The state of asthma in South Australia Key Findings More than one in ten (10.5%) South Australians have asthma, representing 173,000 people 1. In some regions of South Australia, the prevalence is as high as 15.3%. 2 7,400 South Australians are hospitalised each year because of asthma, representing a rate of 244 per 100,000 population, the highest in Australia. 3 35.8% of South Australians with asthma have an Asthma Action Plan. 4 This means almost two thirds do not have an Asthma Action Plan in place. 13.4% of South Australian children have asthma, 5 which is higher than the national prevalence of 10.9%. 1 South Australian children are most likely to be hospitalised because of asthma (760 per 100,000) than any other state or territory. 5 This is also far greater than the national average of 500 per 100,000. 5 49 South Australians die because of asthma each year. 6 About Asthma Asthma is one of Australia s most widespread chronic health conditions. Asthma is a disease which results in narrowing, thickening and tightening of the airways in response to environmental triggers. These processes create breathlessness in the person with the condition. Any degree of asthma symptoms can lead to an asthma flare-up and any asthma flare-up can lead to a life-threatening episode. People with asthma usually need to take a daily preventer-class medication to avoid symptoms and always need a reliever-class medication on them in case symptoms occur. The cause of asthma is not clearly understood but predisposing factors include genetic and familial tendency and exposure to environmental trigger factors. 7 Social factors including socioeconomic status and maternal health also contribute. 7 Asthma management is crucial to ensuring people with the condition remain healthy and well. However, asthma management in Australia is poor, with studies demonstrating: Many people with asthma don t receive treatment in accordance with their clinical condition; 7 Of those that are prescribed a preventer medicine, approximately 90% don t use it as prescribed 8 ; and Of those that use preventer medicine, approximately 90% don t use their device correctly. 9 1. ABS 2016, National Health Survey 2014-15 2. Asthma in South Australia, 2015. University of Adelaide for Government of South Australia 3. Asthma in Australia 2011. Australian Centre for Asthma Monitoring 4. Australian Government 2018, Report on Government Services 5. Asthma in South Australian Children, 2015. University of Adelaide for Government of South Australia 6. ABS, 2017. Causes of death report 7. National Asthma Strategy, 2018. National Asthma Council and Asthma Australia 8. Respiratory medication use in Australia 2003 2013: treatment of asthma and COPD. AIHW, 2015 9. Basheti IA et al, 2008. Evaluation of a novel educational strategy, including inhaler-based reminder labels, to improve asthma inhaler technique. Patient Educ Couns The state of asthma in South Australia Page 1
About this data brief The purpose of this data brief is to provide an overview of the state of asthma in South Australia. A range of indicators are available to understand the significance of asthma in South Australia. These have been outlined below using the latest available data for each indicator. The available indicators of asthma in South Australia and source of the information are included below: Asthma prevalence The data relating to prevalence of asthma in South Australia has been attained from the 2014-15 National Health Survey by the Australian Bureau of Statistics (ABS). The ABS provides information on prevalence of asthma nationally, and by state and territory. Asthma hospitalisations The data relating to asthma hospitalisations in South Australia has been attained from the 2011 Asthma in Australia report by the Australian Centre for Asthma Monitoring. The Australian Centre for Asthma Monitoring report brings together data from a wide range of sources to describe the current status of asthma in Australia. Asthma Action Plans The data relating to South Australian s use of Asthma Action Plans has been attained from the 2018 Report on Government Services (ROGS). ROGS includes information on the uptake of Asthma Action Plans by state and territory, providing the data as a proportion of people with asthma with the most recent data being for 2014/15. Asthma in children The data relating to hospitalisations of children in South Australia due to asthma was attained from the 2015 Asthma in South Australian Children report by the University of Adelaide for the Government of South Australia. This report defines children as people 0-14 years of age. Asthma deaths The data relating to asthma mortality in South Australia has been attained from the 2016 Causes of Death Report by the Australian Bureau of Statistics. ABS provides information on asthma mortality nationally, and by state and territory. The Findings Asthma prevalence in South Australia According to the National Health Survey 2014-15, approximately 173,100 South Australians had asthma, representing approximately 10.5% of the population. 1 The prevalence in South Australia is consistent with national prevalence rates. For example the national rate of asthma is 10.8%. 1 The table below provides an overview of asthma prevalence by state and territory. 1 State/Territory Asthma prevalence (no.) Asthma prevalence (%) ACT 43,500 11.5 NSW 769,500 10.4 QLD 486,100 10.6 SA 173,100 10.5 NT 14,300 8.2 WA 235,300 9.6 VIC 688,000 11.9 TAS 63,300 12.6 AUST 2.5 million 10.8 The state of asthma in South Australia Page 2
