A recent study conducted by public health researchers at Otago University has found that New Zealand’s high rate of acute rheumatic fever (ARF) among children and teenagers could be caused in part by household crowding.

ARF can cause chronic rheumatic heart disease by damaging heart valves, and claims 120 lives a year. Researchers found that ARF rates among Maori and Pacific populations were 20 and 40 times that of New Zealand Europeans and others, respectively. When analysed in conjunction with consensus data, the rates were explained by living conditions.

“We found a clear and positive association between household crowding as a risk factor for ARF incidence, and this effect persisted after controlling for age, ethnicity, household income an density of children in the neighbourhood”, said lead researcher Richard Jaine.

The areas with the most crowded households—those with not enough bedrooms to cater for occupants—were associated with a 90% higher rate of ARF than those with least crowded households.

The findings highlight the fact that while in other developed countries ARF is virtually non-existent, New Zealand continues to have persistently high and growing rates among its Maori and Pacific families.

“Research has already shown that we should be able to reduce ARF by as much as 60% through well-resourced, school-based strep throat treatment programmes. This would avoid costly medical treatment”. The findings also emphasise the importance