The incidence of acute rheumatic fever was found to be high in disadvantaged North Island communities, with high concentrations of Māori or Pacific families, in an analysis of New Zealand national hospital admissions between 1993 and 2009. Incidence rates for all children aged 5-14 years were 17.2 per 100,000 (95% CI 16.1 to 18.3). When stratified for ethnicity, incidence rates were 40.2 per 100,000 (95% CI 36.8 to 43.8) for Māori, 81.2 per 100,000 (95% CI 73.4 to 89.6) for Pacific, and 2.1 per 100,000 (95% CI 1.6 to 2.6) for non-Māori/Pacific. Between 1993 and 2009, incidence rates increased by 79% in Māori and 73% in Pacific youth, while rates in other ethnicities decreased by 71%. During 2000-2009, Māori and Pacific children comprised 30% of children aged 5-14 years, but accounted for 95% of new cases of acute rheumatic fever. Most cases (<90%) were in the highest five deciles of socioeconomic deprivation and 70% were in the most deprived quintile. Similarly, most cases (94%) occurred in one of ten DHBs, which together comprised 76% of children aged 5-14 years in New Zealand. The risk of a child living in the most deprived decile being admitted to the hospital for acute rheumatic fever by 15 years of age was one in 150.
