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Socioeconomic status, asthma and chronic bronchitis in a large community-based study

¹ Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research (IMIM), and ³ Dept of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain. ² Centre for Public Health Research, Massey University, Wellington, New Zealand. ⁴ Dept of Respiratory Epidemiology and Public Health, Royal Imperial College London, London, UK. ⁵ Dept of Medical Sciences, Uppsala University, Uppsala, Sweden. ⁶ Dept of Social Medicine, Medical School, University of Crete, Heraklion, Crete, Greece.

CORRESPONDENCE: L. Ellison-Loschmann, Centre for Research in Environmental Epidemiology (CREAL), Municipal Institute of Medical Research (IMIM), 80 Dr Aiguader Rd, Barcelona 08003, Spain. Fax: 34 932216448. E-mail: eellison-loschmann{at}imim.es

Keywords: Asthma, atopy, bronchitis, socioeconomic status

Received: August 3, 2006
Accepted December 17, 2006

The present study investigated the relationship between socioeconomic status, using measures of occupational class and education level, and the prevalence and incidence of asthma (with and without atopy) and chronic bronchitis using data from the European Community Respiratory Health Survey (ECRHS).

Asthma and chronic bronchitis were studied prospectively within the ECRHS (n = 9,023). Incidence analyses comprised subjects with no history of asthma or bronchitis at baseline. Asthma symptoms were also assessed as a continuous score.

Bronchitis risk was associated with low educational level (prevalence odds ratio (POR) 1.9; 95% confidence interval (CI) 1.4–2.8) and occupational class (1.8; 1.2–2.7). Incident bronchitis also increased with low educational level (risk ratio (RR) 2.8; 95%CI 1.5–5.4). Prevalent and incident asthma with no atopy were associated with low educational level. Subjects in the low occupational class (incident risk ratio (IRR) 1.4; 95%CI 1.2–1.7) and education group (IRR 1.3; 95% CI 1.1–1.6) had higher mean asthma scores than those in higher socioeconomic groups.

Lower educational level was associated with increased risk of prevalent and incident chronic bronchitis and asthma with no atopy. Lower socioeconomic groups tended to have a higher prevalence and incidence of asthma, particularly higher mean asthma scores. Adjustment for variables associated with asthma and bronchitis explained little of the observed health differences by socioeconomic status.

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