The chief executive of a Whangārei community house says rheumatic fever will not be eradicated until poor housing, overcrowding and poor access to heath services are addressed.

The comments from Liz Cassidy-Nelson, chief executive of 155 Community House and Tai Tokerau Community Law, come after an audit on rheumatic fever found that despite significant public health campaigns, rates of rheumatic fever in Northland Māori remained high - with rates for Northland Māori aged 5 to 14 one of the highest in the world.

"I'm really concerned that we still have a rheumatic fever problem in Northland. But the ongoing issues of poor housing, overcrowding and access to heath services continue to be a breeding ground for it. We won't eradicate rheumatic fever until we address these key issues," she said.

Rheumatic fever is a preventable disease which starts with strep throat - a throat infection caused by a bacteria called Group A Streptococcus.

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The audit - authored by Whangārei Hospital medical registrar Kate Wauchop; Anil Shetty, public health strategist for Northland DHB's Public and Population Health Unit; and Catherine Bremner, a paediatrician at Whangārei Hospital - looked at acute rheumatic fever cases during the 2012 to 2017 period.

Liz Cassidy-Nelson, chief executive of 155 Community House and Tai Tokerau Community Law, was concerned there was still a rheumatic fever problem in Northland. Photo / Supplied
Liz Cassidy-Nelson, chief executive of 155 Community House and Tai Tokerau Community Law, was concerned there was still a rheumatic fever problem in Northland. Photo / Supplied

Of the 69 cases identified in the audit, which has been published in the New Zealand Medical Journal, 64 (93 per cent) of all cases were Māori; four cases (6 per cent) were Pacific Islander; and only one case (1 per cent) was New Zealand European.

It also showed 50 of those cases (72 per cent) were 5 to 14-year-olds. This age group showed the greatest disparity between rates in Māori - 64.5 cases per 100,000 people - and non-Māori - 1.5 per 100,000.

Ailsa Tuck, Northland DHB community paediatrician, said Northland DHB was committed to redesigning models of health to remove health inequity.

"Northland Māori carry the burden of disease regionally and this is of great concern," she said.

More than half of the cases (38) in the audit lived in areas ranked as the most deprived on the New Zealand Deprivation Index, while 90 per cent lived in areas with high deprivation.

Cassidy-Nelson said there was a "crisis" in Te Tai Tokerau when it came to adequate housing, and many whānau were living in poor conditions.

"Its appalling to see some of the conditions whānau put up with, but this is a better option than no home at all," she said.

Tuck said the DHB, other government sectors and the community had been working together collaboratively for a long time, and continued to advocate for systems that broke down the traditional Government silos.

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She said an example of this was Healthy Homes Te Tai Tokerau which has resulted in more than 10,000 homes being insulated.

Ailsa Tuck, Northland DHB community paediatrician, said Northland Māori carry the burden of rheumatic fever regionally which was of great concern. Photo / John Stone
Ailsa Tuck, Northland DHB community paediatrician, said Northland Māori carry the burden of rheumatic fever regionally which was of great concern. Photo / John Stone

"It is of long-term frustration to the health sector that the determinants of health - the things that make us healthy - are largely influenced by factors that traditionally lay outside the reach of the health dollar."

Opononi mum Nicky Rogers-Pirini, whose daughter Miya was diagnosed with rheumatic fever in 2015, said it was upsetting rheumatic fever was still a huge issue in the region.

"There needs to be continuous monitoring. For example, throat swabbing in schools needs to be ongoing and consistent throughout the whole of Northland. We also need to look at what other ways could this monitoring process be supported? Not all children recognise or feel any pain with a sore throat. My daughter's an example of this happening," she said.

Dr Caroline McElnay, Ministry of Health director of public health, acknowledged more needed to be done to address rheumatic fever.

"We have been working closely with Northland DHB on its rheumatic fever programme.

"We're continuing to support Northland to determine how best to prevent rheumatic fever and provide care for people with rheumatic fever," she said.