About one in six New Zealanders live with a respiratory illness, and the rate is rising, with latest estimates showing the cost to the country has hit more than $6 billion a year.

The Impact of Respiratory Disease in New Zealand: 2016 Update, commissioned by the Asthma and Respiratory Foundation, found that respiratory disease accounted for one in 10 overnight hospitalisations and highlighted the high degree of socio-economic and ethnic inequality as "by far the most relentless and disturbing pattern".

The report found respiratory hospitalisations had been increasing by 16.4 admissions a year since 2000 but at a sharper rate since 2008.

It also estimated the economic burden to the country was at least $6.16b in 2013. Of that $5.68b were indirect costs from mortality and disability and the remaining $482.1m were direct costs from hospitalisations, prescriptions and doctors' visits. Asthma was calculated separately with a total cost of $858.2m.

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Report author Dr Lucy Telfar-Barnard said the respiratory health of Pacific Islanders was consistently poorest compared to other ethnic groups, followed by Maori.

The reasons for the worsening rates of respiratory illnesses and hospitalisations seemed to be poverty and the lack of access to quality housing, she told the Herald.

Crowding, damp housing and obesity were all factors in respiratory illnesses.

"People in lower socio-economic groups have less access to primary health care and they are more likely to be living in crowded conditions. It's harder for them to heat their homes. It's harder for them to follow a healthy and nutritious diet because of less access to fresh fruit and vegetables."

Telfar-Barnard said improved access to housing and less crowding would be a huge first step in reducing the numbers.

Reducing poverty and inequality, improving access to health care and increasing health literacy would also improve the situation, she said.

Asthma and Respiratory Foundation NZ chairman John Knight said it was "appalling" that, as a first world country, New Zealand was struggling with respiratory health.

He agreed making sure all New Zealanders had access to affordable, warm, dry and uncrowded houses was key.

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"There needs to be a collective effort across all sectors, including government, DHBs, health professionals, sector groups, businesses, local authorities and the voluntary and community sectors."

Ironman not held back by asthma

An Auckland triathlete and Ironman competitor does not let asthma slow him down.

Alistair Harsant, 44, was born with chronic asthma and he spent many of his younger years in hospital or dosed up on strong drugs.

It wasn't until his teens that he managed to get it largely under control through a mixture of preventative medicines and learning to identify and manage the triggers.

Exercise and diet helped to manage the condition although some triggers such as the change of season and cats remained more difficult to control, he said.

Harsant said it wasn't until he took a break from competing in triathlons that he realised how beneficial the exercise was for his asthma.

"My asthma started to come back. I wasn't far off my teenage years where I would have needed hospitalisation," he said.

He was now back into it and started competing in Ironman events as well.

"It doesn't have to control your life," Harsant said. "It's about understanding what your asthma is.

"Exercise is very, very good. It's one of the keys of helping to control asthma. It's helping to strengthen the lungs."

By the numbers:
- 1712 respiratory hospitalisations per 100,000 people in 2015
- 521,000 people take medicine for asthma
- 7258 people are living with bronchiectasis
- 136 children died from pneumonia between 2004 and 2013
- 35,310 New Zealanders live with severe chronic obstructive pulmonary disease