Figure 86.  Children in households that sometimes or often run out of food, by demographic factor, 2019/20 NZ Health Survey

Health

Primary care access

Equitable access to primary health care is a right of children included in the United Nations Convention on the Rights of the Child (Article 24).46 Barriers to accessing primary care can negatively impact prevention or management of health issues, resulting in potentially avoidable hospitalisations and sometimes long-term health problems.

There have been significant policy initiatives to improve access to primary care for children in Aotearoa. In July 2015, the New Zealand Government extended the Zero Fees policy (originally introduced in 2008 for children under the age of six years) to include children under the age of 13 years, removing costs of standard GP and after-hours medical centre visits.47,48 Also from July 2015, the $5 standard prescription co-payment charge for each item of prescription medicine was removed for children aged under 13 years.47 The 2018 Budget further extended these provisions to children under the age of 14 years (from 1 December 2018).48-50

This section presents information for the New Zealand Health Survey about access to primary care for children aged 0–14 years.

Data sources and methods

Indicators

Unmet medical need for primary health care

Unfilled prescription due to cost

Definitions

Child respondents (aged 0–14 years) are defined as having experienced an unmet medical need for primary care when they have experienced one or more type of barrier in the past 12 months when they had a medical problem that needed attention: could not go to a GP or an after-hours medical centre due to cost, could not go to a GP or an after-hours medical centre due to lack of access to transport, could not go to a GP due to lack of childcare services for other children, and inability to get an appointment at their usual medical centre within 24 hours.

Data sources

Barriers to accessing primary health care: New Zealand Health Survey (NZ Health Survey)

Numerator(s):         Sum of the weights for the respondents in the group

Denominator:         Sum of the weights for all respondents/population group

Additional Information

Relevant NZ Health Survey question: unmet need for primary health care (C2.01–02, C2.05, C2.27–29, and C2.49–50).

Survey data (by financial year) is referred to by the year of data beginning. For more information on the NZ Health Survey, please refer either to the Ministry of Health website (https://www.health.govt.nz) or to appendices in this report.

Indicator: Children who have an unmet medical need for primary health care

Question C2.01: Do you have a GP clinic or medical centre that you usually go to when [Name] is feeling unwell or is injured?

     Yes / No

 

Question C2.02: What sort of health care service is this?

     A GP clinic, medical centre or family practice / A clinic that is after-hours only – not an Emergency Department at a public           hospital / Other______ [Specify]

 

Question C2.05: In the past 12 months, has there been a time when you wanted [child’s name] to see a GP, nurse or other health care worker at your usual medical centre within the next 24 hours, but he/she was unable to be seen?

     Yes / No

 

Question C2.27: In the past 12 months, was there a time when [child’s name] had a medical problem but did not visit a GP because of cost?

     Yes / No

 

Question C2.28: In the past 12 months, was there a time when [child’s name] had a medical problem but did not visit a GP because you had no transport to get there?

     Yes / No

 

Question C2.29: In the past 12 months, was there a time when [child’s name] had a medical problem but did not visit a GP because you could not arrange childcare for other children?

     Yes / No / Doesn’t apply

 

Question C2.49: In the past 12 months, was there a time when [child’s name] had a medical problem outside regular office hours but you did not take him/her to an after-hours medical centre because of cost?

     Didn’t have a medical problem outside regular office hours / Yes, didn’t go because of cost / No

 

Question C2.50: In the past 12 months, was there a time when [child’s name] had a medical problem outside regular office hours but you did not take him/her to an after-hours medical centre because you had no transport to get there?

     Yes, didn’t go because had no transport to get there / No

Indicator: Children who have an unmet medical need for primary health care

Question C2.30 In the past 12 months, was there a time when [child’s name] got a prescription but you did not collect one or more prescription items from the pharmacy or chemist because of cost?

Source: New Zealand Health Survey Annual Data Explorer 2019/20

In 2019/20, an estimated 194,000 children missed out on needed primary care services due to at least one barrier, such as cost, transport, lack of childcare, or appointment unavailability (Figure 87).

The most common barrier was being unable to get an appointment at their usual medical centre within 24 hours (Figure 88).

Figure 87.     Children who have an unmet need for primary health care, New Zealand, NZ Health Survey 2019/20

Figure 88.     Children who have an unmet need for primary health care, by barrier, New Zealand, NZ Health Survey 2019/20

The proportion of children experiencing unmet needs for primary medical care due to cost or other barriers increased between 2011/12 and 2015/16 and then returned down to previous levels (Figure 89).

Figure 89.     Children who have an unmet need for primary health care, New Zealand, NZ Health Survey 2019/20

Figure 90 presents the proportion of children who had an unmet medical need for primary care or an unfilled prescription, due to cost, over time. After 2015, there has been an overall decline in the proportion of children missing out on seeing a general practitioner, seeing an after-hours medical centre, or filling a prescription because of cost.

Nearly 7% of children were unable to fill a prescription in 2011/12 because of the cost; the significant decline to 1.9% in 2020 still left an estimated 18,000 children without prescribed medication. Because of cost, nearly 5% of children experienced having a medical need but being unable to see a general practitioner in 2011/12, which also fell to around 2% in 2020.

Figure 90. Children who have an unmet need for primary health care due to cost, New Zealand, NZ Health Survey 2011/12–2019/20

Figure 91 presents the proportion of children missing out on primary care due to lack of transport. The proportion of children missing out on needed general practitioner services due to lack of transport has shown some year-to-year variation and declined overall from 2011/12–2019/20. The proportion of children missing out on after-hours medical care due to lack of transport has remained relatively consistent since 2014 at around 1%.

Figure 91.     Children who have an unmet need for primary health care due to lack of transport, New Zealand,
NZ Health Survey 2011/12–2019/20

There is a social gradient in children’s unmet need for primary care. Barriers to accessing primary care were disproportionately experienced by Māori and Pacific children compared with European/Other in 2019/20. The differences by neighbourhood deprivation are not statistically significant in this overall indicator (Figure 92).

Inequity is most obvious when considering lack of transport as a barrier to primary health care. Māori and Pacific children disproportionately experience lack of transport as a barrier to both GP consultations and after-hours care (Figure 93). There were no children in areas with the lowest NZDep2013 scores who were unable to access primary health care due to lack of transport, whereas this barrier was a reality for 4.5% of children living in areas with the highest deprivation scores for GP visits (Figure 94). While not statistically significant, there was also a tendency for children in these highest deprivation areas to disproportionately experience lack of transport as a barrier to accessing after-hours care.

Figure 92.     Children who have an unmet need for primary health care, by demographic variable, New Zealand
NZ Health Survey 2019/20

Figure 93. Children who have an unmet need for primary health care due to lack of transport, by ethnicity, New Zealand 2019/20

Figure 94. Children who have an unmet need for primary health care due to lack of transport, by neighbourhood deprivation, New Zealand 2019/20

 

Early deaths

Availability and equitable distribution of resources within a society impact on children’s life chances, and children’s lives can be protected through supportive social policy and redistributive fiscal measures.51 Investigation of child deaths is important to increase our understanding of why children die and help prevent future child deaths.52

The all-cause mortality rate for under-15 year olds, excluding neonates, declined from 62.0 to 22.08 deaths per 100,000 age-specific population between 1990–91 and 2018 (Figure 95). Because of delays in recording causes of deaths under coronial investigation, there is a lag in the release of New Zealand mortality data (2018 data were released in 2021).

Figure 95.     All-cause mortality rate in 0–14 year olds (excluding neonates) Aotearoa 1990–2018

In the five years from 2014–2018 there were 1,027 deaths of 0–14 year olds (excluding neonates). Of these deaths, 557 were as a result of medical conditions (an annual average of 111 deaths), 252 as a result of injury (annual average of 50 deaths) and 217 sudden unexpected deaths in infancy (SUDI) (annual average of 43 deaths) (Table 26).

Table 26. All-cause mortality in 0–14 year olds (excluding neonates), by cause of death category, Aotearoa 2014–2018

Cause of death

2014–2018 (n)

Annual average (n)

Rate per 100 000 population

95% CI

%

New Zealand

All-cause mortality

Medical conditions

557

111

12

10.99–13.00

54

Injury

252

50

5

4.77–6.12

25

SUDI

217

43

<5

4.06–5.32

21

Total

1,027

205

22.06

 

100.0

Māori and Pacific under-15-year olds experienced a significantly higher mortality rate compared with Asian/Indian and European/Other children, in the five years from 2014–2018 (Figure 96). The mortality rate for children living in neighbourhoods with the highest NZDep2013 scores (greatest deprivation, quintile 5) was just over three times as high as the mortality rate in quintile 1. Children in quintile 4 also experienced a significantly higher mortality rate than children in quintile 1 (Figure 96).

Figure 96.     All-cause mortality in 0–14 year olds (excluding neonates), by demographic factor, Aotearoa 2014–2018

 

 

The social gradient in all-cause mortality rates in under-15 year olds was present throughout the whole period from 1990–2017, with a marked gap between mortality rates for children living in areas with the highest deprivation scores (quintile 5) and others (Figure 97). Although mortality rates have declined in all NZDep2013 quintiles, there has been no sustained narrowing of the gap between children living in the most deprived areas (quintile 5) and their peers (Figure 97).

Between 1996–97 and 2016–17, there was persistent inequity between mortality rates for Māori and for Pacific children aged under 15 years, compared with mortality rates of their European/Other and Asian/Indian peers. A decrease in mortality rates has been seen across all ethnic groups, with some narrowing of the equity gaps (Figure 98). There is a need for effective policy and sustained effort to bring about a society where every child has an equitable opportunity to survive.

