Geographical variation in the respiratory health of Great Britain

Abstract

Comparing geographical variations in respiratory disease is useful for hypothesis generation, policy (e.g. considering provision and access to health services) and public information. Respiratory disease in Great Britain has often showed higher rates in cities and conurbations, attributed to past and current spatial patterns in smoking prevalence, occupational exposures and air pollution exposures. The aim of this work was to produce maps in order to assess the geographical variations of common respiratory diseases. Methods Maps for thirteen respiratory diseases have been produced using a Bayesian statistical model that can account for small numbers of cases, with adjustments for age, sex and area-level deprivation (Carstairs). Maps display the relative risk of mortality within a 5-years period 2008-2012, hospitalisation in 2010 (Hospital Episode Statistics data) in each local authority district of England, Scotland and Wales (n=408), in comparison with the overall risk in Great Britain. Results Patterns for all respiratory mortality and hospitalisation showed higher risks than average in conurbation areas with areas of lower risk within London. Similar patterns were see for other common respiratory diseases including Pneumonia, COPD and bronchiectasis. There were higher risks in the north of England and Scotland for lung cancer and as expected, the highest risks for mesothelioma and Pneumoconiosis were concentrated in industrial areas including ship-building and automobile industrial areas. Conclusions The collection of maps provides a description of the current burden of respiratory disease in Great Britain and will be of use for hypothesis generation, policy and public information.