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The UK's primary care sustainability network

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 is an exploratory project which can be helpful in identifying 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 and if there are inequalities teams locally you could consider working together on this. The integrated care systems 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

You may wish to become a clean air champion and educate your clinical team on the impacts of air pollution so they can talk to patients about this. The Primary Care Respiratory Society have written a useful summary article on this. 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.


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? This includes the non-pharmacological management resources in Disease Control Project 3