Respiratory disease

Introduction

Respiratory disease is one of the top causes of death in England in people aged under-75 years. Two of the most common lung diseases are asthma and chronic obstructive pulmonary disease (COPD). Smoking is the chief cause of COPD and the Public Health Outcomes Framework¹ indicator on premature mortality from respiratory disease focuses public health attention on the prevention of smoking and other environmental factors that contribute to people getting respiratory disease.

Respiratory disease and COVID-19

People with underlying respiratory and lung diseases (alongside other risk factors) are at increased risk of negative and serious outcomes from COVID-19. It was the leading cause of death in England in 2020, both directly and indirectly.  The COVID-19 page has further details around the impact on Blackpool's residents.

Facts and figures

Across Blackpool in the five year period  2019 to 2023 there were 1,413 deaths from respiratory disease, approximately 283 per year. Deaths from respiratory disease for 2023 show:

• • • 110 deaths were in people aged under 75 years (82.4 per 100,000) and 320 for all ages (211.0 per 100,000)
    • The all-age and the under-75 mortality rates were significantly higher than the national average

Mortality from respiratory disease in people aged under-75 has been significantly higher in Blackpool than in the North West and England over the last 20 years (figure 1).  The main contributor to this is the high levels of smoking in the town. When compared to other upper tier local authorities, Blackpool's mortality rate is the highest in the country (figure 2).

Figure 1: Trend in mortality rate from respiratory disease, persons aged under 75 years, Blackpool, the North West and England, 2001-03 to 2021-23

Figure 2: Mortality from respiratory disease in persons aged under 75 years, Blackpool compared to upper tier local authorities, 2021-23

There is a clear difference in deaths from respiratory disease between males and females (figure 3), with male mortality higher than female mortality (2021-23) although this is not a significant difference. From the 2023 single year data, the male under-75 mortality rate is just over twice the rate of England (85.9 and 39.1 per 100,000 respectively). For females it is almost three times as high (78.7 and 28.7 per 100,000).

Figure 3: Mortality from respiratory disease in persons aged under 75 years, males and females in Blackpool, the North West and England, 2021-23

Preventable mortality

The basic concept of preventable mortality is that deaths are considered preventable if, in the light of the understanding of the determinants of health at the time of death, all or most deaths from the underlying cause (subject to age limits if appropriate) could potentially be avoided by public health interventions in the broadest sense. The most recent three-year data (2021-23) show that

• • in Blackpool 179 (59.9%) of the deaths from respiratory disease in people aged under 75 are considered preventable

  • this is similar to the England proportion of 59.3%

 National and local strategies

National Institute for Health and Care Excellence: everything NICE has produced on the topic of respiratory conditions: general and other. It includes any related guidelines, NICE Pathways, quality standards and advice.

Office for Health Improvement and Disparities (OHID) guidance, Respiratory disease: applying All Our Health

[1] Office for Health Improvement and Disparities, Public Health Outcomes Framework