COPD

Respiratory conditions
COPD
Chronic Obstructive Pulmonary Disease
Air pollution
Asthma
Smoking
Respiratory Diseases
Respiratory Health
Lung disease
Healthy people
Physical health conditions

introduction 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 COPD. Information on asthma 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.

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulties, including:

  • Emphysema - damage to the lungs
  • Chronic bronchitis - long-term inflammation of the airways

Breathing problems can get worse over time and may limit normal activity, treatment can help keep the condition under control.

The symptoms of COPD:

  • A persistent chesty cough with phlegm that does not go away
  • Increasing breathlessness - this may only happen when exercising at first, and you may sometimes wake up at night feeling breathless
  • Frequent chest infections
  • Persistent wheezing

There are a number of risk factors, some of them modifiable that can increase your risk of developing COPD including:

  • Tobacco smoking
  • Occupational exposure e.g. exposure to dust or certain chemicals such as welding fumes
  • Air pollution
  • Genetics
  • Lung development
  • Asthma

COPD is a common condition that mainly affects middle-aged or older adults who smoke. Around 90% of cases of COPD are associated with smoking meaning it is a largely preventable condition. You can significantly reduce your chances of developing it if you avoid smoking. If you already smoke, stopping can help prevent further damage to your lungs before it starts to cause troublesome symptoms.

why is it important to population health Why is it important to Population Health?

Around 4.5% of the population over 40 years old live with COPD. COPD is the fifth most common cause of mortality in the UK and was responsible for 21,701 deaths in 20211. This is a reduction in deaths on the previous years due in part to COVID-19 displacing COPD as the underlying cause of death in people living with COPD2. Population health approaches in the prevention, early detection and management of conditions can alleviate the disease burden on patients and the NHS.

Consequences of COPD: Breathlessness, coughing, sputum production, wheezing, and chest tightness are all symptoms of COPD which have a negative impact on health status, quality of life, sleep, ability to undertake daily activities, and may contribute to increased anxiety and depression levels, increased risk of exacerbations, and a worse disease prognosis3. Early identification and management of COPD can help patients to manage their condition more effectively.

Health Inequalities: Health inequalities are avoidable differences in health between different groups of people. People who live in the 20% lowest income communities are over 12% more likely to live with COPD than people living in the 20% most affluent communities4. Income inequality in patients with COPD is associated with increased emergency health care use, health care costs, and mortality5. Engaging with communities at high risk of developing COPD to target intervention through stop smoking services can enable those in low-income areas to stop smoking and reduce their COPD risk.

Risk Factors: There are several risk factors associated with COPD, some linked to the environment people live and work in. These can increase the risk of a person developing COPD and exacerbate the condition.15% of COPD cases are a result of workplace exposure to dust and chemicals.

Roughly 77% of all COPD related deaths are attributable to smoking6.

Population health approaches to working with employers through the Derbyshire Healthy Workplaces programme, engaging with partners such as local authorities and community and voluntary sector providers to improve air quality and promote stopping smoking can help to manage the COPD risk in the population.

NHS/Healthcare Burden: COPD also has a significant impact on the NHS with £4.5bn each year spenton the treatment of COPD and it is estimated to account for over 1.8 million annual hospital bed days with 620,000 occurring during the winter period7. Action to prevent COPD, including stopping smoking could help alleviate significant pressure on the NHS in Derbyshire.

Social and Economic Burden: Lost productivity from COPD costs around £2 billion and the costs associated with quality of life is £2.6 billion8. Population health approaches to the prevention of COPD can help reduce this wider economic burden.

the derbyshire population approach 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 COPD within The Derbyshire Population Health Approach:

Action to prevent and empower people to stop smoking alongside improving air quality are essential in reducing the long-term risk of COPD and can improve the health and wellbeing of people in communities most at risk of COPD, improve productivity and reduce pressure on the NHS.

The burden of COPD falls disproportionately on lower income communities in Derbyshire. Targeting interventions at areas with the greatest concentration of patients with COPD using services to help people stop smoking and take up the NHS Health Check, in addition to targeted action on housing quality can enable public health to reduce COPD risk.

Prevention and early detection of respiratory disease, including COPD are an important element of the local NHS Stay Well agenda9. There is strong evidence that stopping smoking can lead to a reduction in the risk of developing COPD and improve health outcomes. Public Health work closely with the NHS and partners in local councils and the community and voluntary sector to implement evidence-informed activity to support the management of COPD.

Tackling the causes of COPD are central to the population health approach. These include lifestyle related factors such as stopping smoking. Stop smoking support for all Derbyshire residents is available through the Live Life Better Derbyshire Service.

Public Health works closely with a range of NHS, local authority and community, voluntary and independent sector partners to promote and encourage people, especially those in communities most at risk of COPD to take up the offer of stopping smoking through Live Life Better Derbyshire. Our partners are essential in supporting the development of an air quality strategy for Derbyshire that will help mitigate the risk of COPD.

latest derbyshire data Latest Derbyshire Data

Trend Data

Derbyshire Quilt

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.

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 and assessments 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.

Coming soon…

more information and resources More Information & Resources

Here is a list of useful resources and information to help prevent issues related to COPD. These materials are meant to provide individuals, healthcare professionals, and communities with the knowledge and tools they need as part of efforts to address COPD.

Contributors

Ben Cooper, Advanced Public Health Practitioner, Healthcare Public Health