Chronic Obstructive Pulmonary Disease: What are the key inequalities?

  • COPD is estimated to contribute 11.3% to the gap in life expectancy between Lewisham and England for men, and 9.1% for women5. This equates to about 40 excess deaths per year.
  • Smoking prevalence is higher in lower socio-economic groups and therefore COPD prevalence is higher in more deprived areas. However, as smoking prevalence tends to be lower in Black and minority ethnic groups than in the White population, particularly women, the prevalence of COPD in this group is likely to be lower, although no data are available to verify this. There are certain exceptions to this; for example, Turkish and Vietnamese men have high smoking rates.

Figure 3 below shows ethnicity data for hospital admissions for COPD. Over 80% of admissions are in the White population (including Irish, and other White). The next largest ethnic group is the Black or Black British group, with most of these in the Black Caribbean or Black other ethnic groups. Only three patients’ ethnicity was described as Black African. Figure 4 shows COPD admissions by sex.

Figure 3 COPD admissions by ethnic group 2005/6 - 2009/10

Figure 4 COPD Admissions by sex 2006-2009

  • GP practices with higher IMD scores tend to have higher COPD prevalence and admission rates than those with lower scores. Table 2 looks at the ratio of selected primary care indicators in relation to COPD, compared to Lewisham. A ratio of 1.00 indicates a similar profile to Lewisham, above 1 is higher than Lewisham and below 1 is lower than the Lewisham average.
  • In general, a high IMD score ratio and high smoking prevalence would be expected to correlate with high COPD prevalence and higher numbers of admissions. However, this is not always the case. There are a few practices with a high IMD score but a young population (for example, the Jamil practice) and here the COPD indicators may be lower than expected.

Table 2 Ratio of COPD indicators comparing the least deprived GP practices in Lewisham (shaded) with the

most deprived, by IMD score ratio compared to Lewisham




  1. LHO Inequalities gap tool






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