RT Journal Article
SR Electronic
T1 The association between chronic airflow obstruction and poverty in 12 sites of the multinational BOLD study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1601880
DO 10.1183/13993003.01880-2016
VO 49
IS 6
A1 Townend, John
A1 Minelli, Cosetta
A1 Mortimer, Kevin
A1 Obaseki, Daniel O.
A1 Al Ghobain, Mohammed
A1 Cherkaski, Hamid
A1 Denguezli, Myriam
A1 Gunesekera, Kirthi
A1 Hafizi, Hasan
A1 Koul, Parvaiz A.
A1 Loh, Li C.
A1 Nejjari, Chakib
A1 Patel, Jaymini
A1 Sooronbayev, Talant
A1 Buist, Sonia A.
A1 Burney, Peter G.J.
YR 2017
UL http://erj.ersjournals.com/content/49/6/1601880.abstract
AB Poverty is strongly associated with mortality from COPD, but little is known of its relation to airflow obstruction.In a cross-sectional study of adults aged ≥40 years from 12 sites (N=9255), participating in the Burden of Obstructive Lung Disease (BOLD) study, poverty was evaluated using a wealth score (0–10) based on household assets. Obstruction, measured as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) (%) after administration of 200 μg salbutamol, and prevalence of FEV1/FVC<lower limit of normal were tested for association with poverty for each site, and the results were combined by meta-analysis.Mean wealth scores ranged from 4 in Blantyre (Malawi) and Kashmir (India) to 10 in Riyadh (Saudi Arabia), and the prevalence of obstruction, from 16% in Kashmir to 3% in Riyadh and Penang (Malaysia). Following adjustments for age and sex, FEV1/FVC increased by 0.36% (absolute change) (95%CI: 0.22, 0.49; p<0.001) per unit increase in wealth score. Adjustments for other confounders reduced this effect to 0.23% (0.11, 0.34), but even this value remained highly significant (p<0.001). Results were consistent across sites (I2=1%; phet=0.44). Mean wealth scores explained 38% of the variation in mean FEV1/FVC between sites (r2=0.385, p=0.031).Airflow obstruction is consistently associated with poverty at individual and community levels across several countries.Poverty is a strong predictor of chronic airflow obstruction independent of age, sex, smoking and tuberculosis http://ow.ly/T2Sz30bdUNC