School principals in Tauranga's most socially deprived suburbs are fighting back against statistics that show Kiwi kids living in the poorest areas were three times more likely to die than those from affluent neighbourhoods.
Greerton Village School principal Anne Mackintosh was shocked to learn that the rate of deaths of children and adolescents in New Zealand's most deprived areas was almost 60 per 100,000 head of population - 41 deaths more than the least deprived areas.
''This is appalling for a First World country. It points to poverty and poor housing.''
Her school served a suburb that ranked 9th out of 10 in New Zealand's social deprivation index. ''We have our eyes open all the time for kids at risk.''
The Child and Youth Morality Review Committee's report found that Maori and Pacific children and young people were more likely to die than children from other ethnic backgrounds.
''Every principal dreads one of their children dying,'' she said.
Looking back on her 16 years as principal of Greerton Village School, Mackintosh said she could not think of any pupil who had died.
However they had a high incidence of hospital stays, particularly in winter from bronchial conditions that could be aggravated by damp and mould at home, or the spread of contagious illnesses in crowded communal living.
A success story had been the introduction of free fruit and milk. ''I have noticed a big difference. We don't get as many runny noses.''
And while she welcomed government legislation that forced landlords to improve the warmth of houses, the downside was that some landlords were opting to sell - putting more pressure on fewer rentals.
Salvation Army's Tauranga social service manager Davina Plummer said rising rents were hitting people hard. ''It's hitting the young, it's hitting the old.''
Plummer said staff had more than doubled in four years to cope with the rising demand for services. Budget support for families had increased by 55 per cent in 2017, with16 new emergency houses in Tauranga for homeless families.
Gate Pa School principal Richard Inder, whose students came from the top two deprivation areas, said everybody knew that children struggled if they came from damp and overcrowded homes, lacking facilities most took for granted.
''Some parents are struggling, and we try our level best to support these families in hard times. Wellbeing is our focus in the school and the community. Get that right and everything else kicks in behind.''
Inder said there had been no deaths among pupils since he was appointed 18 years ago. A new programme targeting rheumatic fever saw public health nurses using throat swabs on kids who had sore throats.
Jan Tinetti, the principal of Merivale School until she entered Parliament last year, was ''forever grateful'' that no child had died during her 11 years at the school. Merivale had the highest level of social deprivation.
She recalled how a number had been hospitalised - the worst being a child airlifted to Starship hospital with septicaemia or blood poisoning. Tinetti said the child lay in a coma for about four months.
And with another student falling very sick with rheumatic fever and the Merivale community losing three preschoolers, Tinetti said the mortality statistics did not surprise her.
''We see a lot more grief and hardship than higher decile schools ... a lot of kids live in houses with pretty terrible conditions.''
She said the link between poverty and children's health was borne out by the fact that a public health nurse visited the school every week.
The regional community health manager for kids, Martin Steinmann, said public health nurses did a lot of really good community interaction to help families with health issues that came out of poverty.
More time and money was put into areas that needed it the most, with nurses visiting low decile schools at least once a week. Higher decile schools were on an on-call basis and visited once a term.
Tommy Kapai Wilson of Te Tuinga Whanau Support Services Trust said Tauranga was blessed with a community that cared more than other lower socio-economic areas of New Zealand.
''Sometimes Tauranga does not appreciate the community conscience that we have got and are trying so hard to build - we should celebrate that and not be swamped by those horrific statistics.''
Wilson said he did not know of any children who had died from poverty-related illnesses but knew a lot who had got healthier by being put into warmer homes and wrap-around social services.
''A happy puku is a healthy kid.''
The trust had 11 homes and a dozen motel rooms and was getting two more houses this week.
Age-group deaths 2012-16 in coastal Bay of Plenty's District Health Board and the rate per head of population compared with the country's 19 other DHBs.
1 month to 1 year old: 21 deaths/1.5 deaths per 1000 live births/12th out of 20.
1 year to 4 years: 14 deaths/23 deaths per 100,000 population/8th.
5 years to 9 years: 9 deaths/12 per 100,000/8th equal.
10 to 14 years: 15 deaths/ 19.5 per 100,000/3rd equal.
15 to 19 years: 51 deaths/73 per 100,000/5th.
20 to 24 years: 46 deaths/79.5 per 100,000/7th.