Dortmund – In Westphalia-Lippe, the number of cases treated for the chronic lung disease bronchial asthma decreased significantly in 2021. This is shown by a current evaluation by the Scientific Institute of the AOK (WIdO) on the occasion of World Asthma Day on May 2nd. According to this, a total of 368,200 people in Westphalia-Lippe were suffering from bronchial asthma in 2021. In the previous year, 393,200 people were being treated with medication for asthma. “We assume that this development may be due to the significant decline in respiratory infections during the pandemic years,” says Tom Ackermann, AOK CEO. It is striking that there are clear differences between the regions in Westphalia-Lippe.
Nationwide, the proportion of asthmatics in the total population in Westphalia-Lippe was 4.46 percent. Particularly high asthma prevalences were achieved in Hagen (5.46 percent) and Gelsenkirchen (5.43 percent), particularly low in Münster (3.35 percent) and in the Minden-Lübbecke district (3.66 percent). Compared to the other federal states, Westphalia-Lippe is above the national average of 3.98 percent.
Asthma diseases can occur as a result of infections of the lower respiratory tract. The incidence of these infectious diseases was significantly reduced during the 2020 and 2021 pandemic years. The decline in lower respiratory tract infections during the pandemic years could have led to fewer new cases of asthma as a result. That could explain the decline in prevalence in 2021. “It remains to be seen how the further development will proceed – especially in view of the respiratory diseases that will occur more frequently again from 2022,” says Ackermann.
Significant differences by age and gender
The current evaluation makes clear gender differences transparent: In childhood and adolescence, the frequency of asthma in boys is significantly higher than in girls, whereas in adulthood women are affected much more frequently than men. The peak prevalence is 8.26 percent in women aged 70 to 74 and 5.21 percent in men aged 75 to 79. “The fact that boys are more affected probably has anatomical reasons and can be explained by the narrower bronchi. This makes it easier for the airways to narrow, as is the case with bronchial asthma. In adulthood, the diameter of the bronchi is larger in men than in women, which explains the reversal of gender ratios,” says Ackermann. Other reasons for the gender differences could also be hormonal influences or gender-specific differences in contact with asthma-triggering substances.
Association between asthma and obesity
The evaluations also confirm a connection that is already known from other studies: in regions with a high proportion of people who are morbidly overweight (adiposity), the number of asthmatics is also increased. The regions with the highest proportion of obesity also show the highest frequency of asthma. Most districts and urban districts can be assigned to the categories with an above-average incidence of obesity. The lowest is only in Münster. Hagen, Gelsenkirchen, Bottrop, Herne and Hamm belong to the highest category. “Various studies have shown that weight reduction in severely overweight asthma patients can help improve disease control. Losing weight is also recommended for these patients in the national health care guidelines so that the asthma symptoms improve,” explains Ackermann.
The causes of bronchial asthma are complex
The causes for the development of bronchial asthma are complex and not fully clarified according to the current state of science. Nevertheless, one thing is certain: the development of asthma is a multicausal process. In addition to exogenous factors (environmental factors), genetic dispositions are also involved. The course of an asthma disease can be influenced by climate changes and psychological factors. The main risk factors include the presence of an allergic disease such as hay fever or an allergy to animal dander or house dust mites. But chemical irritants and tobacco use are also part of it. Nothing can be changed about a genetic disposition. This is different with overweight, obesity and tobacco smoke. Lifestyle changes such as not smoking, sufficient exercise, healthy nutrition and losing excess weight can help to significantly reduce the risk of developing asthma.
Special prevention programs help
The AOK NordWest helps its policyholders with special offers as part of their ‘Healthy Living’ course program. The offers are exclusive and free of charge for people with AOK insurance and are carried out on site or as live online offers on the Internet by qualified specialists. “We can only combat asthma effectively if we succeed in protecting people from the onset of the disease, preventing the risk factors and strengthening their own health literacy,” says Ackermann.
Tailor-made supply offers
In addition, the AOK NordWest has been committed to better and more structured medical care for asthma patients in Westphalia-Lippe for years. For example, the disease management program (DMP) ‘AOK-Curaplan’ for asthma patients has been an integral part of care for over ten years. More than 26,000 AOK policyholders in Westphalia-Lippe have currently opted for this program.