$6b NZ’s breathing problem

When Kiwis are out of breath, all of us are out of pocket. Chronic and serious respiratory illnesses cost our economy $6.1 billion in 2013, according to new official figures.

Research from the University of Otago, released yesterday, coughed up this figure as the estimated total cost of asthma, bronchiectasis, childhood bronchiolitis, pneumonia and chronic obstructive pulmonary disease (COPD).

The report, commissioned by the Asthma and Respiratory Foundation, found respiratory conditions accounted for one in 10 overnight hospitalisations.

‘‘The extreme poverty is the real kicker,’’ lead author Dr Lucy Telfar-Barnard said.

Poverty was labelled the key culprit for increased hospital visits in children and elderly people living with chronic lung conditions, such as bronchiectasis.

In the most deprived areas, hospitalisations for asthma were nearly four times higher than they were in wealthy areas.

Data came from the New Zealand Health Survey, as well as pharmaceutical prescriptions, hospitalisations and mortality data between 2000 and 2015.

The Counties Manukau, Lakes, and Northland district health boards had the highest total of respiratory hospitalisation rates.

The $6.1b figure jumped from $5.5b in a 2014 report, which was the first time such an equation had been done.

The same figures are not available for cancer – our biggest killer – but Telfar-Barnard expected the economic cost of cancer would be higher, simply because cancer kills more people.

Bronchiectasis increases in children was the most surprising finding for Telfar-Barnard. The condition is caused by scarring on the lungs from recurring severe chest infections.

‘‘Doctors are diagnosing bronchiectasis in children at younger ages. That means that things are getting worse.’’

In February 2016, 2-year-old Ataahua Journey Harris-Timoti, of Wainuiomata in the Hutt Valley, died after a battle with bronchiectasis.

The condition claims the life of one New Zealander aged 14 or under every 18 months.

The total rise in economic cost is mostly because of rising hospitalisation rates and the increase in the value of a life – which in 2015 was $4.06 million per fatality. The value of a life rises every year, so Telfar-Barnard said she expected some rise, but not as much as $500m.

She described the findings as sobering.

‘‘[There’s] that difficult choice of being depressed or enraged.’’

One in six New Zealanders live with a respiratory condition, and these rates are worsening.

Respiratory disease and stroke jostle for third place in mortality stakes for Kiwis, behind cancer and heart disease.

Hospitalisation rates for bronchiectasis increased by 41 per cent between 2000 and 2015, but asthma hospitalisations have been gradually decreasing.

Overall, respiratory deaths have declined slightly in the past 15 years. But both Maori and those living in the most deprived areas are twice as likely as anyone else to die from a respiratory disease.

The combined effect of ethnicity and deprivation meant Maori and Pacific children in the most deprived areas were more than seven times as likely to be hospitalised than children in the wealthiest areas.

In November 2015, the Asthma and Respiratory Foundation launched the New Zealand Respiratory Strategy, a call to action for urgent recommendations to reduce cases and effects of respiratory disease, and remove inequalities.

Telfar-Barnard, who also specialises in housing quality in New Zealand, said she would like to see ‘‘a determined effort’’ over time to tackle respiratory conditions.

This has to start with policy, she said. ‘‘There has to be a strong policy response and introducing those policies needs a determined effort.’’