Asthma

Key points

• Recorded asthma prevalence in Camden is stable and slightly below the NCL ICB and London averages.

• Camden’s under-19 asthma-related emergency admission rate has consistently been similar to that of NCL ICB and rarely significantly different from that of London.

• While there is no evidence of a trend in emergency admissions by IMD quintile, there is a stronger association between a higher deprivation quintile and the rate of emergency department attendances.

• The prevalence of certain risk factors has reduced over time in Camden, including smoking among residents aged over 14, air pollution and fuel poverty.

Introduction

Asthma is a long-term respiratory condition caused by a combination of genetic, antenatal and environmental factors. It is characterised by inflammation and narrowing of the airways, leading to symptoms such as wheezing, breathlessness, chest tightness, and coughing. Asthma can vary in severity and may be triggered by allergens, air pollution, respiratory infections, or physical activity.

The UK has some of the highest prevalence, emergency admissions and death rates for childhood asthma in Europe. Around 1 in 10 UK children has asthma, and every 20 minutes, a child is admitted to a UK hospital because of an asthma attack.[1] Early exposure to tobacco smoke, air pollution, poor housing conditions, and respiratory infections during infancy increases the risk of developing asthma, so prevention must start early.

The strategic vision for asthma in Camden is a system that:

• Improves early diagnosis of asthma

• Improves outcomes for those with asthma including reducing episodes of acute exacerbation of asthma [2]

• Reduces risk factors both clinical and related to wider determinants

Asthma Prevalence (6+ years)

Asthma prevalence in Camden in 2024/25 was 3.98%, significantly lower than the estimate of 4.51% for North Central London (NCL) ICB, and below most other inner London boroughs. The prevalence estimates across the three higher-level geographies have remained fairly consistent over the last five years.

Although recorded asthma prevalence in Camden appears lower than in many other boroughs, this does not necessarily reflect a lower true prevalence and so should be interpreted with caution. Camden has historically had limited access to children and young people’s (CYP) respiratory diagnostic services, which may have contributed to under-diagnosis and artificially lower prevalence estimates.

A borough-wide CYP respiratory diagnostic service for children aged 6 and over was recently established. Alongside ongoing work to address the backlog of objective asthma testing, recorded prevalence may rise in future years, as a reflection of improved diagnostic processes rather than a true change in asthma prevalence.

Comparison - Higher Geographies

Comparison - Inner-London Boroughs

Ward-level Prevalence (6+ years)

Residents registered with a GP in the East Neighbourhood (Kentish Town North, Camden Square, Gospel Oak and Haverstock), had some of the highest asthma prevalence at 4.9%, 4.9%, 5.1% and 5.5%, respectively. This is consistent with the East Neighbourhood’s poorer health outcomes on other indicators such as adult obesity, alcohol dependence and smoking prevalence. Highgate, in the North Neighbourhood, has a similarly high prevalence at 5.3%. This is consistent with its broader health profile, which is more similar to the East Neighbourhood than to the other north wards, with high levels of alcohol dependence, depression and hypertension.

Although King’s Cross is a relatively deprived area, it has a low level of asthma prevalence at 2.8%.

Chart

Note

People with asthma are counted in a ward if they are registered with a GP based in this ward. This is not based on resident postcode data.

Map

Note

Quintiles are calculated within Camden only. All Camden wards are ranked by prevalence; then the ranked list is split into five (roughly) equal-sized groups (“quintiles”). Colours therefore show how a ward compares to other wards in Camden, not across the whole of England.

Asthma-related Emergency Admissions (0-18 years)

Over time

Following the pandemic, when asthma-related admissions dropped suddenly, rates across all three geographies have shown a steady rise, but have not yet returned to pre-pandemic levels. The leading theory for reduction in rates during the pandemic is reduced exposure to respiratory viruses which are common triggers of asthma exacerbations.[3]

The count of asthma-related admissions for Camden is fairly small, ranging from 35 in 2020/21 and 2022/23, to 80 in 2014/15, 2015/16 and 2017/18. Consequently, the confidence intervals are very large, meaning we cannot confidently conclude that the Camden rates are significantly lower than London rates.

Sex & Age

During childhood, asthma is more prevalent in boys; however, in adulthood, women exhibit both higher prevalence and greater severity. [4]

In Camden, fewer than five girls under the age of 8 were admitted to hospital for asthma in 2024/25. However, between the ages of 10 and 18, admission rates for both boys and girls were much more similar. Across all under 18 admissions, boys had a higher admission rates than girls.

