Respiratory disease in New Zealand

Respiratory Disease 4 Main Stats

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

Te Hā Ora: National Respiratory Strategy outlined the latest overall statistics on respiratory disease in New Zealand.  

Our primary source was The impact of respiratory disease in New Zealand: 2014 update. Measures used in the impact report provide a useful baseline.  We are working on extending these to present a more complete picture of New Zealand’s respiratory health, and will provide updated statistics on an annual basis.

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 asthmaNational pharmaceutical collectionOver 460,000 people take medication for asthma
Respiratory deaths per yearNew Zealand mortality collection2,700 deaths (56.7 per 100,000 people) in 2011
Respiratory hospitalisations per yearNational Minimum Dataset (NMDS) hospitalisations (publically funded hospital discharges)69,000 in 2013 (1,563.1 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$5.5 billion
Respiratory health inequalitiesNMDS and hospitalisations by ethnic group and deprivation (using the New Zealand Deprivation Index)Hospitalisation: 2.6 times higher for Pacific peoples and 2.1 times higher for Māori; 3 times higher for most deprived households than least deprived

 
Presented below is a commentary on the key statistics relating to seven conditions presented in Te Hā Ora: National Respiratory Strategy

Asthma

In New Zealand:

  • over 460,000 people take medication for asthma − one in nine adults and one in seven children
  • large numbers of children (3,730 or 430.9 per 100,000 in 2013) are still being admitted to hospital with asthma, and some of these will have had a potentially life-threatening attack
  • 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 2.9 times and Pacific peoples 3.7 times more likely to be hospitalised than Europeans or other New Zealanders, and people living in the most deprived areas are 3.2 times more likely to be hospitalised than those in the least deprived areas
  • the cost of asthma to the nation is over $800 million per year (Telfar Barnard et al., 2015).

Bronchiectasis

In New Zealand:

  • an estimated 4,226 or 99.6 per 100,000 people are living with bronchiectasis
  • although bronchiectasis is much less common than other respiratory conditions, hospitalisation rates increased by 30% between 2000 and 2013 to 26.4 per 100,000, and deaths doubled from 42 per year in 2000/01 to 84 in 2011
  • there is a much higher risk of hospitalisation or death for people of Māori, Pacific or Asian ethnicity: Pacific people are 6.4 times, Māori 3.7 times and Asians 2.3 times more likely to be hospitalised than other New Zealanders (non-Māori, non-Pacific and non-Asian), and these differences are similar for mortality
  • people living in the most deprived areas are 3.2 times more likely to be hospitalised and 2.7 times more likely to die from bronchiectasis than those in the least deprived areas (Telfar Barnard et al., 2015).

Childhood bronchiolitis

In New Zealand:

  • hospitalisations have increased by nearly a third, from 3,937 in 2000 to 5,351 (1832.3 per 100,000) in 2013
  • these rates are 3.4 times higher for Māori children and 4.3 times higher for Pacific children than for other New Zealanders (Telfar Barnard et al., 2015).

Childhood pneumonia

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 5.42 times higher for Māori children and 6.19 times higher for Pacific children than for other New Zealanders (non-Māori, non-Pacific, non-Asian). Of the 110 children who died between 2002 and 2011, 59 were Māori and 35 were Pacific.
  • Hospitalisation rates are 1.6 times higher for Māori children and 3.1 times higher for Pacific children than for other New Zealanders (non-Māori, non-Pacific, non-Asian).
  • Childhood pneumonia rates are highest in the most deprived areas of New Zealand: 2.5 times higher in the most deprived areas than in the least deprived areas. Over half of all deaths occur in the most deprived areas.
  • Across DHBs the highest rates are in Hutt Valley, Auckland, Counties Manukau and Northland (Telfar Barnard et al., 2015).

Chronic obstructive pulmonary disease (COPD)

In New Zealand:

  • 28,515 New Zealanders are estimated to be living with severe COPD requiring stays in hospital (Telfar Barnard et al., 2015)
  • 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 2013 there were no changes in COPD hospitalisation rates, but there was a decline in reported mortality due to COPD (Telfar Barnard et al., 2015)
  • 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
  • Pacific people’s hospitalisation rates are 2.8 times higher than those of other New Zealanders, though mortality is not significantly different
  • COPD hospitalisation rates are 5.1 times higher in the most deprived areas than in the least deprived, and mortality rates are 2.7 times higher
  • COPD rates are relatively evenly spread across the country, though mortality in 2011 was above average in Hawkes’ Bay, Lakes and Wairarapa DHBs (Telfar Barnard et al., 2015).

Lung cancer

In New Zealand:

  • lung cancer is one of the most common cancers diagnosed, with around 1,800−1,900 new cases per year, accounting for 9.1% of cancer registrations in 2010 (Ministry of Health, 2013)
  • lung cancer is the most common cause of death from cancer in men and women, causing a fifth of all cancer deaths and 1,600−1,700 deaths per year (Ministry of Health, 2013)
  • for Māori, lung cancer causes almost 300 deaths each year, over three times more than the next most common cancer (Ministry of Health, 2013)
  • age-specific death rates for Māori men are around two to three times higher than for non-Māori, and for Māori women are around five times higher (Broad & Jackson, 2003; Ministry of Health, 2013; Shaw, Blakely, Sarfati, Fawcett, & Hill, 2005)
  • Pacific men are both more likely to develop lung cancer and to die from it than the general population, while Pacific women are not more likely to develop it but those older than 65 who have it are more likely to die from it (Northern Cancer Network, 2012)
  • between 2000 and 2010, registration and mortality rates for lung cancer reduced by around 20−25% among males but changed little, or slightly increased, among women (Ministry of Health, 2013).

Obstructive sleep apnoea

In New Zealand:

  • OSA is estimated to affect 3−5% of children and is one of the most common respiratory disorders of childhood (Paediatric Society of New Zealand, 2014)
  • a minimum of 4% of adult males and 2% of adult females experience OSA, though most cases are undiagnosed (Mihaere et al., 2009)
  • OSA rates are higher among Māori and Pacific people: OSA is twice as common in Māori males compared to non-Māori males, Māori and Pacific people tend to have more severe OSA and more co-morbidities, and there are ethnic disparities in the ongoing use of CPAP (Mihaere et al., 2009; Best Practice Advocacy Centre New Zealand, 2012; Bakker, O’Keeffe, Neill, & Campbell, 2011)
  • OSA is considered a contributor to overall health loss and also a risk factor for other life-limiting conditions (coronary heart disease, ischaemic stroke, type 2 diabetes) (Ministry of Health, 2013a; Gander et al., 2010)
  • despite this, there is a lack of up-to-date published data on OSA prevalence in New Zealand (Telfar Barnard et al., 2015).

References:

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