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

¹ Centre for Research in Environmental Epidemiology, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain; and Centre for Public Health Research, Massey University, Wellington, New Zealand
² Centre for Research in Environmental Epidemiology, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain; and Dept of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
³ Centre for Research in Environmental Epidemiology, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
⁴ Centre for Public Health Research, Massey University, Wellington, New Zealand
⁵ Dept of Respiratory Epidemiology & Public Health, Royal Imperial College London, London, England
⁶ Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
⁷ Centre for Research in Environmental Epidemiology, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain; and Dept of Social Medicine, Medical School, University of Crete, Heraklion, Crete

^* To whom correspondence should be addressed. E-mail: eellison-loschmann{at}imim.es.

	Abstract

We 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.

We studied prospectively asthma and chronic bronchitis 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 (POR=1.9; 95%CI 1.4-2.8) and occupational class (POR=1.8; 95%CI 1.2-2.7). Incident bronchitis also increased with low educational level (RR=2.8; 95%CI 1.5-5.4). Prevalent and incident asthma with no atopy was associated with low educational level. Subjects in the low occupational class (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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