Youngsters experiencing deprivation more likely to have asthma attacks when they return to school

Leading lung charity Asthma + Lung UK has found a shocking 320% increase in the number of 5-19-year-olds who experience the greatest deprivation being taken to hospital with a life-threatening asthma attack, once the school holidays end.¹ Among 5-19-year-olds from the least deprived parts of the country, however, the increase is almost half that number, at 170%.  

The charity says this shows a ‘huge disparity’ between the likelihood of children and teenagers from the most deprived areas of England experiencing potentially deadly asthma attacks once they go back to school next month, compared to those experiencing less deprivation. 

This could be due to a number of factors, such as those in more deprived areas living in poorer quality housing or not being able to afford the travel costs needed to attend medical appointments. The cost-of-living crisis has also put a huge strain on low-income families already struggling to pay for things like heating in winter and the health of their children could be suffering as a result.  

Asthma + Lung UK is now calling on the Government to urgently put a strategy in place to improve respiratory care as part of its upcoming Major Conditions Strategy, and to provide tailored financial support for people on low incomes with lung conditions. This will help to ensure families of children with illnesses like asthma can not only afford life’s necessities but can also get access to the treatment and support they need regardless of their income and where they live.

Emma Rubach, Head of Health Advice at the charity said: “We already know that when children go back to school after the summer holidays, we often see a spike in the number of asthma attacks, which leads to more hospital admissions. This is for several reasons, such as being exposed to more colds and viruses or dust mites in a school setting. Some youngsters might also fall out of their usual preventer inhaler routines over the summer break, which can leave them much more vulnerable to an asthma attack when they return to school and are around more triggers for their asthma.

“However, this data also shows a huge disparity between the number of children and teenagers admitted to hospital after having an asthma attack from areas where there are higher levels of deprivation, compared to areas of lower deprivation, which is very worrying. Reasons for this could include children living in poorer quality housing with issues like damp and mould that can trigger asthma attacks, or even experiencing higher levels of stress – another asthma trigger. Our studies have also shown that air pollution levels tend to be higher in more deprived areas, which could be another contributing factor.”

Sonia Destouche, 49, is now home schooling her son Jahmarley, eight, because his asthma is so bad. She is too afraid that her son may have an attack if he returns to school, especially in September. The mum-of-one is disabled and struggles to get by on benefits. She believes the mould in her one-bedroom council flat in Walthamstow, east London, has made Jahmarley’s asthma much worse and that more needs to be done to help those on low incomes with lung conditions.  

“Every day is a struggle,” Sonia explained. “Both Jahmarley and I have developed asthma and I think a lot of it has to do with our living conditions. We have lived in this flat for 11 years and it is covered in mould.  

“I home school Jahmarley now so I can keep a better eye on him, as he has had asthma attacks in school before and I don't want to take the risk that he could have another, and this time might not recover. Living on benefits makes it hard to afford to pay for extra things like travel to and from hospitals and putting on the heating when it’s cold, which is important when you have asthma, as cold weather can trigger an attack.  

“The rising cost of living has made things even harder for families like mine who often have to make tough choices about what they spend their money on. If I could afford it, I would move to a private rented property with no mould and in a nice area. Perhaps then Jahmarley’s asthma would improve, and he could return to school, but sadly I’m not in that situation.”

In its analysis, Asthma + Lung UK looked at the most recent NHS hospital admissions data among 5-19-year-olds in England, which showed how many were admitted to hospital with an asthma attack in September 2021 compared to the previous month of August that same year. Those aged 5-19 were analysed - from the most deprived parts of England and from the least.  

With children across most parts of England due to return to school in just over a week, Asthma + Lung UK is urging parents to be on their guard and look out for signs that their child’s asthma may be worsening, such as wheezing, coughing, chest tightness, and breathlessness, and advises them to make an urgent appointment with their GP or asthma nurse if they have any concerns.

Asthma + Lung UK is supporting the #AskAboutAsthma Campaign, which is run by NHS England – London and focuses on the importance of children getting support with their asthma management, particularly at a time when there is a rise in asthma attacks when they return to school.  

