Introduction Ian P. Sinha1,2, Alice Lee2,3, S. Vittal Katikireddi 4 and Jennifer K. Quint 5 1 Respiratory Medicine, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK. 2 Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK. 3 Alder Hey Children’s Hospital Lab to Life Centre, Innovation Hub, Alder Hey Children’s Centre, Liverpool, UK. 4 MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. 5 National Heart and Lung Institute, Imperial College London, London, UK. Corresponding author: Ian P. Sinha ( @ERSpublications Many forms of respiratory health inequalities exist, across different social groups, health conditions and countries. This ERS Monograph provides an accessible and engaging primer for health professionals and academics on all this and more. Copyright ©ERS 2023. Print ISBN: 978-1-84984-157-3. Online ISBN: 978-1-84984-158-0. Print ISSN: 2312-508X. Online ISSN: 2312-5098. The COVID-19 pandemic brought respiratory health into the global spotlight. People with acute, life-threatening respiratory illness were the face of the pandemic, but the media also reported on health inequalities related to socioeconomic position and race, as well as the risks that come with having chronic respiratory illness. The very factors that influence respiratory health cold and substandard housing, food poverty, air pollution, the tobacco industry, and access to care to name a few are also front-page news and social media hot-topics that are debated and discussed by members of the public, the mainstream media, mass media, healthcare workers, healthcare leaders, policy-makers and politicians alike. It is, however, risky to consider such problems out of context. Health inequalities have been deeply engrained in our societies since long before the pandemic. We need to reflect on what has driven these inequalities, and critically review the approaches that do and do not work, if we are to begin to address them. And that is why we have produced this Monograph. We have brought together leading experts and up-and-coming researchers, in a collection of state-of-the-art articles discussing the drivers and consequences of respiratory inequality. Respiratory disease is inextricably linked to poverty. In the first section of this Monograph, we aim to help the reader understand mechanisms of why this might be the case. It is clear that if people do not live in adequate housing [1], have access to a good diet [2], and breathe clean air [3], then their respiratory health is immediately under threat. For many millions of people around the world, however, this is their reality. Alongside these issues, the first section also considers respiratory inequalities related to sex [4], ethnicity [5] and occupation [6]. In section two we describe some examples of inequalities in respiratory disease. Some of the chapters in this section discuss specific conditions, such as cystic fibrosis [7], lung cancer [8] and asthma [9] others discuss more broad and societal issues, such as antimicrobial resistance [10] and inclusion health [11]. What becomes clear from reading these chapters is that even though diseases have their own particular issues, there are themes common to all. It is here that xi
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