Respiratory disease in New Zealand

Impact Report Web Banner 2018

Click here for a PDF of the full infographic: Respiratory Disease in New Zealand.

The impact of respiratory disease in New Zealand: 2018 update, was created to provide a useful baseline of respiratory statistics in New Zealand. We are working on extending these to present a more complete picture of New Zealand’s respiratory health. Click here to download the full report.

The core set of indicators in the table below was used to measure the prevalence (population rates) and incidence (number of hospital events and deaths) of respiratory disease in general, as well as for individual conditions (asthma, bronchiectasis, childhood bronchiolitis, pneumonia and COPD).  Other data sources were also used to estimate the prevalence and costs of asthma. 

It is important to note that estimating the extent of respiratory disease is not straight forward.  There are issues with reporting, data coding, correct diagnosis, as well as unknown numbers of people who are living with an undiagnosed respiratory condition.  For these reasons the estimates below should be treated as conservative.

IndicatorData sourcesLatest analysis
Medicated asthmaNew Zealand Health SurveyOver 610,000 people take medication for asthma
Respiratory deaths per yearNZHIS Mortality Data2,922 deaths (64 per 100,000 people) in 2015
Respiratory hospitalisations per yearNational Minimum Dataset (NMDS) hospitalisations (publically funded hospital discharges)86,457 admissions in 2017 (1,803 per 100,000)          
Total cost of respiratory disease per year: including private costs (doctors’ visits, prescriptions) and public costs (years of life lost, hospitalisations)National Pharmaceutical Collection; NMDS – mortality, hospitalisations; NZ Health Survey; NZ Census; Pharmac$7.05 billion
Respiratory health inequalitiesNMDS and hospitalisations by ethnic group and deprivation (using the New Zealand Deprivation Index)Hospitalisation: 2.5 times higher for Pacific peoples and 2 times higher for Māori; 2.3 times higher for most deprived households than least deprived

 
Presented below is a commentary on the key statistics relating to the conditions presented in The impact of respiratory disease in New Zealand: 2018 update. 

Respiratory disease in New Zealand:

  • Respiratory disease includes asthma, bronchiectasis, childhood bronchiolitis, childhood pneumonia and chronic obstructive pulmonary disease (COPD). 
  • Respiratory disease is New Zealand’s third most common cause of death.
  • Respiratory disease costs New Zealand more than $7 billion every year (Barnard & Zhang, 2018). 
  • Respiratory disease accounts for one in ten of all hospital stays (Barnard & Zhang, 2018). 
  • More than half of the people admitted to hospital with a poverty-related condition are there because of a respiratory problem such as asthma, bronchiolitis, acute infection or pneumonia (Barnard & Zhang, 2018). 
  • People living in the most deprived households are admitted to hospital for respiratory illness over three times more often than people from the wealthiest areas (Barnard & Zhang, 2018). 
  • Across all age groups, hospitalisation rates are much higher for Pacific peoples (2.5 times higher) and Māori (2.4 times higher) than for other ethnic groups (Barnard & Zhang, 2018). 


     
    Asthma in New Zealand:

    • Over 597,000 people take medication for asthma − one in eight adults and one in seven children (Source: New Zealand Health Survey).
    • Large numbers of children (3,050 or 326.6 per 100,000 in 2017) are still being admitted to hospital with asthma, and some of these will have had a potentially life-threatening attack (Barnard & Zhang, 2018). 
    • By far the highest number of people being admitted to hospital with asthma are Māori, Pacific peoples and people living in the most deprived areas: Māori are almost 3 times and Pacific peoples 3.2 times more likely to be hospitalised than Europeans or other New Zealanders, and people living in the most deprived areas are almost 3 times more likely to be hospitalised than those in the least deprived areas (Barnard & Zhang, 2018). 
    • The cost of asthma to the nation is over $1 billion per year (Barnard & Zhang, 2018). 

     
    Bronchiectasis in New Zealand: 

    • An estimated 8,366 or 175 per 100,000 people are living with severe bronchiectasis (Barnard & Zhang, 2018). 
    • Although bronchiectasis is much less common than other respiratory conditions, hospitalisation rates increased by 45% between 2000 and 2017 to 31.1 per 100,000, and deaths doubled from 42 per year in 2000/01 to 116 in 2015 (Barnard & Zhang, 2018). 
    • There is a much higher risk of hospitalisation or death for people of Māori and Pacific ethnicity: Pacific people are 6.2 times, and Māori 3.8 times more likely to be hospitalised than other New Zealanders (non-Māori, non-Pacific and non-Asian), and these differences are similar for mortality (Barnard & Zhang, 2018). 
    • People living in the most deprived areas are 3.2 times more likely to be hospitalised and 1.8 times more likely to die from bronchiectasis than those in the least deprived areas (Barnard & Zhang, 2018). 


    Childhood bronchiolitis in New Zealand:

    • Hospitalisation rates have increased by nearly half, from 3,984 in 2000 to 6,320 (2,065 per 100,000) in 2017 (Barnard & Zhang, 2018). 
    • These rates are 3 times higher for Māori children and 3.5 times higher for Pacific children than for other New Zealanders (Barnard & Zhang, 2018). 


    Childhood pneumonia in New Zealand:


    In New Zealand, while the overall death rate has not changed over time and hospitalisations have reduced, there are extreme inequities:

    • Childhood death rates from pneumonia are 4 times higher for Māori children and 5.6 times higher for Pacific children than for other New Zealanders (non-Māori, non-Pacific, non-Asian). Of the 122 children who died between 2006 and 2015, 53 were Māori and 38 were Pacific (Barnard & Zhang, 2018). 
    • Hospitalisation rates are 1.5 times higher for Māori children and 2.4 times higher for Pacific children than for other New Zealanders (non-Māori, non-Pacific, non-Asian) (Barnard & Zhang, 2018). 
    • Childhood pneumonia hospitalisation rates are highest in the most deprived areas of New Zealand: 3 times higher in the most deprived areas than in the least deprived areas. Over half of all deaths occur in the most deprived areas (Barnard & Zhang, 2018). 


    Chronic obstructive pulmonary disease (COPD) in New Zealand:

    • 11,842 New Zealanders aged 45 and over were hospitalised due to COPD in 2017 (Barnard & Zhang, 2018). 
    • COPD is often undiagnosed, and for this reason at least 200,000 (or 15%) of the adult population may be affected (Broad & Jackson, 2003).
    • Between 2000 and 2015 there were no changes in COPD hospitalisation rates, but there was a decline in reported mortality due to COPD (Barnard & Zhang, 2018). 
    • A large proportion of COPD deaths are not recorded as such because of misreporting or a co-morbidity (e.g. heart failure or pneumonia) being the final cause of death.
    • Even with under-reporting, COPD is still the fourth leading cause of death after ischaemic heart disease, stroke and lung cancer (Broad & Jackson, 2003).
    • Hospitalisation rates are highest for Māori, at 3.5 times the non-Māori, non-Pacific, non-Asian rate for hospitalisation, and 2.2 times the rate for mortality (Barnard & Zhang, 2018). 
    • Pacific people’s hospitalisation rates are 2.7 times higher than those of other New Zealanders (Barnard & Zhang, 2018). 
    • COPD hospitalisation rates are 5.7 times higher in the most deprived areas than in the least deprived, and mortality rates are 2.2 times higher (Barnard & Zhang, 2018). 
    • COPD rates are relatively evenly spread across the country, though mortality in 2015 was above average in Canterbury, Southern and Waitemata DHBs (Barnard & Zhang, 2018). 

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