Asthma prevalence is higher in inner regional, outer regional and remote areas than in major cities. In South Australia the proportion of people aged 18 and over with asthma is higher in Northern Adelaide and Country South Adelaide, compared to Southern and Central Networks. 2 The table below shows the proportion of people aged 18 and over with asthma in South Australia Local Health Networks. 2 Local Health Network Asthma prevalence (%) Central Adelaide 11 Southern Adelaide 13.1 Northern Adelaide 15.3 Country Health SA 14.3 Asthma hospitalisations in South Australia People with asthma are hospitalised when their asthma symptoms are life threatening and unable to be controlled by emergency treatment. Life threatening symptoms include gasping for breath, inability to speak one to two words per breath, and not being responsive to reliever medication. In 2011-2012, the hospitalisation rate for asthma in South Australia was 244 people per 100,000. 3 This is greater than the national rate of hospitalisations for asthma which is 172 people per 100,000. 3 The chart below provides an overview of asthma hospitalisations by state and territory 3. Each hospitalisation from asthma costs approximately $3,750 and 70% of hospitalisations are considered preventable. South Australians with Asthma Action Plans An Asthma Action Plan is a critical tool developed between the person with asthma and their doctor which defines the escalation plan in case of asthma symptoms. Vast evidence has demonstrated that the Asthma Action Plan has the potential to: Reduce the rate of visits to the emergency department and hospital Reduce the number of schools days missed due to asthma Reduce night waking due to asthma symptoms The state of asthma in South Australia Page 3
Improve symptoms and asthma-related quality of life. 10 The Australian Asthma Handbook, Australia s world-renowned guideline for the management of asthma, recommends every person with asthma should have their own written Asthma Action Plan. 10 Management of asthma is key to prevent children, young people and adults from being hospitalised or dying from the condition. Only 35.8% of people with asthma and 68% of children have and Asthma Action Plan in South Australia. 4 These figures have steadily grown since 2001 when 19.7% of South Australians with asthma and 30.5% of children had an Asthma Action Plan. 4 However, this still means almost two thirds of South Australians with asthma do not have an Asthma Action Plan, which puts them at greater risk of flare ups and life threatening complications. The table below provides an overview Asthma Action Plan ownership for all South Australians and children between 2001 and 2014/15. 4 South Australia 2001 (%) 2004/05 (%) 2007/08 (%) 2011/12 (%) 2014/15 (%) Children (aged 0-14 years) 30.5 39.2 56.1 58.3 68 Adults (aged 25-44) Data not available Data not available 8.1 19.0 17.8 All ages 19.7 22.6 21.9 29.3 35.8 Asthma rates among children in South Australia Asthma is the most burdensome disease for children in Australia. This means asthma has a greater overall negative impact on children s lives than other disease or injury. The prevalence rate for asthma in South Australian children (13.4%)5 is higher than the national prevalence (10.9%). 1 South Australia also has the highest hospitalisation rate for children aged 0-14 years (760 per 100,000 population), which is far greater than any other state or territory and above the national average of 500 per 100,000. 5 The table below provides an overview of asthma hospitalisations for children in South Australia. 5 Asthma is the fourth most common reason children present to emergency departments. 3 Asthma deaths in South Australia Death from asthma is painful and tragic, where the person s increased effort to breathe is overwhelmed by the narrowing of the lungs. This results in respiratory arrest which is where the narrowing airways impede the ability for adequate exchange of oxygen and carbon dioxide and the patient s oxygen levels drop drastically until the level is not able to sustain life. Asthma caused 49 deaths in South Australia in 2016. 6 10 Australian Asthma Handbook, 2014. National Asthma Council. 11 Australian Burden of Disease Study, 2011. AIHW. The state of asthma in South Australia Page 4
The table below provides an overview of asthma deaths by state and territory between 2010 and 2016. 6 State/Territory 2010 (no.) 2011 (no.) 2013 (no.) 2013 (no.) 2014 (no.) 2015 (no.) 2016 (no.) ACT 7 5 4 7 8 7 5 NSW 145 121 129 124 144 147 160 QLD 67 72 74 85 63 72 78 SA 44 26 35 34 54 41 49 NT 2 1 4 2 4 2 3 WA 40 29 28 38 47 35 29 VIC 104 108 112 92 99 110 119 TAS 17 11 12 10 15 12 19 AUST 417 377 393 390 422 421 455 About Asthma Australia Asthma Australia supports the one in nine Australians with asthma to breathe better. For over 50 years Asthma Australia and the Asthma Foundations have been leaders in asthma health care, education, research and advocacy. Asthma Australia delivers evidence-based preventative health strategies through our information provision, phone line and asthma referral and coaching service. The organisation also provides education and training to promote best practice asthma care and first aid training to schools, childcare centres, workplaces and sporting and recreational settings to ensure asthma emergencies are addressed swiftly and appropriately. Asthma Australia supports research that contributes to national and international understandings of asthma and how best to manage the disease. The organisation engages in advocacy on the issues that are important to people with asthma, to ensure policies are in place to support people with asthma achieve optimal health. Through this work, we reach more than 500,000 Australians each year. To find out more about our work, visit www.asthmaaustralia.org. au For more information about this brief, please contact: Michele Goldman, CEO, mgoldman@asthmaaustralia.org.au The state of asthma in South Australia Page 5