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Area-level socio-economic status and health status among adults with asthma and rhinitis

¹ Dept of Medicine, ² Cardiovascular Research Institute, and ³ Institute for Health Policy Studies, University of California San Francisco, San Francisco, and ⁴ Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA.

CORRESPONDENCE: P. D. Blanc, 350 Parnassus Avenue Suite 609, San Francisco, CA 94117, USA. Fax: 1 4154766426. E-mail: blancp{at}itsa.ucsf.edu

Keywords: Adults, asthma epidemiology, asthma quality of life, asthma with chronic sinusitis, economic aspects of asthma

Received: May 26, 2005
Accepted September 5, 2005

Socio-economic status (SES) may affect health status in airway disease at the individual and area level.

In a cohort of adults with asthma, rhinitis or both conditions, questionnaire-derived individual-level SES and principal components analysis (PCA) of census data for area-level SES factors were used. Regression analysis was utilised to study the associations among individual- and area-level SES for the following four health status measures: severity of asthma scores and the Short Form-12 Physical Component Scale (SF-12 PCS) (n = 404); asthma-specific quality of life (QoL) scores (n = 340); and forced expiratory volume in one second (FEV₁) per cent predicted (n = 218).

PCA yielded a two-factor solution for area-level SES. Factor 1 (lower area-level SES) was significantly associated with poorer SF-12 PCS and worse asthma QoL. These associations remained significant after adding individual-level SES. Factor 1 was also significantly associated with severity of asthma scores, but not after addition of the individual-level SES. Factor 2 (suburban area-level SES) was associated with lower FEV₁ per cent predicted in combined area-level and individual SES models.

In conclusion, area-level socio-economic status is linked to some, but not all, of the studied health status measures after taking into account individual-level socio-economic status.

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