Respiratory disease includes relatively common long-term conditions such as chronic obstructive pulmonary disease (COPD) and asthma, and more acute but rarer conditions like tuberculosis.
Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease (COPD) is a respiratory condition associated with smoking which is more common in deprived communities than affluent ones. The recorded prevalence of chronic obstructive pulmonary disease has been steadily rising in York from 1.3% of the registered population in 2006-2007, to 1.4% in 2010-2011 (Health & Social Care Information Centre). The England rate is 1.57%. This is based on general practitioner data which is not standardised for age or sex, and therefore should be considered to be an approximation of the true prevalence.
The modelled estimate for York suggests that 2.8% of the population may have chronic obstructive pulmonary disease, but this should be used with caution (Public Health England, 2011).
The mortality rate in 2007-2009 for chronic obstructive pulmonary disease in York men is significantly lower than the England average. The rate for women was higher than the England average, albeit not significantly so (Health & Social Care Information Centre).
Looking at the prevalence of chronic obstructive pulmonary disease across deprivation quintiles, there appears to be no discernible pattern based on general practitioner data. However when considering the constructive obstructive pulmonary disease mortality rate, there is a striking gradient with the most deprived quintile having a mortality rate of 47.7 per 100,000 population, compared to the least deprived quintile having a rate of 10.9 per 100,000 population, which is illustrated below (Office for National Statistics).
This suggests an under-diagnosis or under-recording of COPD within primary care in York.
The recorded prevalence of asthma for 2010-2011 was significantly lower than the England average (5.6% compared to 5.9%) (Health & Social Care Information Centre, 2012). Asthma-related admissions in York were 127 per 100,000 population which represents 238 admissions. There appears to be no particular trend across the deprivation quintiles regarding asthma admissions.
The annual incidence of tuberculosis for 2007-2009 remains stable at 6 per 100,000 population, and is significantly lower than the England incidence for the same period of 16 per 100 000 population (figures from the NHS North Yorkshire and York Secondary User Service Inpatient Dataset). Treatment for tuberculosis often lasts for six months or more, so ensuring compliance with treatment is essential. Recent data identified that nationally, 83.6% of individuals complete their treatment (Health Protection Agency, 2011). Local figures for completion of treatment are not available.