Skip to main content

Main menu

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Open access
    • COVID-19 submission information
    • Peer reviewer login
  • Alerts
  • Podcasts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Open access
    • COVID-19 submission information
    • Peer reviewer login
  • Alerts
  • Podcasts
  • Subscriptions

Low socioeconomic status and lung function

David C. Taylor-Robinson, Karsten Thielen, Tania Pressler, Hanne V. Olesen, Peter J. Diggle
European Respiratory Journal 2015 45: 857-858; DOI: 10.1183/09031936.00232014
David C. Taylor-Robinson
1Dept of Public Health and Policy, University of Liverpool, Liverpool, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: dctr@liv.ac.uk
Karsten Thielen
2Dept of Social Medicine, University of Copenhagen, Copenhagen, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tania Pressler
3Cystic Fibrosis Center, Rigshospitalet, Copenhagen, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Hanne V. Olesen
4Pediatric Dept A, Cystic Fibrosis Center, Aarhus University Hospital, Aarhus, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Peter J. Diggle
5Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Abstract

Studies should use the Diderichsen approach to unpick the causal chains that link social inequalities and health http://ow.ly/H406C

From the authors:

We thank P.H. Quanjer for his comments regarding our paper, in which we apply a novel modelling approach to lung function data from the unique Danish cystic fibrosis registry and show that low socioeconomic status (SES), as measured by parental education level, is associated with an increased rate of decline of % predicted forced expiratory volume in 1 s in the Danish cystic fibrosis population [1]. We agree that it is important to develop a better understanding of the pathways to social inequalities in cystic fibrosis outcomes.

P.H. Quanjer points out that chest circumference may be an important mediator of the association between SES at birth and later lung function. Malnutrition and poor growth are major concerns in children with cystic fibrosis and optimising nutritional status is clearly important for subsequent lung health. Our analyses have shown social gradients in growth outcomes in children with cystic fibrosis in the UK, evident from around the time of diagnosis [2]. These findings point to important effects of SES in utero or in the initial period prior to diagnosis. Both are plausible, but a limitation of studies thus far has been a lack of data on social gradients in birth weight, which would complete the picture. Further data on SES gradients in birth weight in cystic fibrosis would clarify the extent to which the early growth differentials are simply a reflection of the broader SES effects on birth weight in the general population.

On a related point, height has been independently related to survival in people with cystic fibrosis and it has been suggested that this may be mediated through greater lung capacity in taller people [3]. Furthermore, Fogarty and co-workers [4, 5] have suggested that measures of body habitus may partially explain the male survival advantage in cystic fibrosis. In the UK, SES has an important effect on height from the outset in children with cystic fibrosis and this difference tracks through to adulthood [2]. Further longitudinal analyses are required to understand how inequalities in birth length, and the factors that influence it, may influence chest capacity and lung function in adulthood, and ultimately survival, in cystic fibrosis.

P.H. Quanjer also points to the complex interaction between measures of SES and health over the life-course. The Diderichsen model of pathways to health inequalities has informed our analyses in cystic fibrosis [6, 7]. A key feature of the Diderichsen model is that it incorporates both social causation and social selection mechanisms within a common framework, across the life-course. We encourage further studies that use this approach, in order to better unpick the complex causal chains that link social inequalities and health.

Footnotes

  • Support statement: This work was supported by an MRC Population Health Scientist Fellowship to D.C. Taylor-Robinson (grant G0802448). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding information for this article has been deposited with FundRef.

  • Conflict of interest: Disclosures can be found alongside the online version of this article at erj.ersjournals.com

  • Received December 18, 2014.
  • Accepted December 18, 2014.
  • Copyright ©ERS 2015

