Asthma

Asthma is a chronic inflammatory disorder of the airways. It is a complex and episodic disorder. Although caused by an overactive immune response it is not generally considered an autoimmune disease. Drawing together data from a number of different national datasets, the British Lung Foundation’s ‘Respiratory Health of the UK’ project estimated that 8 million people – over 12% of the population – have been diagnosed with asthma at some point (Mukherjee et al 2016; Snell et al, 2016). Since 2008, young people aged 16-20 have been the group most likely to be diagnosed. Overall, Asthma UK (2019) estimates that 1 in 11 children and young people have asthma. Taken together, these statistics suggest that something in the region of a million young people between the ages of 10 and 24 are likely to have asthma.

There has been much debate about whether rates of asthma have increased in recent years, but time trend data from the Respiratory Health of the UK project, from 2004 to 2012 suggested that lifetime prevalence of asthma had declined in children and increased in adults over that period. It is worth noting that a smoking ban in public places was introduced in Scotland in 2006 and in England and Wales in 2007. In addition, as we saw ‘Public health outcomes’, smoking by young people had fallen over recent decades before the ban, which may have played a role.

More recent data on time trends in prevalence are not available, but statistics on asthma mortality rates for the UK from 1998 to 2019 are available from the Global Burden of Diseases study. Chart 4.6 shows that for 10-14 year olds, 15-19 year olds and 20-24 year olds in the UK there was a decline in asthma mortality from 1998 to 2013, but the recent trend is less clear.

International comparisons of asthma mortality rates, again using the Global Burden of Disease study, have shown that the UK has some of the highest rates compared with other similar high-income countries. Comparisons for rates for 10-14 year olds, 15-19 year olds and 20-24 year olds are shown in Chart 4.7.

Asthma mortality rates also vary within the UK, with higher rates in Northern Ireland, Scotland, Wales and the midlands and north of England than in south England.

Research has shown that there are a number of barriers to the successful management of asthma in this age group which need addressing in order to improve young people’s outcomes, including concerns related to side effects of medication (such as weight gain), social stigma and feelings of embarrassment and exclusion (Simoni et al, 2017). Poor management can result in hospital admissions. Chart 4.9 shows that hospital for admissions for asthma are more likely in 20-24 year olds than they are in either 15-19 or 10-14 year olds.

Chart 4.10 shows that hospital admissions for 10-18 year olds in England have been relatively stable in recent years.

Rates of asthma are related to living in areas of high deprivation. Chart 4.11 shows that hospital admissions for asthma are more than twice as prevalent in the most deprived areas of England, compared with the least deprived.

All data correct as of 1st November 2021