Respiratory diseases

Respiratory disease encompass a wide range of conditions affecting the organs and tissues associated with breathing and are is one of the most commonly diagnosed disease areas across England with around one fifth of the population being affected. Diseases range from mild and self-limiting conditions such as the common cold, to those which are life threatening such as bacterial pneumonia, pulmonary embolism, acute asthma and chronic pulmonary disease (COPD).  Respiratory disease is also one of the most common underlying causes of death nationally with lung cancer, pneumonia  and COPD being the biggest causes of death.

As many as 3 million people suffer from COPD in the UK, of which only around a third of cases have been diagnosed. People with COPD have difficulties breathing, primarily due to the narrowing of their airways and destruction of lung tissue. Typical symptoms include breathlessness when active, a persistent cough and frequent chest infections.

Asthma is a common condition which responds well to appropriate management and which is principally managed in primary care.  It affects people of all ages and often starts in childhood, although it can also develop for the first time in adults.  Common asthma triggers include; allergies – to house dust mites, animal fur or pollen, for example; smoke, pollution and cold air exercise, and infections like colds or flu.

COPD prevalence increasing while asthma prevalence stable

The Herefordshire prevalence of COPD has increased steadily since 2005/06 mirroring the national pattern, although since 2011/12 the local figure has been higher than that for England. In 2019/20 the Herefordshire figure was 2.50% compared to 1.9% for England.

Over the same period the local all age asthma prevalence has remained relatively stable, although it remains higher than that the corresponding figure for England. In 2019/20 the local prevalence was 6.9% compared to the England figure of 6.5%.

Premature mortality similar to national figure

Both the number of deaths with an underlying cause of respiratory disease and the proportion of all mortality in Herefordshire that these deaths represent have been generally rising in Herefordshire since 2010. In 2019 there were 295 deaths representing 12.1% of all deaths in Herefordshire.

While the national premature mortality (occurring at under 75 years) rate has remained relatively stable for the last ten years while for much of this period the corresponding rate for Herefordshire has increased, although small falls were seen in 2018 and 2019.  However, the local rate has been consistently lower than that for England and in 2017-19 was 26.6 per 100,000 compared to 34.2 per 100,000 across England. 

During the pandemic the number of deaths associated with respiratory diseases fell with 21% fewer deaths recorded in both 2021 and 2022.