Title
Socioeconomic status and COPD among low-and middle-income countries
Date Issued
05 October 2016
Access level
open access
Resource Type
journal article
Author(s)
Grigsby M.
Siddharthan T.
Chowdhury M.A.H.
Siddiquee A.
Rubinstein A.
Sobrino E.
Alam D.
Checkley W.
Publisher(s)
Dove Medical Press Ltd.
Abstract
Background: Socioeconomic status (SES) is a strong social determinant of health. There remains a limited understanding of the association between SES and COPD prevalence among low-and middle-income countries where the majority of COPD-related morbidity and mortality occurs. We examined the association between SES and COPD prevalence using data collected in Argentina, Bangladesh, Chile, Peru, and Uruguay. Methods: We compiled lung function, demographic, and SES data from three population-based studies for 11,042 participants aged 35-95 years. We used multivariable alternating logistic regressions to study the association between COPD prevalence and SES indicators adjusted for age, sex, self-reported daily smoking, and biomass fuel smoke exposure. Principal component analysis was performed on monthly household income, household size, and education to create a composite SES index. Results: Overall COPD prevalence was 9.2%, ranging from 1.7% to 15.4% across sites. The adjusted odds ratio of having COPD was lower for people who completed secondary school (odds ratio [OR] =0.73, 95% CI 0.55-0.98) and lower with higher monthly household income (OR =0.96 per category, 95% CI 0.93-0.99). When combining SES factors into a composite index, we found that the odds of having COPD was greater with lower SES (interquartile OR =1.23, 95% CI 1.05-1.43) even after controlling for subject-specific factors and environmental exposures. Conclusion: In this analysis of multiple population-based studies, lower education, lower household income, and lower composite SES index were associated with COPD. Since household income may be underestimated in population studies, adding household size and education into a composite index may provide a better surrogate for SES.
Start page
2497
End page
2507
Volume
11
Issue
1
Language
English
OCDE Knowledge area
Sistema respiratorio
Ciencias socio biomédicas (planificación familiar, salud sexual, efectos políticos y sociales de la investigación biomédica)
Subjects
Scopus EID
2-s2.0-84991720954
PubMed ID
Source
International Journal of COPD
ISSN of the container
11769106
Sources of information:
Directorio de Producción Científica
Scopus