She said often at-risk children can have disrupted experiences in care and be moved to multiple homes.
"It's a significant reminder that we are not getting it right for these young people, and we need to be doing better."
The deaths in care were a testament to how hard it is to change systems, she said.
The Ministry for Children underwent a huge overhaul in 2017, and changed its name from Child Youth and Family "CYFs" to Oranga Tamariki.
Before that, in 2016, the Herald reported 77 children had died in state care in the prior 15 years.
"You would have expected improvement, a lot was promised," Atwool said.
Atwool said the 2017 reforms didn't result in big improvements for children in care so what we're seeing now is "more of the same".
"You would hope to see a reduction in suicides, you'd hope to see a reduction of deaths by abuse in care, and you'd hope to see an elimination of that quite frankly."
She believed that there isn't enough investment in looking after children who do go into state care.
Deputy chief executive for children and families Glynis Sandland said the death of any child or young person is a tragic and distressing event, particularly for their family and others involved in their life.
The number of children in care varied each year, with 5708 in 2017, 6365 in 2018, 6429 in 2019 and 5945 in 2020.
From 2019 these numbers exclude "warrants", who are only in care for a short time.
"Oranga Tamariki strives to ensure that no child or young person is harmed or is injured while in care. Sadly, the majority of the 27 deaths are a result of natural causes."
Sandland said the two deaths from child abuse, homicide or manslaughter remain the subject of active coronial enquiries, so she's unable to discuss them.
The agency said it also had a suicide prevention programme, which gave advice to social workers who work with tamariki and rangatahi and who are having thoughts about suicide or have tried to kill themselves.
If a young person dies in care, Sandland said Oranga Tamariki establishes a key contact person within the family and works alongside them to identify what supports would be helpful to them.
"Each situation is different, support might range from regular phone calls and financial assistance with travel or funeral costs or groceries to practical help like linking them up with other support agencies."
Sandland said they return the child or young person's personal belongings, such as letters, photographs and mementoes, back to their caregiver sensitively and respectfully.
Grieving birth parents, Talia Parkinson and Dion Batt told the Herald this year the heartbreak of losing their son while he was in state care was "unbearable".
Back then the pair said they were still waiting for answers 10 months after his death.
Their child, Deajay Parkinson-Batt died in Palmerston North Hospital mid-last year when life support was switched off after he was rushed to ICU in critical condition.
But after an exhaustive investigation involving a team of highly trained detectives and pathology experts, police said they were stumped by the 2-year-old's mysterious death and have no idea how he died.
And though a doctor told family Deajay had suffered a severe brain injury, the police investigation had been scaled back because of a lack of evidence and at the time no one had been charged.
Oranga Tamariki said the agency does not determine the cause of death, as the coroner decides this and police were responsible for making referrals after receiving a report of death.
Where to get help:
• Lifeline: 0800 543 354 (available 24/7)
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youthline: 0800 376 633 or text 234 (available 24/7)
• Kidsline: 0800 543 754 (available 24/7)
• Whatsup: 0800 942 8787 (12pm to 11pm)
• Depression helpline: 0800 111 757 or text 4202 (available 24/7)
• Anxiety helpline: 0800 269 4389 (0800 ANXIETY) (available 24/7)
• Rainbow Youth: (09) 376 4155
If it is an emergency and you feel like you or someone else is at risk, call 111.
