The nation’s lung health divide

Analysis from Asthma + Lung UK reveals a stark north/south divide in the likelihood of someone with a lung condition being hospitalised or dying. The leading lung health charity’s CEO, Sarah Woolnough, urges UK governments to end the lung health lottery by investing in earlier diagnosis, improved care and respiratory research.

The health of our lungs is tied to many factors that vary wildly from region to region – how dirty our air is, and the quality of our housing and of local stop smoking services, to name a few.

This lottery on lung health has been laid bare by new analysis from Asthma + Lung UK, which ranked local authority areas across the UK by emergency admissions and death rates for lung conditions including asthma and chronic obstructive pulmonary disease (COPD) and respiratory infections like flu and pneumonia.

Just a cursory look at the charity’s findings reveals that the rate of respiratory deaths and emergency hospital admissions in the north of England disproportionality outnumber those in the south. The ten places in England with the highest respiratory death rates and emergency hospital admission rates are all in the north of the country, including Knowsley, Salford, Blackburn with Darwen, Liverpool and Blackpool. If you widen out the data to look at the whole of the UK, regions in the North of England still dominate the top ten (with areas in Scotland and Northern Ireland rounding off the list). Many of these areas have high levels of deprivation.

In stark contrast, the ten places with the lowest death and admission rates tend to be clustered in the south of England. These include Bracknell Forest, Barnet, Kensington and Chelsea, and West Sussex, with York the only northern region to grace the top ten in the UK.

The drivers behind this shocking lung health inequality are complicated. Deprivation certainly plays a role, as many of the areas where people experience the poorest lung health, such as Blackpool, Manchester and Knowsley, are also areas where people are often living on lower incomes. Determinants of worse lung health, like dirty air, damp housing and higher smoking rates, are linked to deprivation. It is well known that the poorest groups in our country are also most likely to smoke, which is a major cause of the gap in life expectancy between rich and poor. The situation is bleak, with those in the poorest neighbourhoods being seven times more likely to die of a respiratory condition than those in the richest areas.

In the face of this, it’s a huge disappointment that the government has recently scrapped its health disparities White Paper, which could have addressed some of the issues driving this untenable lung health lottery. But levelling up our lungs is just one part of the story.

Lung health has been sidelined for decades, across the whole country. Even before the COVID-19 pandemic, lung disease was and still is the third biggest killer in the UK, costing the nation £11 billion a year, yet only 2% of public funding is spent on research into lung conditions that would help diagnose, treat and manage them much more effectively. This is despite lung conditions making up a significant 6% of the burden of disease across the UK.

The Office for Life Sciences previously identified respiratory disease as an area requiring investment, but so far has chosen to focus on other areas including dementia, cancer and mental health. Now we want more investment to improve people’s lung health in the UK.

With Government recently showing a renewed commitment to science with the UK Department of Science, Innovation and Technology, it is perfectly placed to reinstate their commitment to lung health. We are urging Government to increase investment into respiratory research proportionate to the burden of disease, to £150 million, to drive the discovery of new technologies and innovations to improve the nation’s lung health, which could also ease pressure on an overstretched NHS.

Access to care is also a major issue for the 12 million people who’ll develop a lung condition in their lifetime. Even in areas with low rates of emergency admissions and deaths, most people are not getting the basic, fundamental elements of care that they should have, like regular inhaler reviews or a written asthma plan.

Lung disease leaves millions of people across the country fighting for breath and hits some of the poorest people and areas the hardest. The government can change this by prioritising tackling lung conditions in its new Major Conditions strategy, ensuring people living with a lung condition get an early diagnosis by being able to access the right tests, have help quitting smoking, can breathe good quality air and get the right support and treatment to manage their lung condition well.

In the meantime, Asthma + Lung UK is here to help everyone with a lung condition, wherever they live through our helpline, vital health advice and more than 150 support groups around the country. But if we want to change the nation’s lung health we need everyone to take lung conditions seriously and make their voices heard by joining our End the Lung Health Lottery campaign.