Children living in England’s most deprived areas are significantly more likely to be hospitalised for respiratory infections than those in wealthier communities, according to new analysis of NHS data, with experts warning that air pollution and poor housing conditions are worsening health inequalities.
The analysis, carried out by the charity Impact on Urban Health using data obtained through freedom of information requests, found that 1,941 children per 100,000 living in the most deprived areas of England were admitted to hospital for respiratory illnesses in 2024-25.
This compared with 1,380 admissions per 100,000 children in the least deprived areas of the country.
The figures show that children in the poorest communities experienced 82% more hospital admissions for respiratory infections in total. After adjusting for population size, the admission rate was around 41% higher than in the wealthiest areas.
The data examined national deprivation quintiles, comparing the 20% most deprived areas in England with the 20% least deprived. Respiratory conditions included acute upper and lower respiratory infections, influenza and pneumonia.
While the figures do not identify the exact causes behind each hospital admission, experts highlighted air pollution as a major contributing factor. Children in deprived communities are often exposed to higher levels of pollution, alongside other risks including poor-quality housing, damp, mould, overcrowding and exposure to second-hand smoke.
“Children growing up in deprived neighbourhoods are often exposed to dirtier air,” said Dr Gergo Baranyi, a senior research fellow at University College London specialising in air pollution.
He added that pollution was only part of a wider problem, with housing conditions, outdated heating systems and indoor air quality also affecting children’s respiratory health.
“These conditions can all harm children’s respiratory health,” he said, adding that the inequalities shown in hospital admission rates were shaped by both environmental exposure and wider social circumstances.
“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 contribute to up to 43,000 deaths annually in the UK. Previous research has also shown that exposure to polluted air can restrict lung development in children and accelerate existing respiratory conditions.
Ben Pearce, who leads a programme examining the health effects of air pollution at Impact on Urban Health, described the figures as “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 warned that air pollution remained one of the biggest environmental threats to respiratory health, increasing the risk of conditions such as asthma and contributing to avoidable hospital admissions among children.
Pearce called for an update to the UK’s Clean Air Act, including legally binding pollution targets aligned with World Health Organization recommendations and greater protection for children and communities facing the highest levels of deprivation.
“No child’s future should be shaped by the postcode they are born into,” he said.
Dr Helena Clements, climate change officer at the Royal College of Paediatrics and Child Health, said air pollution was harming children’s developing lungs and increasing health inequalities from an early age.
“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,” she said.
“Tackling air pollution is essential to giving every child, regardless of their postcode, the healthy start they deserve.”