Note

All counts and rates in the tooltip are rounded to the nearest 5.

Ethnicity

Note

Counts below 7 have been suppressed and all counts and rates have been rounded to the nearest 5.

The ‘Other Ethnic Group’ ethnic group observed the highest admissions rate at 211.34 admissions per 100,000. The ‘Mixed/Multiple’ ethnic group observed the lowest admissions rate at 49.12 admissions per 100,000.

Statistically significant differences were found between the following Ethnic Groups:

• ‘Asian’ and ‘Mixed/Multiple’
• ‘Asian’ and ‘White’
• ‘Black’ and ‘Mixed/Multiple’
• ‘Black’ and ‘White’
• ‘Mixed/Multiple’ and ‘Other Ethnic Group’
• ‘Other Ethnic Group’ and ‘White’

Index of Multiple Deprivation

Note

Counts below 7 have been suppressed and all counts and rates have been rounded to the nearest 5.

Quintile ‘Q2’ had the highest admission rate at 225.88 admissions per 100,000. Quintile ‘Q5 - Least deprived’ had the lowest admission rate at 76.37 admissions per 100,000.

Statistically significant differences were found between the following quintiles:

• Q2 and Q5 - Least deprived

Asthma-related Emergency Department Attendance (0-18 years)

Ethnicity

Note

Counts below 7 have been suppressed and all counts and rates have been rounded to the nearest 5.

The ‘Other Ethnic Group’ ethnic group observed the highest attendance rate at 619.94 attendances per 100,000. The ‘Mixed/Multiple’ ethnic group observed the lowest attendance rate at 185.15 attendances per 100,000.

Statistically significant differences were found between the following Ethnic Groups:

• ‘Asian’ and ‘Mixed/Multiple’
• ‘Asian’ and ‘Other Ethnic Group’
• ‘Asian’ and ‘White’
• ‘Black’ and ‘Mixed/Multiple’
• ‘Black’ and ‘Other Ethnic Group’
• ‘Black’ and ‘White’
• ‘Mixed/Multiple’ and ‘Other Ethnic Group’
• ‘Other Ethnic Group’ and ‘White’

Index of Multiple Deprivation

Note

Counts below 7 have been suppressed and all counts and rates have been rounded to the nearest 5.

Quintile ‘Q1 - Most deprived’ had the highest attendance rate at 465.78 attendances per 100,000. Quintile ‘Q5 - Least deprived’ had the lowest attendance rate at 149.07 attendances per 100,000.

Statistically significant differences were found between the following quintiles:

• Q1 - Most deprived and Q3
• Q1 - Most deprived and Q4
• Q1 - Most deprived and Q5 - Least deprived
• Q2 and Q3
• Q2 and Q4
• Q2 and Q5 - Least deprived
• Q3 and Q5 - Least deprived

Risk Factors

Smoking

In 2023/24, 82% of children and young people (CYP) with asthma in NCL ICB either smoked or were exposed to second-hand smoke, the same value as for London.[5] This is compared to 79% of CYP across the whole of England.[5]

Camden smoking prevalence has followed a similar trend to London and NCL ICB in falling consistently since 2013/14, reaching a low of 13.72% in 2022/23. Smoking prevalence in Camden is slightly lower than in London as a whole and even lower than in the NCL ICB.

Ward-level Smoking Prevalence

Residents registered with a GP in the East Neighbourhood (Kentish Town North, Camden Square, Camden Town and Haverstock) were in the top 20% of wards for smoking prevalence. In the West, Kilburn and West Hampstead had the highest and fourth-highest smoking prevalence at 18.9% and 17.5% respectively.

Chart

Note

People with asthma are counted in a ward if they are registered with a GP based in this ward. This is not based on resident postcode data.

Map

Note

People with asthma are counted in a ward if they are registered with a GP based in this ward. This is not based on resident postcode data.

Quintiles are calculated within Camden only. All Camden wards are ranked by prevalence; then the ranked list is split into five (roughly) equal-sized groups (“quintiles”). Colours therefore show how a ward compares to other wards in Camden, not across the whole of England.

Smoking at Delivery

Smoking at delivery records the smoking status of the mother when she gives birth. It is used as the measure, for England, of the proportion of maternities where the mother was known be a smoker at the time of delivery. Smoking during pregnancy is associated with asthma via three mechanisms:[6]

1. Nicotine stymies foetal lung development
2. Effect on later immune functioning - increased infection rate
3. Epigenetic (transgenerational) effects

In 2024/25, the proportion of Camden mothers delivering a baby who smoked was estimated at 4.3%.

