Health should not be a postcode lottery

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.

Dr Penny Woods

Dr Penny Woods is Chief Executive of the British Lung Foundation.

Penny, a qualified as a doctor with an MA from Cambridge University and MBA from INSEAD, 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.

You can follow Penny on Twitter: @blfpenny.


  1. Terry Kavanagh says:

    how near are we to having an Independent task force to tackle the inequalities in respitory health.

  2. Dr Penny Woods says:

    Thank you all for your comments.

    Shirley, Jane and Eileen: Thank you for getting in touch and I hope we can help you further, that’s what we are here for, please have a look at the patient support pages on our website. You can also contact our helpline on 03000 030 555, where one of our dedicated team will be there to speak to you.

    Cheryll: I agree it’s a scandal that we still have such large differences in health depending on how wealthy someone is. We want the Government to set up a Taskforce to produce a five year plan to tackle lung health, partly because respiratory illness is a major driver in health inequalities. A co-ordinated approach is best, looking at prevention as well as diagnosis and treatment for people of all ages.

  3. Cheryll Adams says:

    Health visitors pick up risks to young families who are living in damp conditions and work hard to get them rehoused or for their damp to be dealt with. Sadly access to such services at the start of life are about to become a very significant postcode lottery with different local authorities making different decisions about how they manage the cuts to their public health budgets. Some plan to decimate the health visiting service which has just been rebuilt by the last parliament to improve child health and family lives! Consider the knock on effects that will bring, increasing health inequalities and later health spending on things like lung and heart disease alongside increasing the immediate burden on GPs and A&E – though health spending is of course the NHS’s problem not LAs! Will we ever reduce health inequalities when such decisions are allowed to happen to our most vulnerable residents! We need much more joined up decision making across health and social care.

  4. Shirley Hickey says:

    I agree,please continue your fight to help , people with IPF have no chance of recovery but it can be stabilised with the right drugs , but getting them is another story.I would be very grateful for any help you can advise. Shirley Hickey .

  5. Eileen Bangerter says:

    I have bronchietas diagnosed when I was 17. Lung damage from whooping cough. I am now 69 and have really coped well. This last 18months they have started to build new homes at the bottom of my garden. This summer I have experienced being out of breath and have been given COPD inhaler to add to my others. I think I fall between Asthma and COPD with my condition. I wonder if the building site had anything to do with the determination in my condition? or is it coincidence? I am not really poorly but I do the 4 P’s learnt at my pulmonary rehabilitation and so so long as I remember them I cooe quite well. I have never smoked and am not totally sure I have COPD or maybe I find it hard to accept.

  6. Jane Moneypenny says:

    My husband diagnosed with ipf almost four years ago never been offered any anti fibrotic drugs as lung function was only forty nine percent when diagnosed we live in the north west