Figure 97.     Mortality rates in 0–14 year olds (excluding neonates), by deprivation score, New Zealand 1990–2017

Figure 98.     Mortality rate of 0–14 year olds (excluding neonates), by ethnicity, New Zealand 1996–2016

Infant deaths

Infant mortality rates in most high-income countries, as in New Zealand, are lower than 10 infant deaths per thousand live births.53 Differences in infant survival within high-income countries reflect commitment and capacity to provide the services needed to protect parents and infants through pregnancy, birth, and the child’s earliest days.53

The infant mortality rate in New Zealand is higher than that in several other OECD countries (Figure 99).54 Some of the international variation in infant mortality rates is due to variations among countries in registering practices for premature infants. The United States and Canada register a much higher proportion of babies weighing less than 500g, with low odds of survival, resulting in higher reported infant mortality. In Europe, several countries apply a minimum gestational age of 22 weeks (or a birth weight threshold of 500g) for babies to be registered as live births and thus infant mortality rates may be lower.54

Figure 99.     Deaths of children aged under one year, per 1,000 live births, OECD 2018

This section reviews infant deaths, including sudden unexpected death in infancy (SUDI), using information from the National Mortality Collection and the Birth Registration Dataset.

Data sources and methods

Indicators

Infant mortality rate

Sudden Unexpected Death in Infancy (SUDI) rates

Data sources

Numerator:            National Mortality Collection

Denominator:         Birth Registration Dataset (live births only)

Other countries:     OECD (via OECD data)

Definitions

Infant death: Death of a liveborn infant prior to 365 days of life.

Infant mortality rate: Death of a liveborn infant prior to 365 days of life per 1,000 live births

Sudden unexpected death in infancy (SUDI): Death of a liveborn infant prior to 365 days of life, where the cause of death was sudden infant death syndrome (SIDS), accidental suffocation or strangulation in bed, inhalation of gastric contents or food, or ill-defined or unspecified causes

SUDI rate: SUDI per 1,000 live births

SIDS: Refers to refer to the sudden, unexpected death in an infant that is unexplained, even after a complete death scene investigation, thorough post-mortem (autopsy) and review of the infant’s clinical history.

Additional information

Cause of death is the main underlying cause of death. Refer to Appendix 1 for relevant codes.

Infant mortality rates fell overall from 1990 to 2018, with most of that decrease occurring during the 1990s followed by a more gradual decline from 2000 to 2007 (Figure 100). Infant mortality rates in 2018 were lower in all ethnic groups in 2018 compared with 1996-97 (Figure 100). There has been persistent inequity in mortality rates during this time period, with mortality rates for European/Other infants lower than rates for Māori and Pacific infants in all years except 2018 (Figure 100).

Figure 100.   Infant mortality rates by ethnicity, Aotearoa 1990–2018

Inequities in infant mortality rates were observed 2014–2018 by ethnicity and neighbourhood socioeconomic deprivation (NZDep2013) as shown in Figure 101. The mortality rate for infants born in areas with the highest socioeconomic deprivation scores (quintile 5) was more than twice as high as the mortality rate for infants born in areas with the lowest deprivation scores (quintile 1). When compared to European/Other infants, Māori infants experienced a mortality rate that was 1.5 times as high, and Pacific infants experienced a mortality rate twice as high. Infant mortality rates were higher for infants born to birthing parents aged under 25 years compared with older birthing parents, The highest infant mortality rates were observed for infants born at less than 37 weeks gestation.

Figure 101.   Infant mortality, comparison by demographic factors, Aotearoa 2014–2018

Overall the most common causes of infant deaths were congenital anomalies, extreme prematurity and other perinatal conditions (Table 27). Infant deaths that occurred in the first month of life commonly resulted from these congenital anomalies and perinatal conditions. Sudden unexpected death in infancy (SUDI), most commonly as a result of suffocation in bed or sudden infant death syndrome, was the most common cause of death for infants aged from 28 days to one year.

Table 27. Infant mortality by main underlying cause of death, Aotearoa 2014–2018

Cause of death

2014–2018 (n)

Annual average (n)

Rate per 1,000 live births

%

New Zealand

Infant mortality

Congenital anomalies

307

61

1.02

22.1

Extreme prematurity

307

61

1.02

22.1

Other perinatal conditions

406

81

1.35

29.2

SUDI: SIDS

99

20

0.33

7.1

SUDI: suffocation or strangulation in bed

103

21

0.34

7.4

SUDI: all other types

12

2

0.04

0.9

Injury or poisoning

30

6

0.10

2.2

Intrauterine hypoxia or birth asphyxia

10

2

0.03

0.7

Other causes

118

24

0.39

8.5

Total

1,392

278

4.64

100.0

Numerator: National Mortality Collection, Denominator: Birth Registration Dataset;
SUDI = Sudden Unexpected Death in Infancy, SIDS = Sudden Infant Death Syndrome

Sudden unexpected death in infancy

Sudden unexpected death in infancy (SUDI) is the leading cause of death for New Zealand infants aged from 28–364 days and usually occurs in otherwise healthy infants.55

The rate of SUDI in New Zealand has significantly decreased since 1990 (Figure 102). Some of this decrease has been attributed to initiatives that occurred during the 1990s designed to make health messages more accessible (for example about appropriate sleeping positions for babies).55

The rate of SUDI for Māori infants has decreased significantly since 1996. The SUDI rate for Pacific infants has fluctuated from year to year (Figure 102). Persistent avoidable inequities remain for Māori and Pacific infants, with consistently higher SUDI rates compared to their European/Other peers (Figure 102).

Figure 102.   Trends in sudden unexpected death in infancy (SUDI) by ethnicity, New Zealand 1990–2017

During 2014–2018, SUDI was experienced inequitably according to neighbourhood socioeconomic deprivation (NZDep2013) and ethnicity (Figure 103). The SUDI rate for infants born in areas with the highest socioeconomic deprivation scores (quintile 5) was almost eight times as high as the SUDI rate for infants born in areas with the lowest deprivation scores (quintile 1). Māori and Pacific infants experienced SUDI rates around five times as high as the rates for European/other infants. The SUDI rate for infants born to mothers aged under 20 years was almost six times as high as the rate for infants born to mothers aged 30 years or older, while for those born to mothers aged 20–25 years it was four times as high. The SUDI rate for infants born before 37 weeks gestation was almost three times as high as the SUDI rate for infants born at or after 37 weeks gestation.

Figure 103.   Sudden unexpected death in infancy, comparison by demographic factor, New Zealand 2013–2017


Potentially avoidable hospitalisations

Potentially avoidable hospitalisations (PAH) cover a broad category of events that may have been prevented through an appropriate, individualised, preventative intervention56.  Most PAH among children in New Zealand are medical, injury, and vaccine-preventable disease events57

PAH does not describe an instance when a patient was admitted for unnecessary reasons or that treatment was not required.  Rather it describes admissions to hospital that may have been avoided through preventative strategies, early disease management, and/or community-based health services. PAH work can also be taken to a broader level, and involve socioeconomic components including income, housing, poverty, health behaviours, and nutrition and any social policy interventions that address these factors58

The New Zealand Health Strategy (2016) seeks to achieve the best health outcomes by ensuring “the right services are delivered at the right location” (Action 6) and by increasing efforts on “prevention, early intervention, rehabilitation and wellbeing” (Action 8)59.  

PAH features as an indicator in the Child and Youth Wellbeing Strategy and the Child Poverty Reduction Act 201814.  PAH as a whole are not routinely collected by the health administrative systems, but coding classification criteria have been identified 60 and recently formalised by the Ministry of Health (see Appendices) to allow monitoring and reporting in relation to the strategy and legislation61.

Measures that address health literacy and improve knowledge, awareness and skills can help alleviate the need for hospitalisation when combined with appropriate service availability and accessibility62.

It is worth noting that a reduction in PAH events does not necessarily reflect improved clinical outcomes.  When looking to reduce the burden of PAH, the resource demands at primary and preventive levels are likely to increase.

Data sources and methods

Indicator

Potentially avoidable hospitalisations of children aged 0–14 years

Data sources

Numerator(s):         National Minimum Dataset (NMDS)

Denominator:         NZCYES Estimated Resident Population (with intercensal extrapolation)

Definitions

Hospitalisations of 0–14 year olds with a primary diagnosis included in the Child and Youth Wellbeing Strategy list of potentially avoidable hospitalisations.

Additional information

Hospitalisations of neonates are excluded.

Medical conditions are acute and arranged.

Injury hospitalisations exclude ED and waiting list cases

Refer to appendices 2 for the codes included in this section.

In 2019, around 57,000 hospitalisations of under-15-year-olds in Aotearoa New Zealand were classified as potentially avoidable. In 2020, this number dropped to fewer than 40,000 due to a marked reduction in the number of potentially avoidable hospitalisations (PAH) for medical conditions associated with closed borders and community-wide public health measures during the national response to the COVID-19 pandemic. Although not reflected in the currently available national data, there was a rebound in hospitalisation numbers in 2021 for children in this age group. Medical conditions accounted for 85% of PAH and the remaining 15% were the result of injury.

From 2009 to 2019, the medical PAH rate had been stable at around 60 hospitalisations per 1,000 under-15-year olds (Figure 104).In 2020, the rate of medical PAH dropped to 38 hospitalisations per 1,000 under-15-year-olds for the reasons described above (Figure 104).

There has been a small but steady decline in the rate of potentially avoidable hospitalisations for injury over the past twenty years (Figure 104).

Figure 104.   Potentially avoidable hospitalisations, 0–14 year olds (excluding neonates), New Zealand 2000–2020

From 2000 to 2019, there was a clear social gradient in PAH rates, with the highest rates for children living in areas with the highest deprivation scores (quintile 5). The gap between NZDep2013 quintile 1 and quintile 5 increased between 2007 and 2009 and remained high until 2019, although gradually decreasing (Figure 105). The abrupt decline in PAH rates in 2020 was associated with a narrowing of the gap between NZDep2013 quintiles (Figure 105).

Figure 106 shows that from 2000 to 2020, European children were hospitalised for PAH at a rate lower than the rates for Pacific children, Maori children or Middle Eastern, Latin American and African (MELAA) children. The PAH rate for Asian/Indian children was lower than the rates for other ethnic groups in 2000 but rose to become similar to the rate for European/Other children from 2013. The decline in PAH rates in 2020 occurred in all ethnic groups with a narrowing of the gap between Pacific and Maori rates compared with European and Asian/Indian rates. 

