Asthma: Analysing an unknown global epidemic
According to Asthma UK, every day in the UK three people die from asthma, yet because of its commonplace occurrence, the potentially lethal nature of this disease often goes unnoticed. Affecting over 300,000,000 people worldwide, or the equivalent population of the United States, asthma not only affects individuals and families but also world’s GDP.
In this article, we examine how asthma affects those living in different countries, in different socioeconomic groupings and the steps that can be taken to begin to tackle this condition.
Asthma is one of the most chronic diseases in the world today. Globally asthma rates are rising on an average by 50% every decade. In 20 years from now, it is projected that another 100 million people will be diagnosed with asthma.
Despite such reports and overwhelming evidence, world leaders and policy makers don’t take asthma seriously. Asthma cases will skyrocket if no urgent action is taken, says the World Health Organisation.
Whilst millions around the world are able to live with and control their asthma through medication and proper adherence to medical advice, many do need to heed the dangers of their condition. Every day 685 people worldwide die from an asthma attack.
With so many people at risk, the lethal potential of asthma should be more familiar; yet, it is a neglected disease in terms of media attention.
Consider this: globally the economic cost of asthma exceeds those of tuberculosis and HIV/AIDS combined. It’s eating into health budgets globally in an environment of already dwindling cash reserves.
But how does asthma impact budgets and health care capacity?
Asthma is an expensive disease. Which explains why eight out of 10 asthma related deaths are from lower income countries. While Uzbekistan’s death rate is 27 per 1,000,000 asthmatics, in Australia it’s 4. To expect those in lower socioeconomic brackets to use expensive inhalers whilst they scramble for one meal a day is unrealistic at best.
Secondly, it’s a long-term disease with patients never being “cured”. Adherence to medical advice is essential in managing and living with asthma, yet 90% of deaths, according to Asthma UK, could be avoided if patients were to adhere to medical advice.
Illness also means that often people with asthma are not able to work fully and earn the money necessary to deal with the illness. To illustrate this point in India, average cost of a preventive inhaler $8 and that of a high-end one is $16, while daily earning for the vast majority of Indians is little over $2 a day.
Unlike TB, asthma is not a poor man’s disease. Rates of asthma are climbing in the world’s wealthiest country, resulting in a global affliction that does not earn the media attention it deserves.
Asthma and the United States
In the United States 25 million people or 8% of the population are asthmatic. And they are an increasing strain on healthcare providers: every year 1.9 million people visit an emergency department suffering from an attack and everyday nine people in the US die from asthma.
Sadly, the most vulnerable segment of the population are children. About 10.5 million school days are missed every year due to asthma.
Combined, this impacts the US economy. Asthma leads to 14.2 million missed workdays annually, costing the American economy up to US$56 billion a year.
The prevalence of asthma in Canada
A look north into neighbouring Canada points to a similar story. A shocking 3.2 million or over 8% Canadians are asthmatic – making it one of the highest incidences of asthma in the world and things are only getting worse. In 20 years, at predicted rates of diagnosis, the Canadian health system will be struggling with another 700,000 asthmatics. That’s a rise of 22%.
Every year 146,000 Canadian citizens are seen in emergency rooms, with 20 children and 500 adults dying every year. Canada spent CDN$2.2 billion in 2010 to fight asthma, and by 2030, that figure will nearly double to CDN$4.19 billion.
With a population of 62.2 million, just under 9% of Britons are asthmatic. Every day three people die in the UK from an asthma attack and a child is admitted every 17 minutes to the hospital, many in the emergency room. These numbers, says Asthma UK, the country’s leading NGO on the issue, are only going to increase in the future.
“Awareness of the severity of asthma presents a huge challenge for Asthma UK. We represent a condition suffered by 5.4 million people in the UK and from which three people a day die but public perception of the illness and its potential severity, is misguided. For instance, few people realise that the NHS spends over £1billion every year treating and caring for people with asthma. It doesn’t have to be this way. With 90% of asthma deaths being avoidable, we believe that lives can be saved and illness can be prevented,” says Kirsty Ramage, Head of Direct Marketing, Asthma UK.
Whilst the impact is significant in developed countries, the situation in the developing world is even more pressing.
Despite growth in many areas of the Indian economy, India’s air quality is deteriorating at the expense of Indian people’s health. Already one of the most polluted countries in the world, a quick visit to the capital emphasises the point.
A growing middle class has resulted in 4 million vehicles running on Delhi’s roads, with an unbelievable 1,317 new cars added every day.
This new air pollution combined with existing poor air quality has resulted in 13 million people, aged 15 and over, diagnosed as asthmatic, according to a report from India’s Ministry of Health. This number of sufferers is likely under-reported.
The results of a cross-continental study presented at the American Thoracic Society, concludes that ‘Indians have the poorest lung function among the 17 populations (reviewed) across four continents.
With spotty health care standards and limited access to hospitals and trained medical staff, many Indians are faced with personal struggles while the country as a whole sees a major crisis unfolding.
Clearing the air
Asthma is deadly. It’s incurable. Yet asthma in not invincible.
There is much debate around the causes of asthma and most often the triggers are unknown. What is known is that air pollution, more than any other factor; increases the symptoms of asthma.
Environmental changes are slow, with many international players required to affect the complex issues surrounding environmental decline.
With the growing demand for power, many coal plants, especially in countries like India, are inefficient and highly polluting. Individual behaviour change, combined with higher-level policy change must work hand in hand if we are to begin to alleviate the symptoms of the world’s 300 million asthma sufferers.
In the United States, for example, progress is slow but consistent. President Obama has taken a stern look at the coal industry and has shelved several proposed plants. Alternative energy investment is starting to creep upwards and more emphasis is being put on technology and renewable solutions as well as reducing demand by consumers.
European cities, such as Copenhagen and London, are setting the example by encouraging people to walk, bike and use public transport. Congestion charges in London reduce car and large truck traffic, whilst bike rental schemes in Paris, Montreal and Berlin contribute to more people cycling and less air pollution generated from driving.
Organisations like the Global Initiative for Asthma’s (GINA) recommend simple yet powerful steps to reduce the symptoms suffered by asthmatics. Factors like indoor air quality, education, access to treatment and monitoring of triggers are other areas that need attention. Anti-tobacco policy, now active in many countries, is a great starting point to reduce second hand smoke that can often trigger an attack.
While the air hopefully clears up, governments need to make people aware. And non-profits can play a crucial role, working with the government.
Asthma UK, a client of Junxion, is doing just that. It runs a helpline to advise patients and their families. They also support ground-breaking research, campaigns for change and brings asthma patients together to form a stronger community. The success of efforts like these are crucial.
Asthma is a progressive and debilitating disease, impacting society at many levels. Focused leadership on environmental and air quality issues will be hard to achieve unless people demand policy changes and embrace personal behaviour change. Learn more about the work of Asthma UK.
Junxion’s Erin Barrett leads the London office and specialises in fundraising and development, and engagement strategy for NGOs.