Longitudinal Evaluation of the Relationship Between Low Socioeconomic Status and Incidence of Chronic Obstructive Pulmonary Disease: Korean Genome and Epidemiology Study (KoGES)

• Main Authors: Kim CY, Kim BK, Kim YJ, Lee SH, Kim YS, Kim JH
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-01-01
• Series: International Journal of COPD
• Subjects: chronic obstructive pulmonary disease; socioeconomic status; education level; incidence; prevalence
• Online Access: https://www.dovepress.com/longitudinal-evaluation-of-the-relationship-between-low-socioeconomic--peer-reviewed-article-COPD

Chi Young Kim,1,2 Beong Ki Kim,1 Yu Jin Kim,1 Seung Heon Lee,1 Young Sam Kim,3 Je Hyeong Kim1 1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea; 2Yonsei University College of Medicine, Seoul, Republic of Korea; 3Division of Pulmonology, Department of Internal Medicine, Institute of Chest Diseases, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of KoreaCorrespondence: Je Hyeong KimDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, 123, Jeogguem-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of KoreaTel [phone]Fax [phone], Email [e-mail]: Socioeconomic status (SES) is a strong determinant in the development of various diseases. We evaluated the relationship between SES and the incidence of chronic obstructive pulmonary disease (COPD) by using a community-based cohort data.Patients and Methods: Four-year follow-up data of 6341 adults (aged ≥ 40 years), who underwent serial pulmonary function test were analyzed. Incidence of COPD in the participants was defined as the absence of airflow obstruction compatible with COPD (pre-bronchodilator forced expiratory volume in 1 second/forced vital capacity ratio of < 0.7) at baseline but documentation of airflow obstruction in serial testing. SES of patients was divided into quartiles according to household income and educational level. Multivariate logistic regression analyses were performed to estimate the association between SES and COPD incidence.Results: A total of 280 (4.4%) patients developed COPD during the follow-up. The proportion of subjects with lowest education (elementary school) and lowest household income levels (1st quartile) was significantly higher in the COPD group than in the non-COPD group (37.9% vs 29.5%, p< 0.011 and 48.4% vs 30.8%, p< 0.001, respectively). Logistic regression analysis revealed that education level of elementary school was independently associated with COPD incidence after adjustment for sex, age, body mass index, white blood cell count, residence area, and occupation (odds ratio 1.879, 95% confidence interval 1.124– 3.141, p=0.016).Conclusion: In the general population, educational level of elementary school was an independent risk factor for COPD among the components comprising SES. Our results indicate that the implementation of preventive strategies for COPD in those with low educational status could be beneficial.Keywords: chronic obstructive pulmonary disease, socioeconomic status, education level, incidence, prevalence