Figure 105.   Potentially avoidable hospitalisations rates, 0-14 year olds, by deprivation score, Aotearoa 2000–2020

Figure 106.   Potentially avoidable hospitalisations rates in 0-14 year olds, by ethnicity, Aotearoa 2000–2020

Medical conditions

In the five years from 2016–2020, there were around 260,000 potentially avoidable hospitalisations of under-15 year olds for medical conditions, including the subgroup vaccine-preventable diseases. This was an age-specific rate of 55.6 hospitalisations per 1,000 under-15-year-olds.

The age group with the highest hospitalisation rate for medical PAH conditions in children was 0–4 year olds (Figure 107). Within the 0–4 year-old age group, hospitalisation rates for the most common conditions were highest in infants aged less than one year. Among ethnic groups, hospitalisation rates were lowest for European/Other and Asian/Indian children, with higher hospitalisation rates for Māori children and children of Middle Eastern, Latin American and African (MELAA) ethnicity, and the highest rates for Pacific children (Figure 107). Hospitalisation rates for medical conditions were significantly different by NZDep2013 deprivation score, with under-15 year olds living in areas with the highest deprivation scores (quintile 5) experiencing a hospitalisation rate twice as high as those living in areas with the lowest deprivation score (quintile 1) (Figure 107).

This univariate analysis is not able to quantify the independent effect of each demographic factor.

Figure 107.   Potentially avoidable hospitalisations for medical conditions, by demographic factor, 0–14-year-olds New Zealand 2016–2020

 

Over the last twenty years, ethnic disparities in rates of potentially avoidable hospitalisation for medical conditions have not reduced except that the Asian/Indian rate has increased to become similar to the European/Other rate (Figure 108). Pacific, Māori and MELAA rates had a greater decline in 2020 than European/Other or Asian/Indian rates.

Over the last twenty years until 2019, there has been little change in rates of potentially avoidable medical hospitalisations for children living in areas with low NZDep2013 scores (least deprived quintiles 1, 2 and 3) (Figure 109). Rates for children living in the most deprived quintile (quintile 5) have consistently been at least twice as high as those of children living in the least deprived quintile (quintile 1). The rate for children living in quintile 4 has increased since 2013 to become similar to that of children living in quintile 5. There was a fall in potentially avoidable hospitalisation rates for children in all deprivation quintiles in 2020 but the magnitude of the decrease was greater for children in quintiles 4 and 5.

Figure 108.   Trends in potentially avoidable medical hospitalisations of 0–14 year olds (excluding neonates), by ethnicity, New Zealand 2000–2020

Figure 109.   Trends in Potentially avoidable medical hospitalisations of 0–14 year olds (excluding neonates), by deprivation score, New Zealand 2000–2020

Table 28.      Potentially avoidable hospitalisations for medical conditions, by main diagnostic category, 0–14 year olds (excluding neonates), New Zealand 2016–2020

Main Diagnostic Category

n

Rate per 1,000 0–14 year olds

95% CI

%

Hospitalisations of 0–14 year olds (neonates excluded), New Zealand, 2016-2020

Medical conditions

Respiratory conditions

112,752

23.83

23.7–24.0

42.8

Dental conditions*†

37,785

7.98

7.90–8.06

14.4

Gastrointestinal diseases

28,734

6.07

6.00–6.14

10.9

Otitis media†

21,395

4.52

4.46–4.58

8.1

Dermatological conditions

17,085

3.61

3.56–3.66

6.5

Epilepsy

11,208

2.37

2.32–2.41

4.3

Vaccine-preventable diseases

5,281

1.12

1.09–1.15

1.9

Diabetes (including hypoglycaemia)

2,718

0.57

0.55–0.60

1.0

Kidney, urinary tract infection

2,384

0.50

0.48–0.52

0.9

Cardiovascular diseases

712

0.15

0.14–0.16

0.3

Nutrition deficiency and anaemia

690

0.15

0.14–0.16

0.3

Sexually transmitted infections

30

0.01

0.00–0.01

0.0

Other medical conditions

22,730

4.80

4.74–4.87

8.6

Total

263,276

55.63265996

55.4–55.80

100.0

Numerator: NMDS, Denominator: NZCYES Estimated Resident Population.
* Excluding gingivitis and periodontal diseases. † including waiting list admissions

During 2016–2020, respiratory conditions were by far the most common cause of medical potentially avoidable hospitalisations in children. Dental conditions (predominantly dental caries) were the next most common diagnostic category, followed by gastrointestinal conditions (such as gastroenteritis) (Table 28).

The most common type of respiratory illness associated with potentially avoidable hospitalisations was upper respiratory tract infection, followed by asthma and wheezing, bronchiolitis, and pneumonia (Table 29).

Table 29.      Potentially avoidable hospitalisations for respiratory diseases, by sub diagnostic category, 0–14 year olds (excluding neonates), New Zealand 2016–2020

Sub Diagnostic Category

n

Rate per 1,000 0–14 year olds

95% CI

%

Hospitalisations of 0–14 year olds (neonates excluded), New Zealand, 2016-2020

Respiratory diseases

Acute upper respiratory tract infections

32,522

6.87

6.80–6.95

28.8

Asthma and Wheeze

31,901

6.74

6.67–6.82

28.3

Acute bronchiolitis

26,244

5.55

5.48–5.61

23.3

Pneumonia (Viral/Bacteria/VPD)

12,530

2.65

2.60–2.69

11.1

Unspecified acute lower respiratory infection

8,032

1.70

1.66–1.73

7.1

Bronchiectasis (non-CF)

1,077

0.23

0.21–0.24

1.0

Acute bronchitis

446

0.09

0.09–0.10

0.4

Respiratory conditions

112,752

23.82554307

23.7–24.0

100.0

Numerator: National Minimum Dataset (excludes neonates), Denominator: NZCYES estimated resident population;
* Pneumonia includes vaccine-preventable pneumonia (J13, J14), Upper respiratory tract infections –  acute nasopharyngitis, sinusitis, pharyngitis, tonsillitis, laryngitis, tracheitis, croup, and acute upper respiratory infections of multiple and unspecified sites, ,

Figure 110.   Trends in potentially avoidable hospitalisations for respiratory diseases, by sub diagnostic category, 0–14 year olds (neonates excluded), New Zealand 2000–2020

Over the twenty years prior to 2020, rates of potentially avoidable hospitalisations for upper respiratory tract conditions, asthma and wheeze, bronchiolitis and unspecified lower respiratory tract conditions all increased slightly while potentially avoidable hospitalisations for pneumonia decreased slightly (Figure 110). In 2020, rates of all five respiratory conditions decreased sharply and the decline in the hospitalisation rate for bronchiolitis was especially striking (Figure 110).

Vaccine-preventable diseases

In the five years from 2016–2020, there were over 5,000 potentially avoidable hospitalisations of under-15 year olds for vaccine-preventable diseases. The majority of children hospitalised with vaccine-preventable diseases were under five years old (Figure 111). Pacific children had a much higher hospitalisation rate for vaccine-preventable diseases than children from other ethnic groups, with rates three times as high as rates for European/Other and Asian/Indian children. The rate for Māori children was twice as high as the rates for European/Other and Asian/Indian children (Figure 111). There was a clear deprivation gradient with the rate for children living in the most deprived neighbourhoods (quintile 5) being almost three times as high as the rate for children living in the least deprived neighbourhoods (Figure 111).

Rates of potentially avoidable hospitalisations for vaccine preventable disease were unusually high in 2019 and unusually low in 2020.

Pacific children have consistently had the highest hospitalisation rates for vaccine-preventable conditions, and Māori children have consistently had rates higher than those for European/Other and Asian/Indian children (Figure 112). These disparities have changed little over the past twenty years (Figure 112). Prior to 2006, Asian/Indian children had lower rates than European/Other children but in more recent years these two groups have had very similar rates (Figure 112). While the sharp increase in rates in 2019 was evident in all ethnic groups, the magnitude of the increase was much greater for Pacific children (Figure 112).

The decline in 2020 was evident in all ethnic groups with rates so low that the y-axis scale in Figure 112 needed to change to rates per 100,000 under-15 year olds.

Figure 111.   Potentially avoidable hospitalisations related to vaccine-preventable diseases, by demographic factor, 0–14 year olds, New Zealand 2016–2020

Figure 112.   Trends in potentially avoidable hospitalisations for vaccine-preventable conditions in 0–14 year olds (excluding neonates), by ethnicity, New Zealand 2000–2020

Figure 113.   Trends in potentially avoidable hospitalisations for vaccine-preventable conditions, 0–14 year olds (excluding neonates), by deprivation score, New Zealand 2000–2020

Hospitalisation rates for vaccine-preventable conditions collectively have not declined overall in in the past twenty years (Figure 113). Rates have consistently been higher for children living in more deprived neighbourhoods (NZDep2013 quintiles 4 and 5). The same temporal patterns in rates are apparent in all deprivation groups, but in years where there is an upswing, the rise is greater for children in more deprived quintiles. The decline in 2020 was evident in all NZDep2013 quintiles with rates so low that the y-axis scale in Figure 113 needed to change to rates per 100,000 under-15 year olds.

