University of Otago-led research has uncovered strong evidence that household overcrowding is a major risk factor for acute rheumatic fever and streptococcal infections of the skin.
The rates of rheumatic fever in this country are about 20 times higher for Māori, and 44 times higher for Pacific peoples than for non-māori and non-pacific peoples.
Researcher and Otago associate professor Dr Jason Gurney (Ngāpuhi, Ngāti Hine) says the research began almost a decade ago.
“We started it back in 2014. It was a study of around 120 to 130 children who had rheumatic fever. All of them were either Māori or Pasifika. We linked those across, roughly, three times that many 'controlled', in other words, people who didn’t get rheumatic fever.”
The data includes what those with rheumatic fever versus other groups had been exposed to and the differences between the groups.
Better-quality housing needed
Gurney says the disease is one of poverty.
“We only, roughly, have 100-200 cases of rheumatic fever a yea, but it’s one of those diseases that is strongly linked to poverty. It shows us the importance of the social issues of health. Our study puts numbers next to that.
“We’ve known for a long time that household crowding is an indicator that has been a strong implication of rheumatic fever for a very long time," he says.
Gurney believes it’s not about what people need to do to stop the transmission of the disease but that the system needs to change.
“That’s about improving access to better-quality housing, to situations where we don’t need to have a whole whanau gathering in one room around the heater because there’s only one warm room in the house.
“I don’t necessarily want to talk about the things Māori and Pasifika have to do to reduce their own risk of rheumatic fever. The onus is on the system to do something about this.”