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ASTHMA. What is it?. A long-term medical condition in which airways are too sensitive and over-reactive Characterised by “attacks”, which have symptoms such as wheezing, breathlessness, chest tightness, coughing Symptoms are caused by 3 main problems inside airways: muscle constriction
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ASTHMA What is it? • A long-term medical condition in which airways are too sensitive and over-reactive • Characterised by “attacks”, which have symptoms such as wheezing, breathlessness, chest tightness, coughing • Symptoms are caused by 3 main problems inside airways: • muscle constriction • inflammation • excessive mucus • Attacks are normally reversible, and are controlled by good self-management, including appropriate medication use
How common is asthma? • Over 2 million Australians have current asthma • 11-13% of children • 9-11% of adults in Australia, 11% in NSW • Prevalence rates are high by international standards • Ranked 6th overall in commonly reported long term condition (Australia’s Health 2010)
Trends • Prevalence increased in the 1980’s to mid-90’s. In recent years the increasing trend appears to have plateaued in adults and may have even reversed in children (Australia’s Health 2010). • The latest statistics show that 9.9% of the Australian population have asthma. This has decreased from 10.4% in 2004/05 and 11.6% in 2001 • Self reported asthma has decreased over the past 15 years and plateaued since 2004/05 • Hospitalisation rates almost halved in the 15 years from 1989 to 2004 and have now plateaued. • A reduction in hospitalisations may mean better asthma management outside hospitals
Trends in hospitalisations for asthma, by age group, 1993–94 to 2007–08 Source: Australia’s Health 2010
Age groups trends • Most commonly reported long-term condition in 0-14 yr olds • Third most commonly reported condition ages 15 - 24 years • 25 years and greater, other conditions such as hay fever and allergic rhinitis become more common. • < 35 years prevalence has decreased between 2001 – 2005 • > 35 years, no change in same period
Gender trends • Australia: Males 20%, females 21% • NSW adults: 9.9% males, 11.8% females • In males, prevalence is much higher in childhood (16.5%)
Asthma Mortality Rates • 449 people died from asthma in 2008 (ABS 2010, Cause of Death data) • This represents an increase in mortality of just over 16 per cent, compared with 2007 data (385 deaths) • In 2008, 76% of asthma deaths occurred in adults aged 60 years and over • Overall the mortality rate is higher in females • During the last decade the overall numbers of asthma deaths have decreased by around 35 per cent.
Source: ABS 2010 Cause of death data. Table published on National Asthma Council website. Accessed October 2010
Source: ABS 2010 Cause of death data. Table published on National Asthma Council website. Accessed October 2010
Aboriginal and Torres Strait Islander • One in seven Indigenous Australians (16.5%) have current asthma (2001, 2004-05) • 1.6 times more likely to report asthma as a long term health condition than non indigenous people (age adjusted) • Asthma is reported almost twice as often in non-remote areas (17%) as in remote areas (9%) • Asthma is most prevalent for Indigenous Australians aged 45 years and over (19%) • For the younger age groups (0-24) the prevalence of asthma ranges from 12% to16% • Mortality due to asthma is higher among Indigenous Australians
Prevalence of current asthma, by age, sex and Indigenous status, 2004–05 Source: ACAM – Asthma in Australia 2008
Socioeconomically disadvantaged • Asthma prevalence is higher among people with a lower socioeconomic status • Studies have shown that in children that severe asthma is associated with lower socioeconomic status and poverty • The gap in prevalence between the most advantaged and most disadvantaged is widening • Among females in 2004–05, the prevalence of asthma increased with increasing socioeconomic disadvantage • For males there was a significant trend of increasing asthma prevalence with increasing socioeconomic disadvantage but less marked than for women • There is significant relationship between increasing levels of socioeconomic disadvantage and higher risk of death from asthma, particularly among those aged 35–64 years and 65 years and over (ACAM 2008)
Older people • High death rates • Difficulties in awareness and accurate diagnosis • High levels of hospitalisation in winter months • Co-morbidities play a role - 4.5 times more likely to also report emphysema or chronic bronchitis (prevalence 10%) than people without asthma (prevalence 2.2%) (ACAM, 2008).
Asthma is reported at a slightly lower rate for older persons (9%) compared to a rate of 11% for persons aged 15-64 years (ABS 2004-05)
CALD/NESB Prevalence of current asthma by age & country of birth, 2004/05
Rural and Remote Australians • The prevalence of current asthma was slightly higher overall in inner regional and outer regional locations at approximately 11% (NHS, 2008) • Among people aged 5 to 34 years, those living in Inner regional areas had a significantly higher prevalence of asthma (15.1%) (NHS, 2004/05) • Further, among people living in Inner regional areas and Major cities, the prevalence of asthma was significantly higher in people aged 5 to 34 years than in younger or older people
