Socioeconomic status, race and COPD health outcomes
- 23 October 2009
- journal article
- research article
- Published by BMJ in Journal of Epidemiology and Community Health
- Vol. 65 (1), 26-34
- https://doi.org/10.1136/jech.2009.089722
Abstract
Background Although chronic obstructive pulmonary disease (COPD) is a common cause of death and disability, little is known about the effects of socioeconomic status (SES) and race–ethnicity on health outcomes. Methods The aim of this study is to determine the independent impacts of SES and race–ethnicity on COPD severity status, functional limitations and acute exacerbations of COPD among patients with access to healthcare. Data were used from the Function, Living, Outcomes and Work cohort study of 1202 Kaiser Permanente Northern California Medical Care Plan members with COPD. Results Lower educational attainment and household income were consistently related to greater disease severity, poorer lung function and greater physical functional limitations in cross-sectional analysis. Black race was associated with greater COPD severity, but these differences were no longer apparent after controlling for SES variables and other covariates (comorbidities, smoking, body mass index and occupational exposures). Lower education and lower income were independently related to a greater prospective risk of acute COPD exacerbation (HR 1.5; 95% CI 1.01 to 2.1; and HR 2.1; 95% CI 1.4 to 3.4, respectively). Conclusion Low SES is a risk factor for a broad array of adverse COPD health outcomes. Clinicians and disease management programs should consider SES as a key patient-level marker of risk for poor outcomes.Keywords
This publication has 69 references indexed in Scilit:
- Performance of self-reported occupational exposure compared to a job-exposure matrix approach in asthma and chronic rhinitisOccupational and Environmental Medicine, 2009
- Occupational exposures and the risk of COPD: dusty trades revisitedThorax, 2008
- COPD as a Systemic Disease: Impact on Physical Functional LimitationsAmerican Journal Of Medicine, 2008
- Longitudinal Change in the BODE Index Predicts Mortality in Severe EmphysemaAmerican Journal of Respiratory and Critical Care Medicine, 2008
- Risk factors for death in adults with severe asthmaAnnals of Allergy, Asthma & Immunology, 2008
- Pulmonary Function and the Risk of Functional Limitation in Chronic Obstructive Pulmonary DiseaseAmerican Journal of Epidemiology, 2008
- Racial Differences in Waiting List Outcomes in Chronic Obstructive Pulmonary DiseaseAmerican Journal of Respiratory and Critical Care Medicine, 2008
- Temporal relationship between air pollutants and hospital admissions for chronic obstructive pulmonary disease in Hong KongThorax, 2007
- The Effects of Components of Fine Particulate Air Pollution on Mortality in California: Results from CALFINEEnvironmental Health Perspectives, 2007
- Perceived Neighborhood Problems and Quality of Life, Physical Functioning, and Depressive Symptoms Among Adults With AsthmaAmerican Journal of Public Health, 2006