Asthma
Introduction
Respiratory diseases (those affecting the airways and lungs) cover a wide variety of conditions, including common conditions such as asthma and chronic obstructive pulmonary disease (COPD), lung cancer, infections such as pneumonia and flu, and less common diseases such as interstitial lung disease and mesothelioma.
The following JSNA topic summary will concentrate on asthma. Information on COPD can be found here and pneumonia and flu can be found here (coming soon). Information on lung cancer can be found in the cancer topic summary by clicking here.
Asthma is a long-term condition for many people. It is caused by swelling (inflammation) of the breathing tubes that carry air in and out of the lungs. This makes the tubes highly sensitive, so they temporarily narrow. It may happen randomly or after exposure to a trigger.
It is the most common long-term medical condition in children in the UK, with around 1 in 11 children and young people living with asthma. It sometimes goes away or improves during the teenage years but can come back later in life.
Symptoms are individual to each person and can come and go. It is possible to have one or more of the symptoms below:
- Shortness of breath/breathing
- Cough (day or night)
- Wheezing
- Chest tightness
Triggers can change over time, and some will depend on the time of year, or the environment you are in. Cold air can affect people in winter, and pollen can affect people in spring and summer.
Other common triggers include:
- Cigarette smoke
- Exercise
- Colds and viruses
- Pollution
- Pet hair
- Dust mites
Why is it important to Population Health?
Disease Burden and Deaths Due to Asthma: On average three people die from asthma every day in the UK, with up to 9 in 10 of those deaths being preventable. There are currently around 4.3 million adults (around 1 in 12) receiving treatment for asthma in the UK. Asthma is the most common chronic disease of childhood, there are approximately 1.1 million children receiving treatment for asthma in the UK1. Public health action to prevent the causes of asthma and reduce the risk of exposure to risk factors linked to the exacerbation of symptoms is essential in improving health outcomes of people in Derbyshire.
Consequences of Asthma: People with under-treated asthma can suffer sleep disturbance, tiredness during the day, and poor concentration. Asthma sufferers and their families may miss school and work, having a financial impact on the family and wider community. If symptoms are severe, people with asthma may need to receive emergency health care and they may be admitted to hospital for treatment and monitoring2.
Health Inequalities: Health inequalities are avoidable differences in health between different groups of people. The proportion of adults with asthma also varies by income, especially among women. Those in the lowest income households are more likely to have current asthma (10% of men and 15% of women) than those in the highest income households (9% of men and 8% of women)3.
Children living in lower income communities are more likely to have an emergency hospital admission due to asthma and are more likely to be exposed to higher levels of tobacco smoke and environmental pollution, which may contribute to this4.
Poor housing is linked to respiratory disease. Mould spores and dust mites are most common in damper, less well constructed houses and can lead to asthma. This impacts on people who are on the lowest incomes and have the least ability to afford a better home. 24% of people in the lowest income quintile live in a privately rented home, of which 28% do not meet the decent homes standard5.
Tackling health inequalities is complex; however, strategies targeting high-risk groups and modifiable risk factors, could reduce the clinical and economic burden of asthma.
Risk Factors: Air pollution is anything that makes the air more toxic and damaging to our health. Children are more at risk than adults because their lungs are still developing. Being exposed to pollution as a child increases the risk of developing asthma. In some parts of the country it is linked to 33% of childhood asthma cases6,7.
Occupational asthma is reported to be the most common industrial lung disease in the developed world. It is caused by breathing in substances at work, like dust, chemicals, fumes and animal fur. It accounts for between 9-15% of adult-onset asthma8.
The NHS recommends that people with asthma avoid smoking, an estimated 28% of people who died from asthma were current smokers. Smokers with asthma are also more likely to experience higher rates of hospitalisation, have worse symptoms and experience a more rapid decline in health due to smoking9.
