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Respiratory Health 2020

Can your income make your asthma worse?

photo credit: Getty imagestommaso79

Joe Farrington-Douglas

Head of Policy and External Affairs, Asthma UK

COVID-19 has left deep scars on the poorest parts of our society. The high death rates in the most deprived areas of the country highlight the need for urgent action to address health inequalities[1].

Unfortunately, COVID-19 is not the only respiratory condition where your wealth makes a difference to your health.

Asthma affects 5.4 million people in the UK and the number of people dying from the condition is at the highest level this century.[2]

Anyone from any walk of life can have asthma but those on lower incomes are more likely to suffer the worst effects of the condition.

Asthma is often worse and more frequent in lower income homes

Asthma UK recently released a report called The Great Asthma Divide, which revealed that poorer people were more likely to have uncontrolled asthma, resulting in life-threatening asthma attacks.

A 2019 study found 47% of people, with an annual household income of under £20,000, had suffered more than two asthma attacks in the past 12 months. This was almost double that of households with an income of more than £70,000.[3]

Our report revealed that the quality of care people on low incomes receive is less than those on higher incomes.

Asthma patients on lower incomes are less likely to be asked about their symptoms in an annual asthma review, their inhaler usage is not assessed and their adherence to their preventer inhaler is not discussed as often.[4]

An annual review is paramount to preventing asthma attacks and, if key parts are missed out, this leads to people with asthma suffering unnecessarily.

Campaigning to remove asthma prescription costs

We know that costs like prescription charges also fuel health inequalities, as they are often a barrier to people accessing their medication, leading to uncontrolled asthma.

Asthma UK is campaigning to get these removed for asthma patients in England.[5]

A full investigation into the complex causes of health inequalities is vital to understanding what action needs to be taken.

Meanwhile, improving the quality of basic asthma care for all is a good place to start, with time and training for GPs and nurses to carry out high quality asthma reviews.

We need more investment in asthma training for GPs and nurses

Investing in resources such as data analysis, which allow GPs and nurses to intervene if patients are at risk of an asthma attack, will help the NHS in the long run, especially at a time when the health service is under financial strain.

Hospital admissions because of asthma attacks are costly, both to patients’ care and the public purse.

COVID-19 has made more people aware of their asthma management. It shouldn’t have taken a pandemic for this to happen.

It’s important that the one in 12 adults and one in 11 children in the UK who have asthma, know that they have a right to the best quality NHS care.

We must position asthma at the heart of efforts to address health inequalities if we are to start to close the wealth gap in health that COVID-19 has exposed.

No-one should be at more risk of a life-threatening asthma attack because of who they are or where they live.

[1] [2] The Great Asthma Divide, p. 3 [3] Asthma UK conducted a survey of over 12,000 people in summer 2019, results were presented in The Great Asthma Divide, p. 8 [4] In the same report, p. 11 [5]

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