What is the cost? Estimating the economic costs of Māori: non-Māori child health inequities in Aotearoa: a scoping study

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Inequalities in child health between tamariki Māori and non-Māori are largely preventable and unnecessary. An example is rheumatic fever, where tamariki Māori are 30 times more likely to contract the disease than non-Māori.

Being ill as a child has a big impact on school attendance and outcomes, and it may cause lifelong disability or illness. There are high costs involved, both for the health system and for society.

These include costs to whānau (especially caretakers or parents who may have to take time off work), and loss of education and income opportunities. This study aimed to estimate how much not doing anything to reduce child health inequities really costs us.

This project found that:

  • There are large inequities in child health in Aotearoa. If Māori child deaths during 2003-2007 had occurred at the same rate as non-Māori, there would have been 67 fewer deaths of tamariki per year. Likewise, if rates of “avoidable” hospital admissions (that is, those that could be prevented by primary care treatment) were the same, there would have been 3075 fewer Māori admissions per year.
  • However, if tamariki Māori had had the same rates of ACC claims, outpatient visits, lab and pharmaceutical (medicines) claims and primary care visits as non-Māori children, there would have been many more visits by tamariki than there actually were. It seems that it costs the health sector less to admit acutely sick Māori children, than to prevent severe illness or death through ensuring equitable primary care access or effective population-based health promotion interventions.
  • Very conservatively, our study shows the total estimate of the health sector and societal costs of inequity in childhood illness, injury and death is $199,123,994 per year. The largest contributor to this is the cost due to the avoidable deaths ($223,279,750). The difference between this last figure and the total estimate is mainly health sector “savings”, as our study suggests that less money is spent on tamariki Maori than non-Maori children.
  • Applying traditional economic methods to child health has many problems. Traditional approaches do not explicitly consider issues of equity, and many people find putting a monetary value on a child’s life repugnant. We were also not able, with the data available, to cost the lifelong impacts of inequities in illness in childhood, or other things such as the grief and suffering of whānau. Our scoping study shows there is much more research needed in this area, which requires combining both public health and economic expertise to be successful.
Project commenced:

Research Lead(s) and Team

Te Rarawa

Papaarangi is Tumuaki and Head of Department of Maori Health at the Faculty of Medical and Health Sciences, University of Auckland, New Zealand.  She holds science and medical degrees from the University of Auckland and is a specialist in public health medicine. She has tribal affiliations to Te Rarawa in the Far North of Aotearoa and her research interests include analysing disparities between indigenous and non-indigenous citizens as a means of monitoring government commitment to indigenous rights.