The new research published in the journal, PLOS Medicine, was conducted by Swansea University’s Wales Asthma Observatory in collaboration with Asthma UK Centre for Applied Research, Applied Research Collaboration North West Coast (ARC NWC) at the University of Liverpool and BREATHE – The Health Data Research Hub for Respiratory Health.
Jointly funded by Health and Care Research Wales and Swansea Bay University Health Board, the study discovered that people with asthma from socially and economically deprived areas of Wales have less control of their asthma, suffer from more asthma attacks and are at a higher risk of death.
Dr Mohammad Alsallakh, the first author of the study, said,
“This study demonstrates asthma burden is not evenly distributed within society, but it is affected by where people were born and live. We found that lower income and education levels are important drivers of socioeconomic inequalities in asthma.
Lack of educational opportunities likely affects how well people manage their asthma and puts them at higher risk of asthma attacks and death. It is important to target the most deprived communities with better health education strategies to ensure patients regularly and correctly use their preventive inhalers.”
In the most deprived areas in Wales, people with asthma were found to be 50% more likely to be admitted to hospital and to die from asthma compared with those in the least deprived areas. Those from more deprived backgrounds were also found to have a poor balance of essential asthma medications that help prevent asthma attacks.
Commenting on the findings Joseph Carter, Head of Asthma UK & British Lung Foundation Wales, said,
“These findings put the reality into stark contrast and clearly show the link between the environment people live in and their long-term health. Living in a disadvantaged area has a huge impact upon your life. Doing so means you are more likely to develop a serious condition, such as asthma, and are 50% more likely to be admitted to hospital or die because of that condition.
More must be done to address this situation. We need more targeted investment, focused on the most disadvantaged communities, to deliver better healthcare services locally and diagnose conditions sooner. We also need to see a greater focus on tackling air pollution, and creating greener communities, to stop people developing a lung condition and ensure everyone can live a healthy and fulfilling life.“
This study forms part of an important and increasing body of work into asthma-related health research led by the Asthma UK Centre for Applied Research. The Wales Asthma Observatory (WAO) is the latest Centre of Excellence to join the Population Data Science group. WAO is a platform for asthma research and surveillance with a cumulative cohort of asthma patients covering most of Wales and is based on electronic health records dating back to 1990.
WAO lead and Professor of Respiratory Medicine at Swansea University Medical School, Gwyneth Davies, said,
“We found that the most deprived people are three times more likely to use excessive reliever inhalers and have a worse balance of preventer to reliever medications, which means they are at higher risk of preventable asthma attacks and deaths. This study highlights an urgent need to identify ways to improve asthma outcomes for those from deprived communities.”
This study looked at over 100,000 people with treated asthma across Wales over five years. The authors probed routinely collected primary and secondary care data from within SAIL Databank based at Swansea University Medical School, which contains 100% secondary care and 80% primary care data for the population of Wales. SAIL Databank also hosts UK data facilitated by BREATHE – The Health Data Research Hub for Respiratory Health.
Professor Aziz Sheikh, Director of BREATHE and Asthma UK Centre for Applied Research (AUKCAR) said,
“1 in 10 people in the UK are currently receiving treatment for asthma. This research clearly shows inequalities in the experiences of people living with asthma across Wales. Those in less affluent areas have more A&E attendances, hospitalisations, and deaths due to asthma. Developing targeted changes to the way asthma is treated and also opportunities for health education in Wales may reduce the gap for more deprived groups. This study could lead the way in identifying improvements for people with asthma living in more deprived areas that could be implemented across all four UK nations.”
Professor Ronan Lyons, lead for Public Health Research at Health Data Research added,
“This study shows the benefits that Trusted Research Environments, such as the SAIL Databank play in enabling research that changes lives to be undertaken whilst protecting the privacy of patients’ data.”
The authors used SAIL Databank to link data for the period of 2013 to 2017 to investigate the link between GP care data, emergency hospital admissions, prescriptions and asthma deaths together with geographical and socioeconomic measures for ranked areas of deprivation.
Professor Sarah Rodgers, lead of the Care and Health Informatics theme for ARC NWC said,
“This study shows the importance of empowering patients to actively manage their health conditions. We need to work with people in deprived communities to understand what would best help them access preventive asthma treatments.”