High deprivation, overcrowded houses and transient families are behind Northland having the highest rate in the country of children dying from injuries, experts say.
Of the 41 Northland child deaths over five years outlined in a report by Safekids Aotearoa, 35 were from the poorest areas of Northland.
They relate to cases where children 14 years and under have suffocated, drowned, been in a motor vehicle accident or were assaulted. Over half of the deaths were the result of the sudden unexpected death of an infant, known as SUDI.
When the number of deaths were compared to the number of people each district health board covered, Northland topped the list.
The study showed the number of children who died in the Northland District Health Board region between 2006-2010 was equal to DHBs double or triple in size. For example, Canterbury DHB also had 41 deaths despite covering more than triple the number of people.
The data, released by the coroner last year, was included as part of a comprehensive study on children and injuries by Safekids Aotearoa, part of Starship Children's Health. The goal of the organisation was to help reduce the high rates of preventable injuries to children.
Northland DHB spokesperson Jeanette Wedding said health inequalities, transient population, overcrowding, the poorest roading and high deprivation was why the Northland death rate was so high.
"Persons and households experiencing low incomes, low levels of education and under-employment are less likely than others to have access to affordable housing, or to have the ability to secure a good quality of life for themselves and their families, now and in the future," she said.
Ms Wedding said it was inappropriate to compare Northland to other regions because each region has different factors. For example, metropolitan areas vs urban/rural have different risk factors brought about by their environments.
"Given the rate was calculated from 2006-2010 data, a lot has been done since then to address the number of possibly preventable deaths," Ms Wedding said. That included a comprehensive safe sleep programme, paediatric outreach nurses and a first 2000 days initiative aimed at ensuring no child was left behind.
Included in the study was the number of children admitted to hospitals in Northland with injuries - 1689 between 2008 and 2012.
Like elsewhere in the country, the most common injury was from falls.
Safekids Aotearoa Director Ann Weaver said the figures released in the report were alarming.
"All DHBs need to do their part to ensure children enjoy a life free from the adverse effects of unintentional injury and that they grow to their full potential," Ms Weaver said.
The organisation had created tables for each DHB to be used as a quick and easy guide to understanding current child injury trends.
Just behind Northland in terms of rate of death from injury was Hawke's Bay DHB, with 38 deaths, and Lakes Region DHB, with 25.