In Aotearoa, the amount of acute rheumatic fever (ARF) and Rheumatic Heart disease (RHD) seen in Māori and Pacific young peoples is very high. ARF is not often seen in Pākehā (New Zealanders of European descent) and it has been this way since around the 1950s. Risk factors for ARF include living in a house that isn’t well designed for the number of people living there (household crowding) and not being able to access primary health care. These risk factors aren’t spread out fairly in Aotearoa, and neither is ARF and RHD.

The number of ARF cases dropped a lot in 2021 and 2022. This overlaps with the time of significant COVID-19 public health and social measures like border closures, lockdowns and social distancing. It isn’t clearly understood why numbers dropped but they have increased since 2023 back to the high levels seen before the COVID-19 pandemic.

Whāia te Māramatanga is a Kaupapa Māori research project that has explored the impacts of the COVID-19 public health and social measures on the amount of ARF and RHD seen in Māori and Pacific peoples during 2020-2022. We have looked at the number of people admitted to hospital during 2000-2022 and the number of deaths from RHD during 2000-2018 so we can understand how this has changed over time.

We looked at first hospital admissions with ARF for people aged less than 35 years and first hospital admissions for RHD for people aged less than 75 years. We also looked at deaths from RHD for people aged less than 75 years.

There were different approaches to the COVID-19 response in Aotearoa including the elimination, suppression and mitigation strategies. We looked at the times that these strategies were in place, and also when there were either national or regional lockdowns.