8. Wider determinants
Do you routinely consider and code determinants of health when managing asthma? Air pollution, social deprivation and housing quality may all have an impact on asthma. This exploratory project can help to identify trends in your community as well as opportunities to improve health. It may be a suitable project for a medical student or trainee with interest in the area.
Considering the wider determinants of health is important when looking at health inequalities. The integrated care systems in NHS England, have a responsibility to reduce population health inequalities through their Core 20+5 programmes.
The process
Step 1: Investigate the local situation
Think about your practice population. Is there a problem with housing quality, fuel poverty or air pollution locally? You could bring the impact to the attention of the local council.
Step 2: Act on your findings
Do your practice team need training to feel confident on how to support patients to understand the impact of air pollution and reduce their exposure. Global Action Plan is an environmental charity with a focus on air pollution. They have written a report on what works in primary care and a primary care protocol which shows you how to inform patients throughout the patient pathway, integrate conversations into your consultations.
The Primary Care Respiratory Society have written a useful summary article on air pollution. The Royal College of Paediatricians have also produce a toolkit which helps health professionals make the case to councils on the need to address air pollution.
If you have a social prescriber, are they able to advise patients who have problems with housing, such as damp housing or fuel poverty.
Resources:
Step 3: Empower patients
Could you empower patients to take action about wider issues affecting their asthma by putting information and links to services on your website, waiting room or AccuRx messages? This includes the non-pharmacological management resources in Disease Control Project 3