Equal Breath
Priority Setting Partnership
Better respiratory health for Black and Mixed Black heritage.
Equal Breath is a national project that brought together people of Black and Mixed Black heritage and healthcare professionals across the UK to identify what respiratory health priorities research should focus on next.
The Priorities
Research shaped by the people it matters to …
Children, young people and adults with lived experience, parents and carers, and healthcare professionals told us which unanswered questions about respiratory health mattered most to them.
Together, they shaped two sets of research priorities:
Adult – Top 10 priorities
Children & Young People – Top 10 Priorities
Why is Equal Breath Needed?
Persistent and avoidable inequalities in respiratory health remain in the UK.
Black children with asthma had around four times the risk of intensive care admission compared with White children. 1
Black adults with asthma had around 2.7 times the risk of intensive care admission compared with White adults. 1
Among people who died with COPD, Black people had nearly twice the odds of having their COPD diagnosis missed during their lifetime. 2
Respiratory health is influenced by much more than what happens in our lungs. Where we live and work, the air we breathe, our socioeconomic circumstances, access to and experiences of healthcare, and wider social and structural inequalities can all play a role.
Yet, Black communities have historically been underrepresented in health research, meaning their experiences and priorities may not always have been reflected in the research that gets done.
Equal Breath was created to help ensure that future respiratory research focuses on the questions that our communities and healthcare professionals believe matter most.
How We Did It
People’s questions became shared priorities
Equal Breath followed the established James Lind Alliance Priority Setting Partnership approach, which uses two consultation surveys and a final priority-setting workshop.
Hundreds of people across the UK shared the questions they wanted respiratory health research to answer. These questions were summarised by our Steering Group, checked against existing evidence and then prioritised by people with lived experience and healthcare professionals.
Find out more about the JLA Process.
Young people helped shape the process and the priorities
A Young People’s Advisory Group (YPAG) reviewed the wording and questions for both surveys, helping make them clear and appropriate for children and young people.
Children and young people also participated directly, sharing their own questions and experiences in Survey 1 and prioritising the unanswered questions in Survey 2.
Equal Breath at a glance
people shared their questions
381 (Adult survey) + 56 (CYP survey)
questions and insights shared
and Evidence checked
unanswered research questions identified
people voted on the most important questions
284 (Adult survey) + 40 (CYP survey)
Adult + Children and Young People
Built With Communities
Built with us, for us
Community involvement was at the heart of Equal Breath.
We worked with community organisations, champions and networks across the UK to go beyond traditional online recruitment and meet people in trusted community spaces.
Our community partners brought local knowledge, relationships and valuable insight. Their involvement made Equal Breath more accessible and inclusive, helping us reach people whose voices are too often missing from health research.
From Priorities to Action
The Top 10s are just the beginning.
We want the Equal Breath priorities to help shape:
Research
Funding programmes
Healthcare Improvement
Policy
Community-Led Action
Education
Resources
The research behind Equal Breath
Explore our methodology, publications, data and resources, including the peer-reviewed Equal Breath Priority Setting Partnership protocol.
Funding, Leadership and Support
Who funded and supported Equal Breath?
Equal Breath was initiated through the Medical Research Council Black in Biomedical Research Advisory Group (MRC BBRAG) and funded by the Medical Research Council (MRC).
The Priority Setting Partnership was jointly led by MRC BBRAG and Asthma + Lung UK.
Equal Breath Priority Setting Partnership was supported and chaired by an independent James Lind Alliance Adviser.
References
1. Asthma- related intensive care admissions
Simms-Williams N, Nagakumar P, Thayakaran R, et al. Risk factors for asthma-related hospital and intensive care admissions in children, adolescents and adults: a cohort study using primary and secondary care data. BMJ Open Respiratory Research. 2024;11.
Black children aged 5–11 had an incidence rate ratio of 4.07 (95% CI 2.35–7.05) for asthma-related intensive care admission compared with White children.
2. Missed COPD diagnosis
Are we missing lifetime COPD diagnosis among people with COPD recorded death? A population-based retrospective cohort study.
Among people whose death records mentioned COPD, Black ethnicity was associated with 1.87 times the adjusted odds of COPD having been missed during life compared with White ethnicity (OR 1.87, 95% CI 1.37–2.54).