Table 30.      Potentially avoidable hospitalisations for vaccine-preventable diseases, by subcategory, under-15 year olds, New Zealand 2016–2020

Sub Diagnostic Category

n *

Rate per 100,000
0–14 year olds

95% CI

%

Potentially avoidable hospitalisations of 0–14 year olds in New Zealand during 2016-2020

Vaccine preventable diseases

Influenza

2,985

63.08

60.81–65.34

56.4

Varicella

1,047

22.12

20.78–23.46

19.8

Measles

376

7.95

7.14–8.75

7.1

Pertussis

369

7.80

7.00–8.59

7.0

Meningococcal infection

228

4.82

4.19–5.44

4.3

Pneumonia due to streptococcus pneumoniae

117

2.47

2.02–2.92

2.2

Haemophilus pneumonia

65

1.37

1.04–1.71

1.2

Mumps

40

0.85

0.58–1.11

0.8

Tuberculosis

28

0.59

0.37–0.81

0.5

Hepatitis A

25

0.53

0.32–0.74

0.5

Haemophilus meningitis

12

0.25

0.11–0.40

0.2

Diphtheria

< 5

s

s

s

Chronic viral hepatitis

< 5

s

s

s

Total

5,292

111.82

108.90–114.92

100.0

Numerator: NMDS (excludes neonates). Denominator: NZCYES Estimated Resident Population. s indicates suppression if number of hospitalisations less than 5

During 2016–2020, the vaccine-preventable disease associated with the greatest number of potentially avoidable hospitalisations was influenza, which accounted for almost 60% of all such hospitalisations (Table 30). Hospitalisations for varicella accounted for 20%. Influenza vaccination is included in New Zealand’s Immunisation Schedule for children but is recommended and funded only for children with health conditions that put them at greater risk of becoming seriously ill with influenza (this includes children with previous hospitalisation for respiratory illness).63

Figure 114 and Figure 115 present trends in hospitalisations for the five vaccine-preventable diseases most commonly resulting in hospitalisation in New Zealand children. A very substantial rise in hospitalisations for influenza occurred from 2016 to 2019 (Figure 114), and the measles hospitalisation rate went up 100-fold in 2019 (compared to 2018) due to the measles epidemic in that year (Figure 115).64

The pertussis hospitalisation rate had peaks in 2000, 2004, 2012 and 2018 (Figure 115). Hospitalisations for meningococcal disease declined steeply from 2001 to 2006 and have been relatively low since then (Figure 115). Varicella hospitalisations have declined considerably year on year since 2017 when varicella vaccination was added to the immunisation schedule in mid-2017 (Figure 115).63 Hospitalisation rates for all of the top five vaccine-preventable diseases declined sharply in 2020 (Figure 115).

Figure 114.   Potentially avoidable hospitalisations for influenza, 0–14 year olds, New Zealand 2000–2020

Figure 115.   Potentially avoidable hospitalisations for selected vaccine preventable diseases, 0–14 year olds, New Zealand 2000–2020

Figure 116 shows that hospitalisation rates for influenza are much higher for 0–4 year olds than for older children. Rates increased for children of all ages in 2019, but to a greater degree in the youngest age group.

Figure 116.   Potentially avoidable hospitalisations for influenza, 0–14 year olds, by age group, New Zealand 2000–2020

Injuries

In the five years from 2016–2020, there were almost 50,000 potentially avoidable hospitalisations of under-15 year olds for injuries. Injury rates were a little higher for 0–4 year olds than for older children. Injury rates were similar for Māori and European/other children (Figure 117). Compared to the rates for these two groups, Pacific rates were a little higher, and MELAA rates were a little lower and Asian rates were considerably lower (Figure 117). Injury rates were somewhat higher for children living in more deprived neighbourhoods than for those living in less deprived neighbourhoods (Figure 117). The injury hospitalisation rate for male children was higher than that of female children (Figure 117).

Figure 117.   Potentially avoidable hospitalisations related to injuries, by demographic factor, 0–14 year olds, New Zealand 2016–2020

Potentially avoidable hospitalisations for injury in children have declined overall during the last twenty years for all ethnic groups, although the decline has been much less for the Asian/Indian group which has consistently had a much lower rate than the other ethnic groups (Figure 118). Over the last ten years, rates for the European/Other and Asian/Indian groups were steady while Pacific and Māori rates continued to decline with the result that ethnic disparities decreased (Figure 118).

Figure 118.   Trends in potentially avoidable hospitalisations for injury in 0–14 year olds (excluding neonates), by ethnicity, New Zealand 2000–2020

Figure 119.   Trends in Potentially avoidable injury hospitalisations of 0–14 year olds (excluding neonates), by deprivation score, New Zealand 2000–2020

Rates of potentially avoidable hospitalisations for injury have decreased for children of all levels of deprivation over the past twenty years (Figure 119). The decrease has been greater for children living in the most deprived areas (quintile 5) so that disparities between deprivation quintiles have greatly reduced.

Table 31.      Potentially avoidable hospitalisations for injury, by external cause of injury, 0–14 year olds, New Zealand 2016– 2020

Type of Injury

n

Rate per 1,000 0–14 year olds

95% CI

%

Potentially avoidable hospitalisations of 0–14 year olds in New Zealand during 2016-2020

Injuries

Unintentional

Falls

21,002

4.44

4.38–4.50

43.0

Mechanical force (inanimate)

10,628

2.25

2.20–2.29

21.8

Transport accidents

4,583

0.97

0.94–1.00

9.4

Animate mechanical forces (animal-related)

2,652

0.56

0.54–0.58

5.4

Thermal injury (including fire)

1,796

0.38

0.36–0.40

3.7

Poisoning (accidental)

1,480

0.31

0.30–0.33

3.0

Overexertion and strenuous

1,053

0.22

0.21–0.24

2.2

Drowning or submersion

177

0.04

0.03–0.04

0.4

Other unintentional injuries

3,609

0.76

0.74–0.79

7.4

Intentional

Intentional self-harm

1,223

0.26

0.24–0.27

2.5

Assault

650

0.14

0.13–0.15

1.3

Total

48,853

10.09

10.00–10.18

100.0

Numerator: NMDS (excludes ED and waiting list cases), Denominator: NZCYES Estimated Resident Population.

The vast majority of injuries leading to PAH were unintentional. Table 31 indicates that falls were the leading cause of potentially avoidable injury-related hospitalisations in children aged 0–14 years, followed by inanimate mechanical forces and transport accidents. Inanimate mechanical forces includes a wide range of injuries including being struck by sports equipment, being crushed, jammed or pinched in a catch or door, and machinery-related injuries. Intentional self-harm was the leading cause of PAH related to intentional injury in this age group.

Immunisation

Protection from infectious disease through immunisation is a right of every child.46 Immunisation is integral to the United Nations Sustainable Development Goals and supports progress towards goals that could be compromised by the impacts of infectious disease.65

New Zealand currently offers children and adolescents vaccines against more than ten infectious diseases through the National Immunisation Schedule.63

In 2017/2018, the Ministry of Health set a target of 95 percent of infants being fully immunised by eight months. District Health Board performance measures also target 95 percent immunisation coverage at ages 2 years and 5 years.66

The section reports on immunisation coverage in children up to the age of five years.

Data sources and methods

Indicator

Proportion of children fully immunised at each milestone age

Data source

National Immunisation Register (NIR) https://www.health.govt.nz/our-work/preventative-health-wellness/immunisation/immunisation-coverage/national-and-dhb-immunisation-data

Additional information

Milestone ages for vaccination are: 6 months, 8 months, 12 months (1 year), 18 months, 24 months (2 years), 54 months and 5 years.. Parents are able to opt out of having their child’s immunisation information stored in the NIR. Children are fully immunised when they have received all of the target immunisations on the National Childhood Immunisation Schedule for their age.

Details on which vaccines children receive and when can be found in the New Zealand Immunisation Schedule: https://www.health.govt.nz/our-work/preventative-health-wellness/immunisation/new-zealand-immunisation-schedule

Figure 120 presents the proportions of infants and children fully immunised at 8 months, 24 months, and 5 years old. Immunisation rates at age 8-months increased from 2011 to 2017, since when they have been around 87–88%. Immunisation rates for 24-month-olds had been over 90% for nine years until they dipped slightly in 2021, probably due to disruptions from COVID-19. Fully immunised rates for 5‑year-olds increased from 67% in 2010 to 89% in 2020 but showed a slight decline in the year ending June 2021.

Figure 120.   Immunisation coverage, by milestone age, Aotearoa 2008/09–2020/21

Figure 121 and Figure 122 present the proportions of fully immunised 8-month-olds  and 5-year-olds by ethnicity and by deprivation score.

Over the last six years, there has been a marked decline in immunisation rates for Māori 8-month-olds, and a less pronounced drop off for 8-month-olds living in high deprivation areas. From 2019/20 to 2020/21 there was a small decrease in immunisation coverage in all other groups except the Asian ethnic group, probably as a result of the Covid-19 pandemic response. Only the Asian ethnic group has consistently achieved the Ministry of Health’s target of 95% immunisation coverage.

Figure 121.   Immunisation coverage at 8 months of age, by ethnicity and NZ Deprivation Index quintile, New Zealand, years ending 30 June 2014–2021

Immunisation rates for 5-year-olds have gradually increased for all ethnic groups and deprivation scores since 2013/2014. In the last five years Māori immunisation rates for 5-year-olds have been lower than those for other ethnic groups. In 2020/2021, 81% of Māori 5-year-olds were fully immunised, compared to around 90% of children in the Pacific, Asian, and NZ European ethnic groups. The proportion of 5-year-olds fully immunised in areas with high deprivation scores (NZDep2013 quintile 5) has been consistently lower than the proportion in less deprived areas.

Figure 122.   Immunisation coverage at 5 years of age, by ethnicity and NZ Deprivation Index quintile, New Zealand, year ending June 2014–2021

Figure 123.   Fully immunised and immunisation declined, by milestone ages, New Zealand, year ended June 2021

Figure 123 shows that, at each milestone age, around five percent of New Zealand children have parents who decline immunisation. The proportion who are fully immunised at the different milestone ages varies, but is highest for 12-month-olds and lowest for four-and-a-half-year-olds.

Nurtured to thrive

This section reports on the following indicators of failure to protect children from physical violence: hospitalisations due to assault, deaths due to assault, and receipt of physical punishment for misbehaviour.

Reducing physical punishment

This indicator presents information from the New Zealand Health Survey on the prevalence of receipt of physical punishment among 0–14 year olds in in the four weeks preceding the survey interview. The 2019/20 survey collected data up until March 2020 and so its results do not give any indications of impacts related to COVID-19.

Data sources and methods

Indicator

Children who received physical punishment in past four weeks

Definitions

Children aged between 0–14 years old have received physical punishment if their parent or caregiver reported having used  “Physical punishment, such as smacking” when the child misbehaved during the past four weeks.

