Rheumatic fever, heart disease and mental distress are rising among tamariki in Aotearoa, with Māori and Pasifika disproportionately affected, a new Cure Kids report finds.
“It’s pretty pōuri,” says Associate Professor Anneka Anderson.
“Aotearoa is one of the last high-income countries in the world with significant rheumatic fever.”
According to the Cure Kids’ 2026 State of Child Health in Aotearoa New Zealand report, hospitalisations for rheumatic fever and rheumatic heart disease have returned to pre-COVID-19 levels, with nearly 200 first-time cases recorded in 2024–25.
Pacific children are 43 times, and Māori children 16 times, more likely to be hospitalised, with more than 85% of cases considered preventable if inequities were addressed.
“With coordinated prevention strategies and sustained investment in research, this disease is entirely preventable,” Anderson adds.
“Rheumatic fever is a completely preventable disease.”
‘Ko te tāmitanga te pūtake’
Anderson says housing plays a major role in the spread of disease and reflects deeper inequities.
“I think those inequities really stem back from colonisation, and the impact that we’ve had of that throughout different sectors in Aotearoa.”
She says many homes are not designed for Māori and Pasifika whānau.
“They’re damp, they’re often north-facing, and they’re built for mum, dad and two or three kids. We look at whānau Māori or whānau Pacific, we have different values,” Anderson explains.
“I think it’s these kinds of values that aren’t taken into account with housing design in Aotearoa, and that promotes crowding, that spreads infectious diseases.”
He kino tonu te ngau o te mate hinengaro
The report also highlights mental distress - a growing concern for tamariki and rangatahi across the motu.
More than one in five young people reporting serious psychological distress - four times the rate 13 years ago. Hospitalisations among rangatahi increased from 1 per 1,000 in 2000 to 9 per 1,000 in 2019.
“Twenty percent of our tamariki have distress, and this is significant distress,” says Terryann Clark, Cure Kids Professorial Chair in Child and Adolescent Mental Health.
She says the world is a tough place for tamariki right now, who are exposed to global issues like war and politics and feel their impacts on themselves, their whānau and communities.
“I think there’s also the additional impacts of being Māori in a society which is not supportive of being Māori,” Clark says.
“Our young people can see that this is their future, and actually, it doesn’t look so bright.”
The report highlights three main areas: respiratory illness, rheumatic fever and heart disease, and mental health. It also includes neurodevelopmental conditions like ADHD and autism for the first time, as diagnoses increase.
“The report calls on improved and timely access to supports and treatment without unnecessary delays or barriers, particularly for tamariki Māori and Pacific children,” says Dr Helen Templeton.
Autism diagnoses have increased over time, especially for Māori (from about 1% to 4.5%) and Pacific children (from about 1.3% to 4.2%).
Respiratory illness is still a big issue, with hospitalisations up 60% since 2000. It now makes up one in five child hospital stays, with the highest rates among Pacific children, Māori and those in the most deprived areas.
Me kōkiri tonu i ngā rautaki Māori
Anderson and Clark stress the need for Māori-led solutions alongside government action.
“Housing, employment, health care [are] really based on these Western colonial values. How do we have an equitable system in Aotearoa? Honouring Te Tiriti o Waitangi would be a really good start.”
Clark adds, “There are really big responsibilities here by the government to actually do better for our tamariki Māori, and recognising that the one size fits all strategy doesn’t work for Māori.
“We need bespoke created models that work for us, that work for our whānau, that are strength-based, that really uplift the mana of whānau rather than making them feel stink about the situations that there are in.”