Dr Oliver Anglin, NHS England London Clinical Director for babies, children and young people’s transformation programme, said: ‘‘Asthma is one of the most common reasons for children to end up in hospital and sadly remains a cause of death which could be prevented. It is also a condition where outcomes are impacted by wider factors with those from more deprived backgrounds, more than two times more likely to end up in hospital than their less deprived peers.  

‘‘Once again, I am supporting the #AskAboutAsthma campaign which raises the profile of this potentially life-threatening condition. Anyone can take part and support the campaign which centres around four simple measures that can make a big difference to how children and young people experience their asthma – having an asthma plan and regular review, using inhalers properly and knowing how air pollution affects them. This year’s #AskAboutAsthma campaign invites us all to widen our view of asthma care by highlighting the impacts of wider factors such as housing, air quality, vaping and poverty on lung health.’’

If you are a parent or carer of a child or teenager with asthma and are concerned about their return to school, you can help reduce their risk of an asthma attack by doing the following:

• Make sure they use their preventer inhaler daily, as prescribed, even when they feel well, as this helps to build up protection in their airways over time
• Check that your child's reliever inhaler and spacer is in their bag before leaving for school every day. It should be kept somewhere they can get to easily at any time, like during PE or if they are on a school trip
• Ask your doctor's surgery for an extra reliever inhaler and spacer and give it to your child's school or college. This should preferably be in its original packaging. Send in a spacer too, if your child uses one. It should always be easily accessible and not stored in a locked cupboard
• Arrange for them to have an annual asthma review with their GP or asthma nurse if your child is getting asthma symptoms or using their reliever inhaler three or more times a week. Keep a diary if their symptoms have been getting worse or changing. This helps their GP or asthma nurse decide whether their treatment plan needs changing
• Have an asthma action plan – this tells the youngster and their school or college which medicines they take every day to prevent symptoms and cut their risk of an asthma attack and what to do if their symptoms are getting worse. This should be shared with their school, college, any carers, and medical professionals. You can download one from Asthma + Lung UK’s website here
• Make sure your child knows how to use their inhalers properly. You can arrange an inhaler technique check through your GP or asthma nurse and some pharmacies also provide this service. Asthma + Lung UK has a guide here
• If a child is having an asthma attack and their symptoms are not improving with a reliever inhaler, call 999 and follow our asthma attack advice for children here.  

For further information on how to prepare your child for their return to school this September, so their asthma is well managed, visit: https://www.asthmaandlung.org.uk/conditions/asthma/child/back-to-school or call the Asthma + Lung UK helpline on 0300 222 5800 Mon-Fri 9am-5pm.       

ENDS

NHS England London’s #AskAboutAsthma campaign

#AskAboutAsthma highlights the simple changes to children and young people’s care that will make a big difference to how they experience their asthma. Led by NHS England – London’s Babies, Children and Young People programme, the aim is for every person involved in the care of a child or young person with asthma – from GPs and nurses to parents/carers, teachers and youth group leaders – to know about the four asks that can help every person to manage their condition and live full, active lives. Find out more about the campaign here.  

Notes to Editors

1. The data analysed by Asthma + Lung UK showed that in August 2021, there were 87 5-19-year-olds hospitalised with asthma in the most deprived 10%, but the following month when children returned to school, this figure rose to 368 – an increase of over 320%. Among children and teenagers from the least deprived parts of England, however, 31 were hospitalised with asthma in August 2021 and 84 in September 2021 – a much smaller increase of 171%. Alarmingly, the figures also showed that 5-19-year-olds from the most deprived areas accounted for a fifth of all emergency childhood asthma admissions.

Asthma + Lung UK analysis of bespoke data supplied by NHS Digital, (now part of NHS England), 2021, which shows there was a 308% overall increase in emergency asthma admissions in children aged 5-19 in September 2021 (447 to 1822) compared to August 2021 in England. As shown in the graph below:

The data in the table below shows childhood asthma admissions for the least deprived decile (based on Index of Multiple Deprivation data) increased by 171% from August to September 2021 while those from the most deprived decile increased by 323%. There were four times the number of childhood asthma admissions in September 2021 for the most deprived decile (368), compared to the least deprived decile (84).    Table showing the number of asthma admissions for each deprivation decile for August and September 2021 as well as the % change for 15-19-year-olds with asthma: