Children's environmental health indicators

Household crowding

• Nearly one in five (18.2%) children lived in crowded households in 2023.
• Household crowding rates for children were much higher among Pacific peoples (42.3%), followed by Māori children at 28.4%.
• Nearly 1 in 3 children in Tairāwhiti (30.8%) and Counties Manukau (29.8%) lived in crowded conditions.

Damp dwellings

• Slightly over one in four children (26.0%) lived in dwellings that were always or sometimes damp in 2023.
• Pacific children and Māori children had notably high rates of living in damp dwellings, at 41.8% and 38.4%, respectively.
• Tairāwhiti had the highest rate of children in damp homes (45.4%), followed by Northland (38.5%).

Mouldy dwellings

• Over one in five children (21.1%) lived in dwellings where mould larger than an A4 sheet was always or sometimes present in 2023.
• Māori and Pacific children had notably high rates of exposure to mould, at 37.6% and 31.1%, respectively.
• More than one in three children in Tairāwhiti district (36.2%) and Northland district (32.3%) lived in homes where mould larger than an A4 sheet was always or sometimes present.

• Around 13,000 children aged 0–14 years and 157,000 adults were exposed to second-hand smoke in the home in 2024/25.
• Exposure to second-hand smoke for children has decreased considerably from 5.2% in 2012/13 to 1.3% in 2024/25.
• Children living in the most deprived neighbourhoods (NZDep2018 quintile 5) were more likely to be exposed to second-hand smoke in the home than those in the least deprived areas.

• Maternal smoking rates at two weeks postnatal have decreased from 13.7% in 2009 to 7.3% in 2021.
• The gap in smoking rates between Māori mothers and other ethnic groups continues to decrease. Smoking rates among Māori mothers have declined from 32.2% in 2009 to 19.5% in 2021.
• Maternal smoking rates have dropped by more than 30% across most health districts between 2009 and 2021, particularly in Tairāwhiti.

• In 2024/25, around 94,000 children aged 2–14 years were diagnosed with asthma and were currently taking asthma medication.
• There were 8706 hospitalisations in children aged 0–14 years in 2024, up from 7537 in 2023.
• Children under five years old continued to have lower asthma prevalence rates but higher hospitalisation rates compared to other age groups. In 2024, 1-year-olds had the highest asthma hospitalisation rates (3783.1 per 100,000) within the 0–4 year age bracket.
• In 2024/25, Māori children aged 2–14 years had a higher prevalence of asthma compared to nonMāori children. In addition, since 2005, Pacific children aged 0–14 years have consistently experienced the highest asthma hospitalisation rates than other children.
• Asthma hospitalisation rates were higher for children living in the most deprived areas (NZDep23 quintile 5) than for children living in the least deprived areas.
• Children living in major urban areas had higher hospitalisation rates than children living in rural areas in 2024.
• The Auckland district had the highest asthma hospitalisation rates in 2023 and 2024.

• The number of LRTI hospitalisations among 0–4 year olds increased from 10159 in 2023 to 10825 in 2024.
• The pattern of LRTI hospitalisations being highest during winter remained, but some summer months remain higher than pre-pandemic.
• Infants (under one year old) continue to have the highest LRTI hospitalisation rates.
• Pacific children had more than three times the rate of LRTI hospitalisations as European/Other children in 2024.

• 51 babies died from SUDI in 2021, up from 40 deaths the previous year. There has been no improvement in SUDI rates since 2012.
• In 2017–21, Māori babies had five times, and Pacific babies four times, the rate of SUDI as European/Other babies.
• Babies of younger mothers (younger than 25 years) had higher SUDI rates than babies born to mothers in older age groups.
• Babies living in the most socioeconomically deprived areas (NZdep 2013 quintile 5) had a SUDI rate eight times higher than those in the least deprived areas (quintile 1).

• The number of meningococcal notifications declined from 21 (2.2 per 100,000) in 2023 to 18 (1.8 per 100,000) in 2024, primarily due to a decrease in notifications among the under-5 age group.
• Meningococcal B continues to be the most dominant strain in children aged 0–14 years.
• Infants (under 1-year-old) have had the highest rate of meningococcal disease since 2001. In 2022–24, the rate of meningococcal disease among infants (21.0 per 100,000) was 35 times higher than for children aged 10–14 years (0.6 per 100,000).
• Māori and Pacific children had four to six times the rate of meningococcal disease than European/Other children.
• Children living in the most deprived areas (NZDep 2018 quintile 5) had more than three times the rate of meningococcal disease (6.0 per 100,000) as children living in the least deprived areas (1.5 per 100,000) (quintile 1).

Non-occupational lead absorption notifications

• Lead absorption notification rates for children aged 0–14 years have decreased from 2.4 per 100,00 in 2024 to 1.8 per 100,000 in 2025.

• Hazardous substance notification rates for young children, 0–4 years, peaked in 2018–19 (5.9 per 100,000) and have roughly halved in 2021–22 (3.5 per 100,000).
• Roughly two-thirds of exposures involving children aged 0–14 years occurred in the home from 2018–22.
• The most common substances were household cleaning products, other harmful gases, pesticides/insecticides and air fresheners/fragrances/deodorants.

• Children aged 0–4 years continue to experience three times the hazardous substances-related hospitalisation rate of the next most affected age group from 2001–2022.
• Cleaning products are the most common hazardous substances causing hospitalisation in the 0–4 year age group (62/180 notifications).

Active transport to and from school

• In 2024/25, 38.6% of children aged 5–14 years used active transport to travel to or from school.
• The percentage of children using active transport to school has been below 40% for each of the past 3 years.
•  In general, older children (aged 10–14 years) were more likely to participate in active transport than younger children (5–9 years).

• In 2024/25, an estimated 16,000 children aged 0–14 years (1.6% of all children in that age group) experienced an unmet need for GP services in the past 12 months due to a lack of transport.
• The level of inequality was particularly stark for Māori children, who were more than two times more likely than non-Māori children to have experienced an unmet need for GP services due to a lack of transport.

• In 2016, 12 children aged 0-14 years died from traffic injury, the majority as vehicle occupants (8 deaths).
• The mortality rate for traffic injuries for children remained mostly unchanged between 2010 and 2016.
• In 2019, there were 269 hospitalisations for traffic injuries for children, most of which were for vehicle occupant injuries (56.5%) or pedestrian injuries (25.3%). 
• The overall traffic injury hospitalisation rate for children aged 0-14 years has been stable from 2012 onwards.
• Māori children had traffic injury mortality rates which were three times higher than those of children of other ethnicities and represented 52% of all traffic-related deaths between 2007–16.

Notifications of potentially waterborne diseases

• Children aged under four years experienced much higher notification rates for all waterborne diseases in 2024.

• In 2023, 58.3% of the 34,279 five-year-olds seen by community oral health services had no history of dental caries. These children had 2.0 decayed, missing, or filled teeth on average.
• In 2023, 67.9% of the 49,330 children in school-year eight seen by community oral health services had no history of dental caries. These children had 0.7 decayed missing or filled teeth on average.
• Māori and Pacific children had poorer oral health compared to other ethnicities.
• Children in Te Tai Tokerau, Lakes, MidCentral and Counties Manukau districts tended to have worse oral health than those in other districts.

Vulnerability to climate change

• Young children aged 0 to 4 years have fewer sweat glands, making them more sensitive to heat on very hot days.  
• Young children require additional support to cope with unexpected weather events.