Poorest English Children 40% More Likely Hospitalized for Respiratory Infections

Children living in the poorest areas across England are 40% more likely to be admitted to hospital for respiratory infections, an analysis of NHS England data shows, with experts raising the alarm on the impact of air pollution on young people’s health.

The analysis, based on data obtained via freedom of information requests by the charity Impact on Urban Health, revealed 1,941 out of every 100,000 children living in the most deprived fifth of England were admitted to hospital for respiratory illnesses in 2024-25.

The high admission rate contrasted starkly with figures on England’s least deprived area, where 1,380 out of every 100,000 children were admitted to hospital for respiratory illnesses, including acute upper and lower respiratory infections, influenza and pneumonia, that same year.

The groupings were based on national deprivation quintiles, comparing the 20% most deprived areas in England with the 20% least deprived. In absolute terms, the poorest areas registered a total of 82% more hospital admissions for respiratory infections, equivalent to a 41% higher rate when adjusted for population size.

Although the data did not provide an exact cause for these hospital admissions, air pollution was identified as a significant risk factor, with children living in deprived areas exposed to the most extreme levels of toxins and pollutants.

“Children growing up in deprived neighbourhoods are often exposed to dirtier air,” said Dr Gergo Baranyi, a senior research fellow at University College London with a focus on air pollution. “But air pollution is only part of the story. Poor-quality housing, overcrowding, damp and mould, outdated heating systems, indoor air quality and exposure to smoking, are also more common in deprived areas. These conditions can all harm children’s respiratory health.

He added that the “stark” inequalities in admission rates should not come as a surprise. “They are shaped by individual circumstances and environmental exposures where children grow up. Respiratory infections in childhood can have long-lasting consequences on health and wellbeing. Improving air quality and housing conditions can therefore help to protect children’s health and reduce inequalities in the long run.”

Air pollution is estimated to cause up to 43,000 deaths each year in the UK. Studies have previously established how air pollution can slow the lung growth of children and also speed the progression of lung disease.

Ben Pearce, who is heading a programme looking at the health effects of air pollution at Impact on Urban Health, called the figures “shocking” and “appalling”.

“For decades, planning decisions and wider systemic inequalities have meant that many lower-income communities live closer to busy roads, industrial sites and other major sources of air pollution,” Pearce said.

He said air pollution was the biggest environmental threat to respiratory health. “It worsens conditions such as asthma and increases the likelihood that a child will end up needing hospital treatment. It is a serious harm, unequally shared. It is also one the government can act on quickly.”

Peace said the UK’s Clean Air Act needed an overhaul, “with legally binding targets” aligned with World Health Organization guidelines that prioritised “children and communities experiencing the greatest levels of deprivation”.

“No child’s future should be shaped by the postcode they are born into,” he said.

Dr Helena Clements, officer for climate change at the Royal College of Paediatrics and Child Health, said: “Air pollution is damaging children’s developing lungs, driving avoidable illness and hospital admissions, and widening health inequalities from the earliest years and throughout their life course.

“Tackling air pollution is essential to giving every child, regardless of their postcode, the healthy start they deserve.”

The Guardian approached the Department of Health and Social Care for comment.