Data sources

Source: New Zealand Health Survey Annual Data Explorer 2019/20.

Indicator: Children who received physical punishment in past 4 weeks (0-14 years) https://minhealthnz.shinyapps.io/nz-health-survey-2019-20-annual-data-explorer/_w_20e602b4/#!/explore-indicators

 

Numerator(s):         Sum of the weights for the respondents in the group

Denominator:         Sum of the weights for all respondents/population group

Additional information

Relevant NZ Health Survey question: physical punishment (C3.15 and C3.16a):

 

Question C3.15: Thinking back over the past 4 weeks, when [child’s name] misbehaved, which of the following, if any, have you done?

     Made him/her go without something or miss out on something

     Yelled at him/her

     Explained why he/she should not do it

     Physical punishment, such as smacking

     Told him/her off

     Sent him/her to the bedroom or other place in the house

     Ignored his/her behaviour

     Something else [specify] ______

     My child has not misbehaved during the past 4 weeks

 

Question C3.16a: Using the scale on the showcard, to what extent do you disagree or agree with the following statement? There are certain circumstances when it’s alright for parents to use physical punishment, such as smacking, with children.

     Strongly disagree / Disagree / Neither disagree nor agree / Agree / Strongly agree

 

Survey data (by financial year) is referred to by the year of data beginning. For more information on the NZ Health Survey, please refer either to the Ministry of Health website (https://www.health.govt.nz) or to appendices in this report.

In the 2020 NZ Health Survey, 36.9% of parents or primary caregivers of children aged 0–14 years agreed that “there are certain circumstances when it is alright for parents to use physical punishment, such as smacking, with children”. This percentage is the sum of the percentages of those who “agreed” and those who “strongly agreed” with the survey statement.

Since 2011/12 there has been an overall fall in the prevalence of children aged 0–14 years experiencing physical punishment (Figure 124). In 2019/20, 4.5% of children were reported to have received physical punishment compared to 7.4% in 2011/12 and 10.4% in 2006/07.

The percentages of 0–14 year olds who received physical punishment are presented as unadjusted rates by demographic factor in Figure 125 and as adjusted rate ratios in Figure 126. In the unadjusted analysis, although rates varied by each demographic factor, group, differences between demographic groups were mostly not statistically significant (Figure 125). In the adjusted analysis, rates of physical punishment were significantly higher for Māori children (compared to non-Māori children), Pacific children (compared to non-Pacific children) and male children (compared to female children) (Figure 126). The rates of physical punishment for children living in the most deprived neighbourhoods (quintile 5) were almost four times as high as those for children in the least deprived neighbourhoods in both the unadjusted and adjusted analyses (Figure 125, Figure 126).

Figure 124.   Physical punishment in 0–14 year olds, by survey year, New Zealand 2006/07–2019/20

Figure 125.   Physical punishment in 0–14 year olds, by demographic factor, New Zealand 2019/20

Figure 126.   Physical punishment in 0–14 year olds, by demographic factors, New Zealand 2019/20

Care and protection

Oranga Tamariki receives reports of concern when someone believes that a child or young person has been harmed or is at serious risk of harm. These reports of concern are assessed by a social worker to determine if further action is required. Oranga Tamariki aims to support families, children and young people so that children and young people can be safely kept at home but if this is not achievable children or young people may need to be in care and protection custody.67

The section reports on care and protection notifications, substantiated abuse findings, and children and young people in Care and Protection Custody of the Chief Executive, using data from Oranga Tamariki.

Data sources and methods

Indicator

Numbers of Reports of Concern and proportion of Reports of Concern that require further action

Substantiated findings of abuse in children and young people notified to Oranga Tamariki

Children and young people in the Care and Protection Custody of the Chief Executive

Data source

Oranga Tamariki

Further information

For more information on Oranga Tamariki data please refer either to the Oranga Tamariki website https://www.orangatamariki.govt.nz/ , or to the data source appendix in this report.

Figure 127 presents the number Reports of Concern for children and young people received by Oranga Tamariki from 2003/04 to 2020/21 and the percentage of Reports of Concern that were assessed by a social worker as requiring further action from Oranga Tamariki.

Figure 127. Reports of Concern and proportion requiring further action, New Zealand 2003/04–2020/21

The total number of Reports of Concern was generally variable from year-to-year from 2010/11 onwards but there appears to have been a slight downward trend over the last few years (Figure 128).  In 2020/21 Oranga Tamariki received 77,953 Reports of Concern about 68,672 distinct children (Figure 128).  A child or young person may have more than one notification in a year so the number of children who were the subject of Reports of Concern is somewhat less than the total number of Reports of Concern (Figure 128).

Figure 128. Numbers of Reports of Concern and children with Reports of Concern, New Zealand 2010/11–2020/2021

Figure 129 shows substantiated abuse cases broken down into the percentages of the total cases that were different types of abuse over the period 2003/04–2020/21.

Since 2005/06 the most common type of substantiated abuse has been emotional abuse. In 2020/21, emotional abuse was found in 51% of substantiated abuse cases, neglect in 19%, physical abuse in 21%, and sexual abuse in 8%.

Figure 129. Substantiated abuse findings, by type, by year, New Zealand 2003/04–2020/21

In 2020/21 there were 5,250 children and young people in Care and Protection Custody of the Chief Executive (Figure 130). The number of children and young people in care and protection custody increased from 2016 to 2019, partly because the age until which a young person can remain in care was increased from 17 years to 21 years.68

In 2020/21, almost 6 in 10 (57%) children and young people in Care and Protection Custody of the Chief Executive identified as Māori69

Figure 130.   Children and young people in the custody of the Chief Executive (CE), New Zealand 2012/13–2020/21

Assault, neglect and maltreatment

Children have the right to live free from abuse and neglect.70 Maltreatment has serious impacts on children’s developing brains and on their physical and mental health that can be lifelong.70

Child maltreatment is not caused by poverty alone, and most poor children are not maltreated, but many factors associated with poverty increase the risk of child maltreatment: family isolation and social exclusion, alcohol and drug abuse, unemployment, experiencing discrimination, and inadequate and/or crowded housing.70

The following section reviews deaths and hospitalisations of New Zealand 0–14 year olds that were due to injuries from assault, neglect or maltreatment, using data from the National Mortality Collection and the National Minimum Dataset. Hospitalisations for child maltreatment are the “tip of the iceberg” but they do provide some indication of the numbers of children who are severely maltreated.

Data sources and methods

Indicators

Deaths from injuries arising from the assault, neglect, or maltreatment of 0–14 year olds

Hospitalisations for injuries arising from the assault, neglect, or maltreatment of 0–14 year olds

Definitions

Deaths in 0–14 year olds are those where intentional injury is a cause of death.

Hospitalisations* of 0–14 year olds are those where there is a primary diagnosis of injury and an intentional injury (assault) external cause code in any of the first 10 external cause codes.

Data sources

Numerator(s):         Deaths: National Mortality Collection;

                               Hospitalisations: National Minimum Dataset.

Denominator:         NZCYES Estimated Resident Population (with intercensal extrapolation)

Additional information

* As outlined in Appendix 3, in order to ensure comparability over time, all hospitalisations with an emergency department specialty code on discharge were excluded, as were hospitalisations with a non-injury primary diagnosis.

Refer to Appendix 1 for the codes included in this section.

Deaths from assault, neglect or maltreatment

From 1990–2018, an average of seven children per year (aged 0–14 years) died from injuries arising from assault, neglect, or maltreatment, corresponding to a rate of around one death per 100,000 children per year. Lower rates in 2002–03, 2012–13 and 2016–17 and 2018 were not statistically different from the rates in other year-pairs (Figure 131).

In the five years from 2014–2018 there were 33 deaths of 0–14 year olds children that resulted from assault, neglect or maltreatment. Fourteen of these deaths were of female children and nineteen were of male children. Infants aged under one year had the highest mortality rate from assault, neglect, or maltreatment (5 deaths per 100,000 age-specific population per year). Fourteen of the total 33 deaths (42%) occurred in infants aged less than one year, fifteen deaths (45%) were of children aged 1–4 years, and four were children aged 5–10 years. In these five years there were no deaths from assault of children aged 11–14 years.

Figure 131.   Deaths due to injuries arising from assault, neglect, or maltreatment of 0–14 year olds, New Zealand 1990–2018


 

Hospitalisations due to assault, neglect or maltreatment

Over the last ten years, from 2011 to 2020, the numbers and rates of hospitalisations for injuries arising from assault, neglect or maltreatment of New Zealand children aged 0–14 years have been stable with only small year to year fluctuations (Figure 132).

Figure 132.   Hospitalisations due to injuries arising from assault, neglect, or maltreatment in 0–14 year olds, by year, New Zealand 1990–2020

In the five years from 2016–2020 there were 1043 hospitalisations of 0–14 year olds for injuries arising from assault, neglect or maltreatment, 414 of girls and 629 of boys. Age-specific hospitalisation rates for injuries arising from assault, neglect or maltreatment were highest for children in the first year of life or in their early teenage years, and considerably lower for children aged between 2 and 10 years of age (Figure 133). Male rates were higher than female rates at most ages, but the differences were not always statistically significant.

Figure 133.   Hospitalisations due to injuries arising from assault, neglect, or maltreatment in 0–14 year olds, by age and gender, New Zealand 2016–2020.

In children overall, the most common injuries recorded in hospitalisations resulting from assault, neglect or maltreatment  in 2015–2020 were head injuries (550 out of the total 1,043 or 52.7%). These included 198 traumatic brain injuries (18.5%), 137 superficial head injuries (13.7%), 57 fractures of the skull or facial bones (5.5%) and 158 other head injuries (15.1%).

The nature of the injuries differed by age group. In the period 2016–2020, maltreatment, traumatic brain injuries, and superficial head injuries were the most commonly recorded diagnoses in children aged under five years (Table 32). In the 5–9 year old age group other head injuries and maltreatment were the most common diagnoses (Table 32). In 10–14 year olds, traumatic brain injuries, other head injuries, upper limb injuries and superficial head injuries were the most common diagnoses (Table 32).

