Higher levels of financial inequality linked to increase in asthma deaths – new international study

The study conducted by researchers at the University Hospital Southampton mapped data on asthma death rates in children (aged 5-14 years) and young adults (aged 15-49 years) in 32 OECD countries (including UK) against markers of financial inequality.

In a population about the size of the UK the data suggests that an increase in the GINI index of 0.1 (on a scale of 0 to 1 where 1 indicates maximum inequality and 0 indicates everyone having the same income), is associated with 37 additional deaths amongst children aged 5-14 years and 81 amongst adults aged 15-49 years.

Previous studies have shown that death rates for asthma in the UK, Australia, New Zealand and the USA - where all four countries have high levels of social inequality - are three times higher than most European countries.

The new research coincides with a key conference debate at the Society’s meeting – held by ‘Respiratory Futures’ - on inequalities and the future of respiratory care.

Professor Gary Connett, Consultant Respiratory Paediatrician from University Hospital Southampton, presented the findings saying:

“Asthma is a challenging health care problem with complex interacting factors determining the risk of severe and life-threatening attacks. These data provide some support for the hypothesis that at a national level - high levels of financial inequality are associated with fatal asthma.

"We know from previous studies that hospital admissions for acute asthma attacks are related to socioeconomic factors. Those from the most deprived areas of the UK are almost twice as likely to be admitted as those from the wealthiest parts. Previously identified risk factors for poor outcomes amongst people from deprived areas include delayed presentation to emergency services, and increased exposure to tobacco smoke and air pollution.  What this study additionally suggests is that relative inequality at a national level might also be important - acting independently of the absolute wealth of the countries studied. 

"Future research should determine whether increased psycho-social stresses in more unequal societies are the drivers for poorly controlled asthma as is thought to occur for mental health outcomes.”  

Professor Jon Bennett, Consultant Respiratory Physician and Chair of the British Thoracic Society’s Board, said:

“We know that many lung diseases are highly linked to financial and social deprivation – they play a major part in the widening life expectancy gap between rich and poor in this country. It is unacceptable and we must tackle it.

"The good news is that the NHS Long Term Plan in England aims to tackle health inequality and innovative lung teams in some parts of the country are targeting work at specific populations and areas of need – preventing lung disease and managing it earlier and more effectively. It is making a real difference.  However, we do need more resources and investment to scale this good practice right across the nation.”

Facts about asthma:

• 4 million people in the UK are currently receiving treatment for asthma: 1.1 million children (1 in 11) and 4.3 million adults (1 in 12)
• More than 1,400 people died from an asthma attack last year
• Around 200,000 people in the UK have severe asthma, this is a debilitating form of the condition that doesn’t respond to usual treatments and can cause people to be in and out of hospital
• The NHS spends around £1 billion a year treating and caring for people with asthma.

The NHS Long Term Plan spotlights the disproportionate contribution that lung diseases make to the health inequality gap. For example, in males, lung disease contributes more years of life lost (2.2 years) and exerts a greater impact on the life expectancy gap between the least and most deprived populations – than any other major disease area.

ENDS

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Note to Editors:

The British Thoracic Society is the UK’s professional body of respiratory specialists. The Society seeks to improve standards of care for people who have respiratory diseases and to support and develop those who provide that care.  A registered charity, it has about 3,700 members including doctors, nurses, respiratory physiotherapists, scientists and other professionals with a respiratory interest.

The British Thoracic Society Winter Meeting takes place between 4-6 December 2019 at the Queen Elizabeth II Conference Centre in Westminster, London.

Respiratory Futures works in partnership with the British Thoracic Society and NHS England to support the NHSE Long Term Plan’s ambitions for respiratory services.  It is the platform for resources to support integrated respiratory care, commissioning, innovation and networking, in an effort to bring together the diverse UK respiratory sector.