The Camden smoking prevalence at time of delivery appeared to drop suddenly in 2014/15 to 3.98% (below the NCL ICB and London averages), and rise again in 2020/21 to 5.3, a level similar to the NCL ICB and at least as high as the London average. The reasons for this sudden decrease and subsequent sudden increase are unclear, though it should be noted that this indicator is based on observation and therefore susceptible to measurement bias.

Air Pollution

Exposure to both indoor and outdoor air pollution is linked to an increased risk of asthma development and exacerbation. [7]

Air quality has improved significantly in London in recent years thanks to programmes such as ULEZ, cleaner taxi and bus fleets, programmes to encourage cycling and electric vehicle usage, funding for London boroughs’ projects through the Mayor’s Air Quality Fund.[8]

Between 2016 and 2023, annual average roadside concentrations of NO2 dropped by 49%, compared to 35% in the rest of England. Preliminary evidence suggests 2023 was the lowest ever recorded year for NO2 concentrations. In 2016, 56 (around one third) of London’s monitoring sites exceeded the legal limit for NO2, compared to just 5 in 2023. For PM2.5, 2023 was the first year concentrations did not exceed the interim WHO air quality target.[8]

Currently, borough-level estimates of air pollution are available only for PM2.5, not for NO2. Defra estimates of PM2.5 concentrations in Camden have decreased substantially in the last 6 years, from 12.51µg/m³ in 2018, to 9.55µg/m³ in 2024. Nevertheless, the concentration remains above the estimate for London - a gap which has widened since 2020.

Fuel Poverty

For England, the government uses the Low Income Low Energy Efficiency (LILEE) definition of fuel poverty. Under the LILEE definition, a household is considered to be fuel poor if it meets both of the following criteria:

• The property has an energy efficiency rating of band D or lower; and
• After spending the amount needed to adequately heat their home, the household’s remaining income falls below the official poverty threshold.[9]

If a household is in fuel poverty, their home is more likely to be cold. To keep heat in, windows and doors remain closed in cold homes, with this poor ventilation causing damp, mould and a proliferation of house dust mites.[10] This increases the risk of developing asthma and experiencing an acute asthma attack.[11]

Across England, lone-parent families have the highest prevalence of fuel poverty: 24.7% in 2024. 34.5% of all fuel poor households had one or more dependent children.[12]

In 2023, 8.6% of Camden households were in fuel poverty, 2.8 percentage points lower than the average of 11.4% for England.

The map below visualises relative rankings of fuel poverty prevalence by LSOA. Wards with the highest prevalence of fuel poverty were King’s Cross, St Pancras and Somers Town, and Bloomsbury - all in the South of the borough. There are also pockets of top-quintile fuel poverty across Central and West.

Note

Quintiles are calculated within Camden only. All Camden wards are ranked by prevalence; then the ranked list is split into five equally-sized groups (“quintiles”). Colours therefore show how a ward compares to other wards in Camden, not across the whole of England.

Appendix - Neighbourhood and Ward Overview

This appendix provides a high‑level overview of neighbourhood and ward‑level patterns across a range of measures, offering a quick comparison against the borough‑wide position (Camden Total).

NoteInterpreting colours in the tables

The colours show a within‑row gradient from lowest to highest:

light blue → dark blue
= lowest → highest values within that measure (row)

red → peach → teal
= worst → best values within that measure (row)

This gradient helps to show relative positioning between neighbourhoods or between wards. It does not correspond to statistical significance.

Camden Neighbourhoods

Camden Neighbourhoods Overview

View cell colour legend

For rows where the comparison column retains its grey background, the statistical significance of the difference between its value and the values in other cells within the same row has been assessed. The colours must be interpreted as follows:

For rows where the comparison column has a different background colour, the gradients should be interpreted as follows:
      = Lowest to Highest within each row
      = Worst to Best within each row (continuum)

North Neighbourhood

North Neighbourhood Overview

View cell colour legend

For rows where the comparison column retains its grey background, the statistical significance of the difference between its value and the values in other cells within the same row has been assessed. The colours must be interpreted as follows:

For rows where the comparison column has a different background colour, the gradients should be interpreted as follows:
      = Lowest to Highest within each row
      = Worst to Best within each row (continuum)

