As MPs prepare to debate health inequality in parliament tomorrow, the Chief Executive of the British Lung Foundation explains why everyone should have the same opportunities to lead a healthy life:
What you earn, where you live and your education should not mean that you’re more likely to be diagnosed with a killer disease – everyone should have the same opportunities to lead a long and healthy life.
We now have a population living longer and healthier lives. However, there is an alarming gap in life expectancy between those at the top and those at the bottom of society. This could not be truer for lung disease.
People from the most deprived section of society are two-and-a-half times more likely to have chronic obstructive pulmonary disease (COPD), and nearly twice as likely to develop lung cancer, than those from the least deprived section of society. This is a grave injustice.
The landmark report ‘Fair Society, Healthy Lives’, by Sir Michael Marmot, makes the case that reducing health inequalities is an urgent matter of social justice. Wealthy people are easily able to protect and improve their health. Poor people, quite often, are not.
In England, people living in the poorest areas will die, on average, seven years earlier than those in the richest areas. The gap in disability-free life expectancy is even greater at 13 years.
The British Lung Foundation’s Battle for Breath report, a three year epidemiological study into lung disease, explains some of the reasons for widening lung health inequalities:
Lung cancer and COPD are more common in poorer communities, due to their association with smoking. This in large part reflects higher rates of smoking among deprived groups. A total of 23% of those earning under £10,000 are smokers, compared with 11% of those earning £40,000.
Outdoor air pollution, which is generally higher in deprived areas, worsens symptoms of lung disease and can even cause it to develop.
Poor housing is another challenge. Mould spores and dust mites, which can lead to asthma and general respiratory irritation, are most common in damp, less well-constructed houses. This obviously affects mainly people who are on the lowest incomes and unable to afford a better home.
Finally, there are 11,000 new cases of breathing or lung problems caused or made worse by work each year. In 2014/15 464,000 working days were lost due to work-related lung problems. 15% of COPD cases are the result of workplace exposure to dust and chemicals. Workers with fewer skills and qualifications are more likely to be exposed to such hazards. Why should people on the sharp end of poverty suffer?
It’s vital that we explore solutions that will help us to mitigate these disparities. Healthcare and political leaders have stated a desire to reduce health inequalities throughout the country. A clear strategy to prevent and tackle lung disease will be essential if we are to achieve this aim.
The British Lung Foundation believes an independent taskforce for respiratory health in England is the answer. A joint approach from health and political leaders, committed to improving respiratory health, will go a long way towards providing better respiratory care for all those who need it and to reducing lung health inequalities.
- Follow Penny on Twitter at @blfpenny
Penny qualified as a doctor in 1987 and has an MA from Cambridge University and MBA from INSEAD.
She has many years’ experience in the healthcare sector working as a management consultant for clients including governments, multi-national companies, NHS organisations and private healthcare providers. She spent seven years in a number of senior roles at BTG plc, and before joining the BLF she was chief executive of the Picker Institute Europe.
Penny is passionate about working on behalf of patients, from personal and family experience of COPD, asthma, obstructive sleep apnoea and motor neurone disease.