UK has higher death rates from respiratory illnesses than other developed nations

Death rates from respiratory illnesses are higher in the UK than similar countries in Europe, North America and Australia, shows a study published in The BMJ today.

Respiratory illnesses such as obstructive lung conditions like COPD (chronic obstructive pulmonary disease) and infections like pneumonia are common causes of death, but death rates can be reduced through effective healthcare interventions.

Death rates have been coming down in all countries, and the authors wanted to look at whether the gap between the UK and similar countries, particularly those in the European Union, had closed.

In the UK, deaths fell from 151 to 89 per 100,000 in men and changed from 67 to 68 per 100,000 in women. In comparison countries, death rates fell from 108 to 69 per 100,000 in men and changed from 35 to 37 per 100,000 in women.

The international research team, led by Justin Salciccioli at Harvard Medical School, extracted data on death rates for respiratory illnesses from the World Health Organization (WHO) Mortality Database for the countries of interest.

UK data were compared with data from other countries which were EU member states before May 2004 (i.e., Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, and Sweden) and data from Australia, Canada, United States, and Norway.

Between 1985 and 2015 death rates from respiratory conditions decreased for men and remained relatively static for women in both the UK and the comparison countries. However, death rates remained higher in the UK.

In the UK, death rates were higher than in the other countries for all respiratory conditions assessed except for lung cancer.

These included infections of the lungs (including influenza, pneumonia and tuberculosis); interstitial diseases (conditions affecting the tissue and space around the air sacs of the lungs); and obstructive diseases such as COPD, asthma and bronchiectasis (where the airways of the lungs become abnormally widened).

Previously higher UK death rates from respiratory conditions have been attributed to the UK's higher smoking rates, but smoking levels have decreased considerably since the 1970s.

The researchers emphasise that this is an observational study, so no firm conclusions can be drawn about cause and effect, but say that pollution may be a contributing factor as the UK has a higher rate of deaths attributable to household and ambient air pollution than most of the comparator countries.

Further studies are required to look at how differences in the healthcare system and health behaviour differences of patients with respiratory diseases might impact on death rates, they add.

"The difference in mortality between the UK and other similar nations does not exist for other chronic medical conditions such as cardiovascular and cerebrovascular diseases, or death from renal disease," they conclude.