Respiratory disease in New Zealand:
Asthma in New Zealand:
- Respiratory disease includes asthma, lung cancer, chronic obstructive pulmonary disease (COPD), obstructive sleep apnoea, bronchiectasis, childhood bronchiolitis and childhood pneumonia.
- Respiratory disease is New Zealand’s third most common cause of death.
- Respiratory disease costs New Zealand more than $6 billion every year.
- One in six (over 700,000) New Zealanders live with a respiratory condition, and these rates are worsening.
- Respiratory disease accounts for one in ten of all hospital stays.
- 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.
- 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.
- Across all age groups, hospitalisation rates are much higher for Pacific peoples (3.1 times higher) and Maori (2.4 times higher) than for other ethnic groups (Telfar Barnard et al., 2015).
Bronchiectasis in New Zealand:
- Over 521,000 people take medication for asthma − one in nine adults and one in seven children (Source: New Zealand Health Survey).
- Large numbers of children (3,552 or 410.3 per 100,000 in 2015) 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 3.4 times and Pacific peoples 3.9 times more likely to be hospitalised than Europeans or other New Zealanders, and people living in the most deprived areas are 3.7 times more likely to be hospitalised than those in the least deprived areas.
Childhood bronchiolitis in New Zealand:
- An estimated 7,258 or 158 per 100,000 people are living with bronchiectasis.
- Although bronchiectasis is much less common than other respiratory conditions, hospitalisation rates increased by 36% between 2000 and 2015 to 28.6 per 100,000, and deaths doubled from 42 per year in 2000/01 to 96 in 2013.
- People living in the most deprived areas are 3.4 times more likely to be hospitalised and 2.1 times more likely to die from bronchiectasis than those in the least deprived areas (Telfar Barnard et al., 2015).
Childhood pneumonia in New Zealand:
- Hospitalisaton rates have increased by nearly half, from 3,937 in 2000 to 6,308 (2063 per 100,000) in 2015.
In New Zealand, while the overall death rate has not changed over time and hospitalisations have reduced, there are extreme inequities:
Chronic obstructive pulmonary disease (COPD) in New Zealand:
- Childhood death rates from pneumonia are 5.9 times higher for Māori children and 7.3 times higher for Pacific children than for other New Zealanders (non-Māori, non-Pacific, non-Asian). Of the 136 children who died between 2004 and 2013, 63 were Māori and 41 were Pacific.
- Hospitalisation rates are 2 times higher for Māori children and 3.6 times higher for Pacific children than for other New Zealanders (non-Māori, non-Pacific, non-Asian).
- 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.
- Across DHBs the highest rates are in Counties Manukau, Bay of Plenty, Taranaki, Northland and Waikato (Telfar Barnard et al., 2016).
- 35,310 New Zealanders are estimated to be living with severe COPD requiring stays in hospital (Barnard & Zhang, 2016).
- 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 3.7 times the non-Māori, non-Pacific, non-Asian rate for hospitalisation, and 2.2 times the rate for mortality (Barnard & Zhang, 2016).
- Pacific people’s hospitalisation rates are 2.8 times higher than those of other New Zealanders, and 1.9 times higher for mortality (Barnard & Zhang, 2016).
- COPD hospitalisation rates are 5.7 times higher in the most deprived areas than in the least deprived, and mortality rates are 2.4 times higher (Barnard & Zhang, 2016).
- COPD rates are relatively evenly spread across the country, though mortality in 2013 was above average in West Coast, Tairawhiti, and Lakes DHBs (Barnard & Zhang, 2016).