Table 32.      Hospitalisations due to injuries arising from assault, neglect, or maltreatment in 0–14 year olds, by age groups and nature of injury, New Zealand 2016–2020

Primary diagnosis

2016–2020 (n)

Annual average

Rate per 100,000 population

%

Assault, neglect, or maltreatment hospitalisations of 0–14 year olds

0–4 year olds

Traumatic brain injuries

76

15

4.98

20.8

Superficial head injury

60

12

3.93

16.4

Fracture skull or facial bones

9

2

0.59

2.5

Other head injuries

31

6

2.03

8.5

Injuries to the neck

<5

s

s

s

Injuries to thorax (including rib fractures)

13

3

0.85

3.6

Injuries to abdomen, lower back, and pelvis

20

4

1.31

5.5

Injuries to upper limb

32

6

2.10

8.8

Fractured femur

9

2

0.59

2.5

(Other) Injuries to lower limbs

19

4

1.25

5.2

Maltreatment

79

16

5.18

21.6

Other injuries

13

3

0.85

3.6

Total

365

73

23.93

100.0

5–9 year olds

Traumatic brain injuries

9

2

0.55

5.4

Superficial head injury

20

4

1.22

12.0

Fracture skull or facial bones

5

1

0.30

3.0

Other head injuries

30

6

1.83

18.1

Injuries to the neck

9

2

0.55

5.4

Injuries to thorax (including rib fractures)

<5

s

s

s

Injuries to abdomen, lower back, and pelvis

19

4

1.16

11.4

Injuries to upper limb

16

3

0.98

9.6

Injuries to lower limbs (includes fractured femur)

18

4

1.10

10.8

Maltreatment

28

6

1.71

16.9

Other injuries

8

2

0.49

4.8

Total

166

33

10.12

100.0

10–14 year olds

Traumatic brain injuries

113

23

7.21

22.1

Superficial head injury

57

11

3.64

11.1

Fracture skull or facial bones

43

9

2.74

8.4

Other head injuries

97

19

6.19

18.9

Injuries to the neck

24

5

1.53

4.7

Injuries to thorax (including rib fractures)

17

3

1.08

3.3

Injuries to abdomen, lower back, and pelvis

34

7

2.17

6.6

Injuries to upper limb

71

14

4.53

13.9

Injuries to lower limbs (includes fractured femur)

21

4

1.34

4.1

Maltreatment

14

3

0.89

2.7

Other injuries

21

4

1.34

4.1

Total

512

102

32.66

100.0

Numerator: National Minimum Dataset, Denominator: NZCYES Estimated Resident Population

There was a clear social gradient in hospitalisation rates as rates increased with increasing scores on the NZDep2013 index of deprivation. Hospitalisation rates for children who lived in areas with the highest NZDep2013 scores were five times those for children living in areas with the lowest scores. There were also marked differences by ethnicity, with hospitalisation rates for Māori children nearly three times, and Pacific children over two times, those of European/Other children (Figure 134).

Figure 134.   Hospitalisations due to injuries arising from assault, neglect, or maltreatment in 0–14 year olds, by demographic factor, New Zealand 2016–2020

 

Opportunities for learning

Participation in education is a fundamental right of every child.46 Education is the key to breaking intergenerational cycles of poverty and improving quality of life for children and families.71

Regular school attendance enhances both student wellbeing and attainment.72 An investigation by the Ministry of Education indicated that, in the attendance range above 70%, the relationship between attendance and NCEA attainment is essentially a straight line and that there is no level of non-attendance that has no effect on educational attainment. This investigation also found that the decline in attainment with decreasing attendance was steeper for students for student from more disadvantaged socioeconomic backgrounds.73

Achieving school qualifications and higher education qualifications leads to higher earnings in the workforce. A recent Ministry of Education report found that, nine years after leaving school, a person who left school with NCEA level 2 could expect to be earning, on average, twice as much as someone who left with no qualifications.74

The following sections present Ministry of Education information on school attendance and the attainment of school leavers from 2009–2020.

Data sources and methods

Indicators

Students attending school regularly

School leavers with below level 1 qualifications

School leavers with NCEA Level 1 or above

School leavers with NCEA Level 2 or above

School leavers with a University Entrance Standard

Data source attendance

Ministry of Education: Attendance survey. https://www.educationcounts.govt.nz/statistics/attendance

Numerator:            The total number of students who have attended more than 90% of all school time in Term 2, where time is measured in half-days.

Denominator:        The total number of students enrolled for 30 half-days or more during Term 2, in each year, except 2020, which the minimum enrolled half-day is 1 during Term 2

Data source attainment

Ministry of Education https://www.educationcounts.govt.nz/statistics/school-leavers

Numerator:            Number of students leaving school with no qualifications, NCEA Level 1 or higher, NCEA Level 2 or higher, or a University Entrance Standard (or equivalent qualifications). NCEA data was provided to the Ministry by NZQA, data on other qualifications was provided by schools.

Denominator:         Number of school leavers in a given year (from the Ministry of Educations’ national register of student enrolments, ENROL). Further information on exactly who is classed as a school leaver can be found on the weblink above.

Definitions

The National Certificate of Educational Achievement (NCEA) is part of the National Qualifications Framework (NZQF).  NCEA can be achieved at three levels: 1,2 and 3, typically gained in years 11, 12 and 13.75  At each Level, students must achieve a certain number of credits to be awarded the qualification, and these may be gained over more than one year. University Entrance is the minimum requirement for attending a New Zealand University and it requires all of the following: NCEA level 3 with 14 credits in each of three approved level 3 subjects; 12 level 2 literacy credits (5 in writing and 5 in reading); and 10 level 1 numeracy credits.75 Not all students who attain level 3 will attain University Entrance. Listed qualification levels include qualifications on the  NZQF as well as other equivalent qualifications that are non-NZQF such as Cambridge International Assessment and International Baccalaureate.

School socio-economic decile: 76  All schools are assigned a decile ranking based on the socio-economic status of the area they serve. These rankings are based on census data from families with school age children in the areas from which the school draws its students. Five census variables used in the ranking procedure: equivalent household income (i.e. income adjusted for the number of adults and children in the household and the ages of the children), parental occupation and educational qualifications, household crowding and receipt of income support payments. Schools are assigned a decile ranking, with decile 1 schools being the 10% of schools with the highest proportion of students from low socio-economic communities and decile 10 schools being the 10% of schools with the lowest proportion of these students. Decile ratings are used by the Ministry of Education to allocate targeted funding, as well as for analytical purposes. Ranking of deciles is in the opposite direction to that of the NZDep2013 index of deprivation used with health data in this report.

School socioeconomic quintiles are aggregates of the deciles, with quintile 1 = deciles 1 and 2 (highest disadvantage) and  quintile 5 = deciles 9 and 10 (lowest disadvantage).

 

Ethnicity is total response so individual students may be counted in more than one ethnic group.

Additional information

These data follow a new definition of school leavers from the Ministry of Education ENROL system employed from 2009 onwards so comparison with previous years is not possible.

Regular attendance

The percentages and numbers of students/akonga in Aotearoa who attended school/kura regularly (attended more than 90% of Term 2) are presented in Figure 135. The most recent data indicates that 64.0% of students attended regularly, which is an increase of 6.3 percentage points on the previous year (Figure 135). Note that the 2020 data describes attendance for the 7 weeks of Term 2 when COVID-19 restrictions were lifted.

Figure 135.   Students attending school regularly, by year, New Zealand 2011–2020

Students of all ethnic groups and across school deciles had overall decreases from 2015–2019 in the proportion who attended school regularly (Figure 136, Figure 137) and varying increases from 2019 to 2020.

Differences in regular school attendance by ethnicity and by school socioeconomic quintile have persisted over time (Figure 136, Figure 137). The difference in attendance rates between students in school decile 1 and students in school decile 10 increased in 2020 (Figure 137).

Figure 136.   Students attending school regularly, by year and by ethnicity, New Zealand 2011–2020

Figure 137.   Students attending school regularly, by year and by selected school deprivation decile, New Zealand 2011–2020

Educational attainment

The proportion of young people in Aotearoa who left school having achieved an NCEA Level 1 or equivalent qualification increased from 2009 to 2017 with a very slight decline from 2017 to 2020 (Figure 138). The proportion of young people leaving school who achieved the Level 2 NCEA qualification or above rose from 68% in 2009 to 81% in 2020. Over the same period, the proportion achieving Level 3 NCEA and/or University Entrance increased from 37% to 59%. The percentage of young people leaving without having obtained any NCEA qualifications decreased from 19% in 2009 to 10% in 2017 but had increased to 12% by 2020.

Figure 138.   Educational attainment of school leavers, by qualification, New Zealand 2009–2020

There are disparities in educational attainment by ethnicity and by school socioeconomic quintile. The Ministry of Education has noted that there is considerable variation in achievement rates within each quintile.77 Some schools in the lowest quintile have a  higher proportion of students achieving qualifications at NCEA Level 2 than some schools in the highest quintile.77 This highlights the importance of schools creating an environment where students can thrive.

For every qualification, there were overall increases for young people of all ethnic groups in the proportion of who achieved qualifications before leaving school (Figure 139). Between 2009 and 2020, the increases were greater for Māori and Pacific students than for European and Asian students so ethnic disparities decreased (Figure 139). In 2020, compared with 2009, an additional 20% of Māori and 22% of Pacific young people achieved Level 2 NCEA and an additional 26% of Māori and 39% of Pacific young people achieved Level 3 and/or University Entrance (Figure 139).

There has been a decrease overall for all ethnic groups over the past decade in the proportion of young people who leave school without having obtained an NCEA qualification but for Māori and European young people there has been slight increases since 2017 (Figure 139).

Figure 139.   Educational attainment of school leavers, by qualification and by ethnicity, New Zealand 2009–2020

In 2020, the proportion of students who left school before obtaining an NCEA qualification was higher in schools which have students from communities with the highest degree of socio-economic disadvantage (low quintile schools) (Figure 140). In the lowest quintile schools 21% of young people left school without achieving an NCEA qualification, compared with 4% in the highest quintile schools (Figure 140).

