Abstract

Background
Chronic obstructive pulmonary disease is a preventable and treatable chronic lung disease affecting three million people in the UK and is associated with a substantial healthcare burden. It is the third leading cause of death globally and accounts for 10% of all premature deaths in England annually. Chronic obstructive pulmonary disease is commoner in deprived communities, where risk factors for chronic obstructive pulmonary disease such as smoking, air pollution, occupation, and poor housing are more common. Some ethnic minority groups are likely to be at higher risk of developing chronic obstructive pulmonary disease as they are more likely to smoke and live in the most income-deprived neighbourhoods (e.g. >25% Pakistani men smoke and 30.7% live in deprived neighbourhoods).

Aim
To explore the relationship between known risk factors for chronic obstructive pulmonary disease and the percentage of patients diagnosed in General Practice in England.

Methods
National publicly available Quality and Outcomes Framework data from general practices in England and ethnicity data from the 2021 census data were analysed. A multivariable analysis was conducted including ethnicity, age, smoking and index of multiple deprivation deciles. All data analyses were done using R (V4.1.0).

Results
The greater the percentage of ethnic minorities registered at a general practice in Sheffield the lower the percentage of patients diagnosed with chronic obstructive pulmonary disease when adjusting for age, smoking and index of multiple deprivation decile. The same pattern is observed within South Yorkshire Regional, and England National general practice data.

Conclusion
These data suggest that current strategies used for recognising chronic obstructive pulmonary disease are disproportionately missing cases in ethnic minority populations at high risk of chronic obstructive pulmonary disease. Further work is required to confirm this at the level of individual patients.