Socioeconomic status and COPD among low- and middle-income countries

• Autores: Grigsby, Matthew; Siddharthan, Trishul; Chowdhury, Muhammad; Siddiquee, Ali; Rubinstein, Adolfo Luis; Sobrino, Edgardo; Miranda, Jaime J.; Bernabe Ortiz, Antonio; Alam, Dewan; Checkley, William
• Año de publicación: 2016
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: COPD; socioeconomic; status; low- and middle-income country
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

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.
Fil: Grigsby, Matthew. University Johns Hopkins; Estados Unidos
Fil: Siddharthan, Trishul. No especifíca;
Fil: Chowdhury, Muhammad. No especifíca;
Fil: Siddiquee, Ali. No especifíca;
Fil: Rubinstein, Adolfo Luis. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Sobrino, Edgardo. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Miranda, Jaime J.. Universidad Peruana Cayetano Heredia; Perú
Fil: Bernabe Ortiz, Antonio. Universidad Peruana Cayetano Heredia; Perú
Fil: Alam, Dewan. York University; Canadá
Fil: Checkley, William. University Johns Hopkins; Estados Unidos