New Zealand’s ongoing housing crisis is fuelling high rates of rheumatic fever among Māori and Pacific peoples, says epidemiologist Dr Jason Gurney.
Gurney has intensively studied the disease’s causes and has woven his family history with his research in The Twisted Chain, a new book out Wednesday. His father contracted the disease at age 14, leading to severe health complications later in life.
Speaking to Q+A, the researcher, director of the Cancer and Chronic Conditions Research Group at Otago University, highlighted the long-term impacts of the disease.
“By far, the biggest killer of rheumatic fever is rheumatic heart disease, which happens later in life. There’s this kind of a silent phase in the middle after rheumatic fever as a kid, a sort of silent, clinically silent phase, and then it really kicks in later in life.”
Infection rates dropped during the Covid-19 pandemic but there are signs they are heading back up. (Source: 1News)
Indigenous and Pacific populations in New Zealand and Australia have some of the highest rates of rheumatic heart disease in the world.
In 2015, there were an estimated 233,000 deaths around the world from the disease.
Gurney explained his personal connection to the issue, involving his father, who developed a strep infection at age 14 while in Auckland for a rugby tournament.
“He was in bed for months. He basically couldn’t leave the house, and had quite severe carditis — swelling of his heart, inflammation of his heart. Then later in life, we had that clinically silent phase. He ran marathons. He played rugby for Horahora up in Whangārei.
The family say there have been a raft of failures by health officials. (Source: 1News)
“He had us kids. But then later on in life, the consequences of that early childhood disease really raised its ugly head, and so the story really started.
“There were a couple of reasons why I wrote the book, one of them was just to be able to relive this experience of my dad’s experience, but also our whānau experience.
“I spent more days than I could care to remember next to his sort of bed suffering from the consequences of this early childhood disease,” he said, speaking to Q+A.
NZ’s housing crisis at heart of issue
Gurney explained key factors in rheumatic fever stemmed from long-standing problems with housing and poverty, which disproportionately affects Māori and Pacific peoples.
“It is absolutely a disease of the social determinants of health,” he told Q+A.
“We can focus on the upstream determinants first, which is essentially the lion’s share of what’s driving rheumatic fever in New Zealand.
Two new studies are highlighting the impact of rheumatic fever, a disease which kills over 230,000 people globally every year. (Source: 1News)
“Our housing stock is old, cold, and full of mould… It’s a catchy term which I think everyone needs to understand — our housing stock is not fit for purpose. It never was.
“Building regulations have got better over time, but the new housing stock that’s being built, that’s warm, safe, healthy is not going to Māori and Pacific peoples living in poverty, right? It’s going to the high-end rental market, and it’s going into private hands.
“We have this enormous stock of old, cold, full of mould housing, which is leading to not only rheumatic fever, or group-A strep infection, but lots of other diseases that are caused by poverty and poor housing.”
Political ‘bravery’ needed for long-term solutions
The Otago University academic said the outcomes of fixing the issue wouldn’t be seen for a decade, making it a “tough sell” for many politicians looking for quick wins.
Professor Michael Baker says new research reinforces the link between household overcrowding and the disease. (Source: Breakfast)
“The problem with the three-year, three-ish-year election cycle in New Zealand is it’s very hard to convince governments to basically plant trees they might not see the shade of.
“Trying to convince people to pump in hundreds of millions of dollars into the Healthy Homes Initiative that might only start reducing rates of rheumatic fever in five, 10, 15 years, it’s a pretty tough sell.
“Collectively, we need a bit of bravery in terms of being OK with setting these long-term goals and then communicating why we’re setting these long-term goals,” he said.
For the full interview, watch the video above
Q+A with Jack Tame is made with the support of New Zealand On Air
