Excellent health is now reserved for just a small minority of working age New Zealanders, as physical health falls and psychological distress climbs, according to new research.

Managed Decline is the latest report from the Association of Salaried Medical Specialists which looks at the decline in health of New Zealanders aged 15-and over since 2011/12.

The report analyses health data gathered as part of the New Zealand Health Survey and uses values from Treasury to estimate the increased costs that result.

Since 2011/12 there has been now an additional social cost of between $2.6 and $8.6 billion a year.

The paper shows between 2011/12 and 2023/24:

• a decline in excellent health of adults which dropped from an average of 20 per cent to 11.5 per cent
• an increase in overall fair/poor health from 11 per cent to 14.6 per cent
• unmet need for mental health across all adults has more than doubled in the past five years alone
• psychological distress increased among all adults under 65. The greatest change is among the 15-24 year-old age group, which climbed from 5 per cent to 23 per cent

"These changes compound the increased demand on our health system, over and above the impact from an increasing and aging population," report author Andrea Black says.

"Working age groups saw an almost 50 per cent increase in poor or fair health.

"It is just a matter of time before this spills over into poor health - with implications for health services, the workforce and society as a whole."

The report estimated the additional annual costs from a decline in health:

- $400 million in additional fiscal costs. This is an estimate of an increase in visits to ED and hospital admissions that could have been prevented by earlier primary care.

- $2.6 billion - $8.6 billion per year is the estimate of the social costs from the overall decline in health. 

These costs represent the amount of money an individual would need to receive to be compensated for their decline in health, with the higher number representing the annual losses if the increase in psychological distress continues.

Report author Andrea Black says the research looked to put dollar values on the declining state of New Zealand’s general health.

"The health system is dealing with increased, preventable hospital admissions due to a lack of access to primary care."

Unmet need for a GP due to wait time has more than doubled in the past three years to 25.7 per cent in 2023/24. For women, unmet need due to wait time is now 30 per cent.

"The decline in health will be driven primarily by determinants such as housing, incomes and education rather than necessarily the state of the health system," Black says.

"If trends continue over the next 12 years, the report estimates that only 6.6 per cent of adults will be in excellent health while almost 20 per cent would be in fair/poor health. The impact of this decline doesn’t seem to have been factored into the government’s long-term thinking. We need to address this."

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