Of those young people in schools serving communities with greatest degree of socioeconomic disadvantage (quintile 1 schools), 78% achieved Level 1 before leaving school and 65% achieved Level 2 while in schools with the least degree of socioeconomic disadvantage (quintile 5 schools), 96% achieved Level 1 and 91% achieved Level 2 (Figure 140).

Figure 140.   School leavers’ qualifications by deprivation quintile, New ‍Zealand ‍2020

 

 

Appendices

 

Appendix 1: ICD-10-AM codes for potentially avoidable hospitalisations

Medical conditions

 

Respiratory

 

Pneumonia

J12, J15, J16, J18, J69, J851

Asthma and wheeze

J45–J46, R062*

Acute bronchiolitis

J21

Upper respiratory and ENT infections

J00–J04, J06, J050, H65–H67

Lower respiratory tract infection (LRTI)

J22

Bronchiectasis

J47

Dental

 

Dental caries

K02

Diseases of pulp and periapical tissues

K04

Gastrointestinal

 

Constipation

K590

Gastroenteritis/dehydration

A00–A09, R11, K529

Gastro-oesophageal reflux disease

K21

Nutrition deficiency and anaemia

 

Anaemia

D50–D53

Nutritional deficiency

E40–E46, E50–E56, E58–E61, E63, E64

Cardiovascular

 

Acute rheumatic fever

I00–I02

Chronic rheumatic heart diseases

I05–I09

Dermatological

 

Skin infections

L00–L05, L08, H000, H010, J340, L980

Dermatitis and eczema

L20–L30 (for L22, 0-14 only)

Diabetes

 

Diabetes and complications

E10, E11, E13, E14, E162

Renal tract

 

Kidney, urinary tract infection

N10, N12, N136, N300, N309, N390

Sexually transmitted infections (STIs)

 

Sexually transmitted infections (STIs)

A50–A60, A63, A64, M023, N341

Vaccine-preventable diseases

 

Influenza and related pneumonia

J09–J11, J13, J14,

Haemophilus meningitis

G000

Meningococcal infection

A390–A395, A398, A399

Tetanus, Diphtheria, Whooping cough

A33–A35, A36, A370, A371, A378, A379

Poliomyelitis, Varicella

A80, B010–B012, B018, B019

Measles, Rubella, Mumps

B050–B054, B058, B059, B06, P350, M014, B260–B263, B268, B269

Hepatitis A, Hepatitis B

B150, B159, B160–B162, B169

Chronic viral hepatitis

B180–B182

Tuberculosis

A15–A19

Epilepsy

 

Epilepsy

G40, G41, O15, R568

Other non-injury conditions

 

Other non-injury conditions

A403, M86, A87, G01–G03, B34, B171

Injury and poisoning (external cause codes)

Unintentional injuries

V010–V899, V910-V919, V930–V978, V98, V99, Y850, Y859, W00–W19, X00–X19, W65–W74, V900–V909, V920–V929, X40–X49, W20–W49, W53–W598, W610–W619, X20–X278, X29, X50, V00, W50–W52, W60, W64, W75–W79, W80–W84, W85–W99, X28, X30–X39, X51–X57

Intentional injuries

X60–X84, Y870, X85–X99, Y0000–Y0909, Y871, Y3501–Y369, Y890, Y891

Medical hospitalisations acute and arranged admissions (arranged = within 7 days of referral); Injury hospitalisations exclude ED admissions and waiting list admissions; Injury range does not include diagnostic codes of late effects of injuries, poisonings, toxic effects, and other external causes

Appendix 2: New Zealand Index of deprivation

The NZ index of deprivation (NZDep) was first created using information from the 1991 census, and has been updated following each census. It is a small area index of deprivation, and is used as a proxy for socio-economic status. The main concept underpinning small area indices of deprivation is that the socio-economic environment in which a person lives can confer risks or benefits which may be independent of their own social position within a community.78 They are aggregate measures, providing information about the wider socio-economic environment in which a person lives, rather than information about their individual socio-economic status.

The latest index, NZDep2013, combines nine variables from the 2013 census to reflect eight dimensions of material and social deprivation (Table 33). Each variable represents a standardised proportion of people living in an area who lack a defined material or social resource. These are combined to give a score representing the average degree of deprivation experienced by people in that area. Individual area scores are ranked and placed on an ordinal scale from 1 to 10, with decile 1 reflecting the least deprived 10% of small areas and decile 10 reflecting the most deprived 10% of small areas.79

The advantage of the NZDep is its ability to assign measures of socio-economic status to the older population, the people who are not in employment, and to children, to whom income and occupational measures often don’t apply, as well as to provide proxy measures of socio-economic status for large datasets when other demographic information is lacking. Small area indices have limitations, however, as not all individuals in a particular area are accurately represented by their area’s aggregate score. While this may be less of a problem for very affluent or very deprived neighbourhoods, in average areas, aggregate measures may be much less predictive of individual socio-economic status.78 Despite these limitations, the NZDep has been shown to be predictive of mortality and morbidity from a number of diseases in New Zealand.

Table 33. Variables used in the NZ index of deprivation 2013 (NZDep2013)

Dimension

Variable in order of decreasing weight in the index

Communication

People aged <65 with no access to the Internet at home

Income

People aged 18–64 receiving a means tested benefit

Income

People living in equivalised* households with income below an income threshold

Employment

People aged 18–64 who are unemployed

Qualifications

People aged 18–64 without any qualifications

Owned home

People not living in own home

Support

People aged <65 living in a single parent family

Living space

People living in equivalised* households below a bedroom occupancy threshold

Transport

People with no access to a car

* The setting of the household equivalised income threshold was based on two principles:
1) the proportion of the population identified as being socio-economically deprived by the threshold should be broadly consistent with the other variables in the index, and
2) the threshold should be broadly consistent with other measures of income poverty.


 

Appendix 3: Data sources

The Child Poverty Monitor presents information derived from several national administrative datasets. These are described briefly below, and limitations and issues to be aware of when interpreting results drawn from these sources are outlined.

National Mortality Collection

The National Mortality Collection is a dataset managed by the Ministry of Health which contains information on the underlying cause, or causes, of death along with basic demographic data for all deaths registered in New Zealand since 1988. Fetal and infant death data are a subset of the Mortality Collection, and cases in this subset have additional information on factors such as birth weight and gestational age.80 Each of the approximately 28,000 deaths occurring in New Zealand each year is coded manually by Ministry of Health staff. For most deaths the Medical Certificate of Cause of Death provides the information required, although coders also have access to information from other sources such as Coronial Services, Police, NZ Transport Agency, the NZ Cancer Registry, the Institute of Environmental Science and Research, and Water Safety NZ.81

National Minimum Dataset

The National Minimum Dataset (NMDS) is the national hospital discharge dataset and is maintained by the Ministry of Health. It is used for policy formation, performance monitoring, and research purposes, providing key information about the delivery of hospital inpatient and day patient health services both nationally and on a provider basis. It is also used for funding purposes.82

Information in the NMDS includes principal and additional diagnoses, procedures, external causes of injury, length of stay and sub-specialty codes; and demographic information such as age, ethnicity, and usual area of residence. Data have been submitted by public hospitals electronically since the original NMDS was implemented in 1993, with additional data dating back to 1988 also included. The private hospital discharge information for publicly funded events has been collected since 1997. The current NMDS was introduced in 1999.82

Birth Registration Dataset

Since 1995 all NZ hospitals and delivering midwives have been required to notify the Department of Internal Affairs within five working days of the birth of a live or stillborn baby. This applies to stillborn babies born at or more than 20 weeks gestation, or those weighing 400g or more; prior to 1995, only stillborn babies reaching more than 28 weeks of gestation required birth notification. Information on the hospital’s notification form includes maternal age, ethnicity, multiple birth status, and the baby’s sex, birth weight, and gestational age. In addition, parents must jointly complete a birth registration form as soon as reasonable practicable after the birth, and within two years of delivery, which duplicates the above information with the exception of birth weight and gestational age. Once both forms are received by Internal Affairs the information is merged into a single entry. This two-stage process is thought to capture 99.9% of births occurring in New Zealand and cross-checking at the receipting stage allows for the verification of birth detail.83

Dataset limitations

There are limitations when using any of these datasets. The following are of particular relevance to this report. The quality of data submitted to the administrative national datasets may vary. While the data for the National Mortality Collection and the Birth Registration Dataset are coded by single agencies, the clinical information held in the NMDS is entered by health providers before being collated by the Ministry of Health. In a 2001 review of the quality of coding in the data submitted to the NMDS, 2,708 events were audited over ten sites during a three month period. Overall the audit found that 22% of events required a change in coding, although this also included changes at a detailed level. Changes to the principal diagnosis involved 11% of events, to additional diagnoses 23%, and to procedure coding, 11%. There were 1,625 external causes of injury codes, of which 15% were re-coded differently.84 These findings were similar to an audit undertaken a year previously. While the potential for such coding errors must be taken into consideration when interpreting the findings of this report, the average 16% error rate indicated by the 2001 review may be an overestimate as, in the majority of the analyses undertaken in this report, only the principal diagnosis is used to describe the reason for admission.

Changes in the coding systems used over time may result in irregularities in time series analyses.81 New Zealand hospitals use the clinical coding classification developed by the World Health Organization and modified by the National Centre for Classification in Health, Australia. The current classification is called The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), the Australian Classification of Health Interventions (ACHI) and Australian Coding Standards (ACS). The introduction of ICD-10-AM represented the most significant change in classification in over 50 years, expanding the number of codes from ~5,000 to ~8,000, to provide for recently recognised conditions and allow greater specificity about common diseases.

From 1988 until 1999, clinical information in the NMDS was coded using versions of the ICD-9 classification system. From July 1999 onwards, the ICD-10-AM classification system has been used. Back and forward mapping between the two systems is possible using predefined algorithms,82 and for most conditions there is a good correspondence between ICD-9 and ICD-10-AM codes. Care should still be taken when interpreting time series analyses which include data from both time periods as some conditions may not be directly comparable between the two coding systems.