References

  1. ↵
    1. Taylor-Robinson DC,
    2. Thielen K,
    3. Pressler T, et al.
    Low socioeconomic status is associated with worse lung function in the Danish cystic fibrosis population. Eur Respir J 2014; 44: 1363–1366.
    OpenUrlFREE Full Text
  2. ↵
    1. Taylor-Robinson D,
    2. Smyth RL,
    3. Diggle P, et al.
    The effect of social deprivation on clinical outcomes and the use of treatments in the UK cystic fibrosis population: a longitudinal study. Lancet Respir Med 2013; 1: 121–128.
    OpenUrlCrossRefPubMed
  3. ↵
    1. Beker LT,
    2. Russek-Cohen E,
    3. Fink RJ
    . Stature as a prognostic factor in cystic fibrosis survival. J Am Diet Assoc 2001; 101: 438–442.
    OpenUrlCrossRefPubMedWeb of Science
  4. ↵
    1. Fogarty AW,
    2. Britton J,
    3. Clayton A, et al.
    Are measures of body habitus associated with mortality in cystic fibrosis? Chest 2012; 142: 712–717.
    OpenUrlCrossRefPubMed
  5. ↵
    1. Fogarty AW,
    2. Lewis SA,
    3. McKeever TM, et al.
    The association of two different measures of body habitus with lung function: a population-based study. Respir Med 2011; 105: 1896–1901.
    OpenUrlCrossRefPubMed
  6. ↵
    1. Diderichsen F,
    2. Evans T,
    3. Whitehead M
    . The social origins of disparities in health. Challenging inequities in health. New York, Oxford University Press, 2001.
  7. ↵
    1. Taylor-Robinson DC,
    2. Smyth R,
    3. Diggle PJ, et al.
    A longitudinal study of the impact of social deprivation and disease severity on employment status in the UK cystic fibrosis population. PLoS One 2013; 8: e73322.
    OpenUrlCrossRefPubMed
View Abstract
PreviousNext
Back to top
View this article with LENS
Vol 45 Issue 3 Table of Contents
European Respiratory Journal: 45 (3)
  • Table of Contents
  • Table of Contents (PDF)
  • About the Cover
  • Index by author
Email

Thank you for your interest in spreading the word on European Respiratory Society .

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Low socioeconomic status and lung function
(Your Name) has sent you a message from European Respiratory Society
(Your Name) thought you would like to see the European Respiratory Society web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Print
Citation Tools
Low socioeconomic status and lung function
David C. Taylor-Robinson, Karsten Thielen, Tania Pressler, Hanne V. Olesen, Peter J. Diggle
European Respiratory Journal Mar 2015, 45 (3) 857-858; DOI: 10.1183/09031936.00232014

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Low socioeconomic status and lung function
David C. Taylor-Robinson, Karsten Thielen, Tania Pressler, Hanne V. Olesen, Peter J. Diggle
European Respiratory Journal Mar 2015, 45 (3) 857-858; DOI: 10.1183/09031936.00232014
del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
Full Text (PDF)

Jump To

  • Article
    • Abstract
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

Subjects

  • Lung structure and function
  • Tweet Widget
  • Facebook Like
  • Google Plus One

More in this TOC Section

Agora

  • Rifapentine access in Europe: concerns over key TB treatment
  • P. aeruginosa membrane vesicles cause endothelial barrier failure
  • Mortality after admission with pneumonia higher than after admission with COPD exacerbation
Show more Agora

Correspondence

  • Extracorporeal life support as a bridge to lung transplantation strategy in anti-MDA5+ rapidly progressive interstitial lung disease is life-saving but with persistent difficulties at the bedside
  • Liver cancer in severe alpha-1 antitrypsin deficiency: Who is at risk?
  • Cancer risk in severe alpha-1-antitrypsin deficiency - the importance of the early identification
Show more Correspondence

Related Articles

Navigate

  • Home
  • Current issue
  • Archive

About the ERJ

  • Journal information
  • Editorial board
  • Reviewers
  • Press
  • Permissions and reprints
  • Advertising

The European Respiratory Society

  • Society home
  • myERS
  • Privacy policy
  • Accessibility

ERS publications

  • European Respiratory Journal
  • ERJ Open Research
  • European Respiratory Review
  • Breathe
  • ERS books online
  • ERS Bookshop

Help

  • Feedback

For authors

  • Instructions for authors
  • Publication ethics and malpractice
  • Submit a manuscript

For readers

  • Alerts
  • Subjects
  • Podcasts
  • RSS

Subscriptions

  • Accessing the ERS publications

Contact us

European Respiratory Society
442 Glossop Road
Sheffield S10 2PX
United Kingdom
Tel: +44 114 2672860
Email: journals@ersnet.org

ISSN

Print ISSN:  0903-1936
Online ISSN: 1399-3003

Copyright © 2022 by the European Respiratory Society