Population health action to manage risk factors associated with the development and exacerbation of asthma, through the air quality strategy, Healthy Workplaces Derbyshire programme and offering support to stop smoking through Live Life Better Derbyshire can help manage the risk of asthma.
NHS/Healthcare Burden: Asthma has a significant impact on NHS resources. It is estimated that the diagnosis and management of asthma costs over £1.2bn per year and patients with non-severe uncontrolled asthma cost 62% more per person than those with controlled asthma10. Asthma accounts for 2-3% of primary care consultations, 60,000 hospital admissions, and 200,000 bed days per year in the UK. Action to manage symptoms and risk factors associated with asthma, including stopping smoking and air quality can support the NHS to manage the long-term impact of asthma.
Social and Economic Burden: The indirect costs of uncontrolled asthma is estimated to be £4.5bn annually, 70% of this cost is absorbed in lost productivity11.
The Derbyshire Population Health Approach
The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.
When considering the topic of asthma within The Derbyshire Population Health Approach:
Proactive measures to prevent people developing asthma through improvements in air quality, both indoors and outdoors and environmental risks in workplaces and support to manage exacerbations through lifestyle changes such as stop smoking support can empower people to manage risks associated with asthma and reduce pressure on the NHS.
Children in lower income communities are more likely than their counterparts in higher income areas to be hospitalised due to asthma. Working with colleagues in local authorities, community and voluntary sector organisations and the NHS to enable communities at high risk of developing complications related to asthma to take action on air quality alongside stopping smoking will enable people in Derbyshire to manage and prevent risks associated with asthma.
Childhood asthma is one of the key areas of focus in the NHS Core 20 Plus 5 Strategy which aims to reduce health inequalities in children. Specifically, it aims to reduce over reliance on reliever medication and decrease the number of asthma attacks. Population health approaches through improvements in air quality can support the NHS in achieving these aims through the reduction in risk of making asthma symptoms worse, especially in areas with poor air quality.
Managing the environmental, occupational and lifestyle factors associated with asthma risk are important factors related to the population health approach. Improving air quality in the places people live and work can help manage a reduction in risk associated with asthma triggers such as air pollution in addition to preventing the risk of developing occupational asthma. In addition to this, supporting people to stop smoking can help people with asthma to manage their condition more effectively.
Taking a partnership approach to the management of risks associated with developing and aggravating asthma is important in ensuring we prevent people needing hospital care by helping them to manage their asthma symptoms. Population health will work with local authorities, NHS and community and voluntary sector partners to engage with communities where asthma is most common to support the management of risks associated with asthma.
Latest Derbyshire Data
Trend Data
Prevalence Maps of Derbyshire
The maps below illustrate Lower Super Output Areas (LSOAs) and Middle Super Output Areas (MSOAs) for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.
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In the top right of the map, you’ll find the ‘Layer Control’ icon. This is an easy way to customise what you see on the map visualisation. Click the ‘Layer Control’ to choose which information is displayed on the map. Pick the indicator that interests you the most, and the map will transform accordingly. |
Slope Index
This chart illustrates the differences in health and lifestyle factors across areas in Derbyshire, from the most deprived (decile 1, red) to the least deprived (decile 10, green). As you move from left to right on the chart (from more deprived to less deprived areas), the line shows whether these factors are becoming more or less common. Essentially, it’s a way to see how living in wealthier or poorer areas affects the prevalence of these factors.
Further Analysis & Assessments
Derbyshire Joint Strategic Needs Assessment (JSNA) involves a thorough examination of a specific health problem, exploring its causes, consequences, and underlying factors. It combines various data sources, collaboration with stakeholders, and rigorous analysis to generate insights for evidence-informed interventions and policy changes.
More Information & Resources
Here are some useful resources and information to help prevent issues related to asthma. These materials are meant to provide individuals, healthcare professionals, and communities with the knowledge and tools they need as part of efforts to address asthma.
Contributors
Ben Cooper, Advanced Public Health Practitioner, Healthcare Public Health