Asthma squeezing the life out of us

By ANGELA GREGORY health reporter

Asthma affects one in every six people in New Zealand and costs this country over $800 million each year.

A generation of young New Zealanders is being struck by the disease in numbers which experts struggle to explain.

Asthma is now the cause of most admissions to hospital for children and the number of sufferers increases 50 per cent every 15 years, yet it remains underrated and underfunded.

Sufferers in this country have to pay more to control the condition than those affected overseas.

Herald inquiries show widespread mismanagement of the chronic illness at virtually every age and social grouping - by sufferers themselves, employers, doctors and Government agencies.

Experts are frustrated at being unable to pinpoint the reason behind asthma's exponential growth - New Zealand is among the world's worst-affected countries - but say underfunding is hampering the prevention of the disease.

Research into its cause is continuing with the introduction of various drugs as well as detailed management plans for sufferers and the people that treat them.

Inhaled steroids in particular have transformed asthma treatment by helping many keep the disease under control.

But experts are mindful that control is not a cure.

Some researchers say many New Zealanders fail to cope with their asthma - often because they have not been taught how to - and some hide their problems from employers for fear of workplace discrimination.

And many employers fail to take the necessary steps to reduce the risks of asthma caused by their working conditions, a problem often not acted on by Occupational Safety and Health.

The clinical director of medicine at Middlemore Hospital, Jeff Garret, said asthma was poorly funded and poorly supported by the medical health care system.

A respiratory physician, Dr Garret said the amount the Government spent on an individual asthmatic, about $1000 a year, was lower than any other Western country.

The patients themselves spent up to $300 a year on treatment, mainly for drugs and doctor visits, and lost about a further $1300 a year in indirect costs such as lost days at work.

"Those New Zealanders are being vastly disadvantaged by their medical condition. It is unfair they have to bear such a large proportion of the costs."

Dr Garret said asthmatics' contributions of 25 to 30 per cent of their direct asthma costs compared unfavourably with the five to 10 per cent of direct costs met by patients in countries such as Australia, England, Canada and the United States.

As a consequence New Zealand admission rates to hospitals for the treatment of asthma were among the highest, he said.

If the condition were to be managed well it needed to be at the primary care level, with only occasional and severe asthma cases dealt with at hospital.

Although steps had been taken to establish asthma clinics in areas such as South Auckland, many outpatients failed to attend because they were scared to let their employer know they had a chronic illness.

Some had simply used up all their sick leave, he said.

Dr Garret remained concerned asthma was not rated among the country's 12 health priority goals, especially given that respiratory disorders were now the top killer in Britain.

A report by the Asthma and Respiratory Foundation in December highlighted the burden of asthma in New Zealand, estimated to cost the economy over $800 million.

The foundation called for the urgent elimination of barriers to adequate primary health care and adequate funding made available to those providers.

The report also found that severe restrictions on the availability of new medication had contributed to the problem.

A greater understanding of what caused asthma was also needed, along with the promotion of proven approaches to its management, the report said.

The foundation's medical director, Professor Ian Town, said the report seemed to get good recognition from the Government.

District health boards were being encouraged to set up incentive schemes for doctors to ensure more successful management of asthmatics, and address the shortage of trained asthma educators, Professor Town said.

A spokesman for Health Minister Annette King said asthma was an issue she was concerned about.

Mrs King has told the Herald asthma came under three health priorities in the New Zealand Health Strategy which was revealed in 2000 - in Maori and Pacific Island health, child health, and the smoking strategy.

She said there was a need to be realistic about spending, noting that more than $50 million was spent on asthma drugs last year, and the major health priorities were presently heart disease, cancers and diabetes.

The ministry said it was working hard with district health boards to build up a primary health care infrastructure with an aim to provide the best possible services for people who suffered from asthma and other chronic conditions.

Diseas runs in the family

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