Abstract
Background Lung function is an important predictor of health and a marker of physical functioning at older ages. This study aimed to quantify the years of lung function lost according to disadvantaged socioeconomic conditions across the life-course.
Methods This multicohort study used harmonised individual-level data from six European cohorts with information on life-course socioeconomic disadvantage and lung function assessed by forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). 70 496 participants (51% female) aged 18–93 years were included. Socioeconomic disadvantage was measured in early life (low paternal occupational position), early adulthood (low educational level) and adulthood (low occupational position). Risk factors for poor lung function (e.g. smoking, obesity, sedentary behaviour, cardiovascular and respiratory diseases) were included as potential mediators. The years of lung function lost due to socioeconomic disadvantage were computed at each life stage.
Results Socioeconomic disadvantage during the life-course was associated with a lower FEV1. By the age of 45 years, individuals experiencing disadvantaged socioeconomic conditions had lost 4–5 years of healthy lung function versus their more advantaged counterparts (low educational level −4.36 (95% CI −7.33–−2.37) for males and −5.14 (−10.32–−2.71) for females; low occupational position −5.62 (−7.98–−4.90) for males and −4.32 (−13.31–−2.27) for females), after accounting for the risk factors for lung function. By the ages of 65 years and 85 years, the years of lung function lost due to socioeconomic disadvantage decreased by 2–4 years, depending on the socioeconomic indicator. Sensitivity analysis using FVC yielded similar results to those using FEV1.
Conclusion Life-course socioeconomic disadvantage is associated with lower lung function and predicts a significant number of years of lung function loss in adulthood and at older ages.
Abstract
This multicohort study of 70 496 individuals from four European countries shows that life-course socioeconomic disadvantage is associated with a lower lung function and is an important predictor of years of lung function loss during adulthood and older ages https://bit.ly/3huxpOX
Footnotes
Author contributions: V. Rocha, S. Fraga and S. Stringhini conceived the study. V. Rocha wrote the first and successive drafts of the manuscript. C. Moreira, V. Rocha and C. Carmeli modelled and analysed the data. A. Lenoir, A. Steptoe, G. Giles, M. Goldberg, M. Zins, M. Kivimaki, P. Vineis, P. Vollenweider and H. Barros collected the data. All authors revised the manuscript for important intellectual content.
The members of the LIFEPATH Consortium (in alphabetical order): Jan Alberts, Harri Alenius, Mauricio Avendano, Laura Baglietto, Valeria Baltar, Henrique Barros, Mel Bartley, Michele Bellone, Eloise Berger, David Blane, Murielle Bochud, Giulia Candiani, Cristian Carmeli, Luca Carra, Raphaele Castagne, Marc Chadeau-Hyam, Sergio Cima, Giuseppe Costa, Emilie Courtin, Cyrille Delpierre, Angelo D'Errico, Angela Donkin, Pierre-Antoine Dugue, Paul Elliott, Guy Fagherazzi, Giovanni Fiorito, Silvia Fraga, Martina Gandini, Valérie Gares, Pascale Gerbouin-Rerolle, Graham Giles, Marcel Goldberg, Dario Greco, Allison Hodge, Maryam Karimi, Piia Karisola, Michelle Kelly-Irving, Mika Kivimaki, Jessica Laine, Thierry Lang, Audrey Laurent, Richard Layte, Benoit Lepage, Dori Lorsch, Giles Machell, Johan Mackenbach, Michael Marmot, Cathal McCrory, Carlos de Mestral, Cynthia Miller, Roger Milne, Peter Muennig, Wilma Nusselder, Dusan Petrovic, Lourdes Pilapil, Silvia Polidoro, Martin Preisig, Ana Isabel Ribeiro, Fulvio Ricceri, Paolo Recalcati, Erica Reinhard, Oliver Robinson, Jose Rubio Valverde, Severine Saba, Frank Santegoets, Gianluca Severi, Terrence Simmons, Silvia Stringhini, Adam Tabak, Vesa Terhi, Joannie Tieulent, Salvatore Vaccarella, Federica Vigna-Taglianti, Paolo Vineis, Peter Vollenweider, Marie Zins.
This article has an editorial commentary: https://doi.org/10.1183/13993003.04025-2020
This article has supplementary material available from erj.ersjournals.com
Conflict of interest: V. Rocha reports grants from Fundação para a Ciência e Tecnologia, during the conduct of the study.
Conflict of interest: S. Fraga reports grants from Fundação para a Ciência e Tecnologia, during the conduct of the study.
Conflict of interest: C. Moreira has nothing to disclose.
Conflict of interest: C. Carmeli has nothing to disclose.
Conflict of interest: A. Lenoir has nothing to disclose.
Conflict of interest: A. Steptoe has nothing to disclose.
Conflict of interest: G. Giles has nothing to disclose.
Conflict of interest: M. Goldberg has nothing to disclose.
Conflict of interest: M. Zins has nothing to disclose.
Conflict of interest: M. Kivimäki reports grants from Medical Research Council, US National Institute on Aging, NordForsk, the Academy of Finland and Helsinki Institute of Life Science, during the conduct of the study.
Conflict of interest: P. Vineis has nothing to disclose.
Conflict of interest: P. Vollenweider has nothing to disclose.
Conflict of interest: H. Barros has nothing to disclose.
Conflict of interest: S. Stringhini reports grants from University of Lausanne, during the conduct of the study.
Support statement: This work was supported by European regional development fund through the Operational Programme Competitiveness and Internationalisation and national funding from the Foundation for Science and Technology (FCT; Portuguese Ministry of Science, Technology and Higher Education) under the EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal (POCI-01-0145-FEDER-006862; reference: UID/DTP/04750/2019). It is also supported by the European Commission (Horizon 2020 grant number 633666), PhD grant SFRH/BD/103726/2014 (V. Rocha) co-funded by FCT and the POCH/FSE Program, FCT contract CEECIND/01516/2017/CP1406/CT0001 (S. Fraga), and by the University of Lausanne (Pro-Femmes grant, S. Stringhini). M. Kivimaki was supported by the Medical Research Council (K013351, R024227), the US National Institute on Aging (R01AG056477), NordForsk, the Academy of Finland (311492), and Helsinki Institute of Life Science during the conduct of the study. The CoLaus|PsyCoLaus study is supported by research grants from GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, and the Swiss National Science Foundation (grants 3200B0_105993, 3200B0_118308, 33CSCO_122661, 33CS30_139468 and 33CS30_14840). The Constances cohort is supported by the Caisse nationale d'assurance maladie and by a grant from the Agence nationale de la recherche (ANR-11-INBS-0002). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received May 5, 2020.
- Accepted September 10, 2020.
- Copyright ©ERS 2021
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