East Neighbourhood

East Neighbourhood Overview

View cell colour legend

For rows where the comparison column retains its grey background, the statistical significance of the difference between its value and the values in other cells within the same row has been assessed. The colours must be interpreted as follows:

For rows where the comparison column has a different background colour, the gradients should be interpreted as follows:
      = Lowest to Highest within each row
      = Worst to Best within each row (continuum)

Central Neighbourhood

Central Neighbourhood Overview

View cell colour legend

For rows where the comparison column retains its grey background, the statistical significance of the difference between its value and the values in other cells within the same row has been assessed. The colours must be interpreted as follows:

For rows where the comparison column has a different background colour, the gradients should be interpreted as follows:
      = Lowest to Highest within each row
      = Worst to Best within each row (continuum)

South Neighbourhood

South Neighbourhood Overview

View cell colour legend

For rows where the comparison column retains its grey background, the statistical significance of the difference between its value and the values in other cells within the same row has been assessed. The colours must be interpreted as follows:

For rows where the comparison column has a different background colour, the gradients should be interpreted as follows:
      = Lowest to Highest within each row
      = Worst to Best within each row (continuum)

West Neighbourhood

West Neighbourhood Overview

View cell colour legend

For rows where the comparison column retains its grey background, the statistical significance of the difference between its value and the values in other cells within the same row has been assessed. The colours must be interpreted as follows:

For rows where the comparison column has a different background colour, the gradients should be interpreted as follows:
      = Lowest to Highest within each row
      = Worst to Best within each row (continuum)

References

[1]

England N. NHS England » National bundle of care for children and young people with asthma 2021. https://www.england.nhs.uk/publication/national-bundle-of-care-for-children-and-young-people-with-asthma/ (accessed July 7, 2025).

[2]

Scenario: Acute exacerbation of asthma | Management | Asthma | CKS | NICE n.d. https://cks.nice.org.uk/topics/asthma/management/acute-exacerbation-of-asthma/ (accessed March 16, 2026).

[3]

Shah SA, Quint JK, Sheikh A. Impact of COVID-19 pandemic on asthma exacerbations: Retrospective cohort study of over 500,000 patients in a national English primary care database. The Lancet Regional Health – Europe 2022;19. https://doi.org/10.1016/j.lanepe.2022.100428.

[4]

Chowdhury NU, Guntur VP, Newcomb DC, Wechsler ME. Sex and gender in asthma. Eur Respir Rev 2021;30:210067. https://doi.org/10.1183/16000617.0067-2021.

[5]

Digital N. Quality and Outcomes Framework, 2023-24 n.d. https://digital.nhs.uk/data-and-information/publications/statistical/quality-and-outcomes-framework-achievement-prevalence-and-exceptions-data/2023-24 (accessed July 7, 2025).

[6]

Zacharasiewicz A. Maternal smoking in pregnancy and its influence on childhood asthma. ERJ Open Res 2016;2:00042–2016. https://doi.org/10.1183/23120541.00042-2016.

[7]

Zhou X, Sampath V, Nadeau KC. Effect of air pollution on asthma. Annals of Allergy, Asthma & Immunology 2024;132:426–32. https://doi.org/10.1016/j.anai.2024.01.017.

[8]

(GLA) GLA. Air Quality in London 2016-2024 | London City Hall 2024. https://www.london.gov.uk/programmes-strategies/environment-and-climate-change/environment-and-climate-change-publications/air-quality-london-2016-2024 (accessed July 7, 2025).

[9]

(NEA) NEA. What is fuel poverty? n.d. https://www.nea.org.uk/what-is-fuel-poverty/ (accessed July 7, 2025).

[10]

Barrett C, Lee AR, Abrams EM, Mayell SJ, Hawcutt DB, Sinha IP. Eat or heat: Fuel poverty and childhood respiratory health. The Lancet Respiratory Medicine 2022;10:229. https://doi.org/10.1016/S2213-2600(21)00584-1.

[11]

Gray-French M, Fernandes RM, Sinha IP, Abrams EM. Allergen Management in Children with Type 2-High Asthma. J Asthma Allergy 2022;15:381–94. https://doi.org/10.2147/JAA.S276994.

[12]

Energy Security and Net Zero D for. Annual fuel poverty statistics report: 2025 n.d. https://www.gov.uk/government/statistics/annual-fuel-poverty-statistics-report-2025 (accessed July 7, 2025).