Stats NZ Child poverty statistics

The Stats NZ’s Child Poverty Statistics are produced for the 2017/18 year and previous years using the Household Economic Surveys (HES), administrative (admin) data via the Integrated Data Infrastructure (IDI) and quarterly Household Labour Force Survey (HLFS).85 The NZ HES is a survey of between 3,000 to 5,500 households, randomly sampled, of which around 30% are households with children.85 For more information, please refer to the Child Poverty Statistics Technical Appendix 2017/18.85 The sample size increased from 2018/19 to obtain good measures of child poverty. The methodology also changed to make greater use of administrative data.

Table 34. Number of survey participants and coverage, New Zealand Household Economic Surveys

Survey year (1 July–30 June)

Achieved sample size

Coverage (%)

New Zealand Household Economic Surveys

2011/2012

3,565

83

2012/2013

3,003

67

2013/2014

3,391

814

2014/2015

5,561

78

2015/2016

3,499

78

2016/2017

3,703

83

2017/2018

5,482

76

Source: Child Poverty Statistics Technical Appendix 2017/1885

New Zealand Health Survey

The Ministry of Health’s New Zealand Health Survey (NZHS) became an annual survey in 2011. The survey is conducted by interviewing a sample of adults and children’s parents or caregivers. The NZHS consists of a core set of questions that cover a range of health-specific indicator areas, including health behaviours, conditions, and use of health services. The survey also includes a flexible programme of rotating topic modules, which change every 12 months.86 Table 35 presents the number of participants selected for each NZHS conducted and the corresponding coverage rate (an indicator of the extent to which the population has been involved in the survey).

The NZHS reports present adjusted rate ratios to account for the potential influence of other demographic factors on comparisons between groups. Gender comparisons are adjusted for age, ethnic comparisons are adjusted for age and gender, and deprivation comparisons are adjusted for age, gender and ethnicity.87

Table 35. Number of survey participants and coverage, New Zealand Health Survey

Survey year (1 July–30 June)

Adults (15 years and over)

Children (0–14 year olds)

n

Coverage (%)

n

Coverage rate (%)

New Zealand Health Survey

2006/2007

12,488

59

4,921

67

2011/2012

12,370

54

4,478

68

2012/2013

13,009

59

4,485

69

2013/2014

13,309

54

4,699

63

2014/2015

13,497

59

4,754

69

2015/2016

13,781

67

4,721

76

2016/2017

13,598

63

4,668

73

2017/2018

13,869

61

4,723

74

2018/2019

13,572

62

4,503

72

2018/2019

13,572

62

4,503

72

2019/2020

9,699

62

3,290

72

Source: New Zealand Health Survey Methodology reports 2006/07–2017/18

Estimated prevalence

The NZHS presents the demographic factors for each surveyed condition using unadjusted prevalence rates and adjusted rate ratios. The survey uses the calibrated weighting method to construct survey weights that rate up the responding sample to represent the target population. This method takes into account the probability of selection of each respondent, and uses external population benchmarks (typically based on the most recent population census) to correct for any discrepancies between the sample and population benchmarks (by age, sex, ethnicity and the 2013 New Zealand Index of Deprivation).87

The prevalence of a condition, or the proportion of the population with the condition was estimated by calculating the sum of the weights for the survey respondents with the condition divided by the sum of the weights of all survey respondents. For example, the sum of the weights for survey respondents with self-reported diabetes is divided by sum of the weights for all survey respondents.87

Further information on the NZHS results, content, methodology, and interpretation of the estimates is available on the NZHS pages of Ministry of Health website http://www.health.govt.nz/nz-health-statistics/national-collections-and-surveys/surveys/current-recent-surveys/new-zealand-health-survey

Ethnicity in National Datasets

There were inconsistencies in the manner in which ethnicity information in New Zealand was collected prior to 1996. This report presents ethnic-specific analyses for 1996 onwards and, unless otherwise specified, prioritised ethnic group has been used to ensure that each health event is only counted once.

Despite significant improvements in the quality of ethnicity data in New Zealand’s national health collections since 1996, care must still be taken when interpreting the ethnic-specific rates as the potential still remains for Māori and Pacific children and young people to be undercounted in our national data collections. The data presented in this report may undercount Māori and Pacific children to a variable extent depending on the dataset used; in the case of the hospitalisations for Māori, this undercount may be as high as 5–6%.


 

Appendix 4: Statistical methods

Counts of events

Some of the data presented in this report are counts of events, such as hospitalisations and deaths, and rates which represent the number of these events per head of population in a certain time period. The rates are crude age-specific rates, calculated by dividing the number of events, such as hospitalisations or deaths, in a particular age group by the corresponding “at-risk” population in the same age group and then multiplying the result by a constant (such as 100,000) to derive the rate. Age-specific rates are commonly expressed per 1,000 or per 100,000 population.

Some of the graphs of rates of events in this report include 95% confidence intervals. Confidence intervals are a statistical tool used to indicate the range of variation that occurs in the number of randomly occurring discrete events that occur per unit of measurement (such as per year).88 It is usual to use 95% confidence intervals, which indicate that there is a 95% probability that the number of random events that occur with a particular probability in a given time period will be within the range of the confidence limits.

To compare rates between different demographic groups in New Zealand, some tables and graphs in this report include rate ratios. The rate ratio is the rate for one particular category divided by the rate for a category chosen as the reference category, for example the rate for Māori divided by the rate for European/Other. Rate ratios calculated this way are properly known as crude or unadjusted rate ratios, because their calculation does not take into account differences in population demographic structure between the two categories being compared.

Rate ratios can be interpreted as follows89:

· A value of 1 indicates that there is no difference between the group of interest (for example Māori) and the reference group (for example European/Other).

· A value higher than 1 shows that the rate is higher for the group of interest than for the reference group.

· A value lower than 1 shows that the rate is lower for the group of interest than for the reference group.

Proportions

Some of the data in presented these reports are proportions. It is common practice to use data from a subset of the population (such as survey participants) to estimate the proportion of the whole population who have the characteristic of interest.

Proportions are commonly expressed as percentages, for example:

% of babies fully breastfed at 6 weeks = × 100

For the purposes of estimating 95% confidence intervals, the subset of the population used to estimate the proportion in the total population is regarded as a random sample of people from the total population, who can either have, or not have, the characteristic of interest.

In this situation the 95% confidence interval is the range of values that has a 95% probability of including the value of the proportion for the whole population. It quantifies the uncertainty resulting from random variation in the estimation of the population proportion. The width of the 95% confidence interval depends on the sample size (larger samples yield more precise estimates) and the degree of variability in the phenomenon being measured.

Proportions can be compared between two population groups using the rate ratio: the ratio of the estimated proportion having the characteristic of interest in the comparison group to the estimated proportion having the characteristic of interest in the reference group.

The rate ratios for proportions presented in this report that are derived from the New Zealand Health Survey have been adjusted by the Ministry of Health for differences in demographic factors between the groups being compared that might influence (confound) the comparison.89: The adjustments are as follows89:

· The gender comparison has been adjusted for age.

· The ethnic comparisons have been adjusted for age and gender.

· The deprivation comparison have been adjusted for age, gender and ethnic group.

Adjusting for potential confounding factors makes comparisons more accurate and meaningful because it removes the effect of these confounding factors.89

Appendix 5: Measures of material hardship

DEP-17 is a 17 item deprivation index that includes a range of items considered essential and enjoyed by the majority of New Zealand households. This is working on a spectrum from lower to higher levels of hardship. A score of 6+ is considered to indicate households experiencing material hardship and 9+ indicates households experiencing severe material hardship.21

Table 36. Items used in the New Zealand Household Economic Survey and scoring details for the material deprivation index (DEP-17)

Item description

Enforced lack of essentials (for respondent or household as a whole)

1.    

Meal with meat, fish or chicken (or vegetarian equivalent) at least each 2nd day

2.    

Two pairs of shoes in good repair and suitable for everyday use

3.    

Suitable clothes for important or special occasions

4.    

Presents for family and friends on special occasions

5.    

Home contents insurance

Economised, cut back or delayed purchases ‘a lot’ because money was needed for other essentials (not just to be thrifty or to save for a trip or other non-essential)

6.    

Went without or cut back on fresh fruit and vegetables

7.    

Bought cheaper cuts of meat or bought less than wanted

8.    

Put up with feeling cold to save on heating costs

9.    

Postponed visits to the doctor

10.    

Postponed visits to the dentist

11.    

Did without or cut back on trips to the shops or other local places

12.    

Delayed repairing or replacing broken or damaged appliances

In arrears more than once in last 12 months (because of shortage of cash at the time, not through forgetting)

13.    

Rates, electricity, water

14.    

Vehicle registration, insurance or warrant of fitness

Financial stress and vulnerability

15.    

Borrowed money from family or friends more than once in the last 12 months to cover everyday living costs

16.    

Feel ‘very limited’ by the money available when thinking about purchase of clothes or shoes for self (options were: not at all, a little, quite limited, and very limited)

17.    

Could not pay an unexpected and unavoidable bill of $500 within a month without borrowing

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Disclaimer:

While every endeavour has been made to use accurate data in this report, there are currently variations in the way data are collected by various agencies that may result in errors, omissions, or inaccuracies in the information in this report. The Child Poverty Monitor does not accept liability for any inaccuracies arising from the use of these data in the production of this report, or for any losses arising as a consequence thereof.

ISSN 2357-2078

 

 

2021

Contact us:

New Zealand Child and Youth Epidemiology Service (NZCYES)

University of Otago

Dunedin

www.otago.ac.nz/nzcyes

@NZCYES

 

 

Suggested citation:

Duncanson M, van Asten H, Adams J, McAnally H, Zhang X, Wicken A, and Oben G. (2021) Child Poverty Monitor 2021 Technical Report. Dunedin. NZ Child and Youth Epidemiology Service, University of Otago

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License http://creativecommons.org/licenses/by-nc-nd/4.0/