Equity in respiratory health: actionable recommendations for Spain

Abstract

Chronic respiratory diseases are a major public health burden, affecting over 7 million people in Spain and representing the third leading cause of death. Conditions such as chronic obstructive pulmonary disease, asthma, and lung cancer are heavily influenced by social and environmental determinants, including socioeconomic status, air quality, and smoking. Moreover, the increasingly aging Spanish population and persistent urban pollution levels further expand the burden of these diseases. This article underscores the urgent need to address inequities in respiratory healthcare through comprehensive policy action. To this end, we herein propose measures such as strengthening primary care to ensure early diagnosis, enhancing coordination between community pharmacy, primary and hospital care, incorporating specialised roles such as continuity-of-care nurses, prioritising access to cost-effective innovative treatments, promoting healthy environments, and reinforcing anti-smoking initiatives. We also advocate for inclusion of social determinants of health indicators in electronic health records and for development of patient education programmes. Tackling respiratory health disparities requires targeted strategies that involve all healthcare and social stakeholders to optimise resource use and improve the quality of life of patients with respiratory diseases in Spain.