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. 2016 Oct 4;11:2475–2496. doi: 10.2147/COPD.S79077

Table 3.

Relationship between socioeconomic status and COPD prevalence

References Population, description, and N Socioeconomic status measure(s) Outcome measure(s) Main findings
Bakke et al24 Cross-sectional study of general adult population in Norway (N=1,512) Occupation Asthma and COPD prevalence OR of 3.6 for obstructive lung disease in people with high degree of airborne exposure
Eachus et al25 Adults from 40 general practices in the UK (N=28,080) Deprivation score based on residence Disease prevalence including COPD Emphysema and chronic bronchitis relative index of 2.72 and 2.27, respectively (values higher than most other conditions)
Chen et al26 National population survey in Canada (N=7,210) Income COPD disease prevalence For low income persons OR = 3.7 for males and 2.4 for females
Marmot et al27 Civil servants in London, UK (N=10,308) Occupation (employment grade) Chronic bronchitis prevalence OR for CB for men 1.44 and women 1.21
Montnemery et al28 Adults in Sweden (N=12,071) Occupation, social position, and residence location Prevalence of CBE and respiratory symptoms CBE more common in unskilled and semiskilled workers, low social position
Lindberg et al29 Sweden (N=1,165) Occupation COPD incidence over 10 years in subjects with respiratory symptoms Manual workers had an OR = 1.78 vs professionals. Low education level had an OR = 1.73
Ellison-Loschmann et al30 European Community respiratory health Survey in Europe, Australia, New Zealand, and the US Educational level and occupational class Prevalence and incidence of chronic bronchitis Low educational and occupational levels (prevalence ratio =1.9 and 1.8, respectively)
Halvorsen and Matrinussen32 Norwegian prescription database of COPD patients (N=62,882) Educational level and level of unemployment in community COPD prevalence Communities with low educational levels and unemployment associated with higher risk of COPD
Karnevisto et al33 Finland – national population-wide survey (N=6,525) Education and household income COPD and asthma prevalence Education significant risk factor for COPD, whereas low household income was a risk factor for asthma
Lovasi et al34 Multi-ethnic study of artherosclerosis at multiple sites in the US (N=3,706) Education, household income, and wealth indicators Degree of emphysema on computed tomography scan Higher percent of emphysema in people with lower high school education, annual income, and wealth
Yin et al35 People’s Republic of China (31 provinces), (N=49,363) Education and household income COPD prevalence by self-report SES predictive of COPD risk independent of smoking and rural vs urban residence
Herrick et al36 Cross-sectional population study in one US state (N=25,986) Annual household income and highest level of education COPD prevalence COPD prevalence threefold greater between highest and lowest income levels as well as between lowest and highest education levels
Burney et al60 Multicenter (n=22 countries), international study burden of obstructive lung disease (N=15,355) Poverty as measured by GNI of countries COPD prevalence COPD prevalence fivefold greater between highest and lowest income levels as well as between lowest and highest education levels
Kainu et al37 Finnish population (N=8,000, COPD N=628) Occupation COPD prevalence Prevalence higher in manual than nonmanual occupations
Golec et al38 Polish farmers (N=64) Size of farm COPD prevalence Lower SES in COPD patients
Hagstad et al39 Swedish never-smokers with obstructive lung disease (N=967) Education level, occupation Proportion of nonsmokers with COPD who had occupational exposures OR of COPD related to occupation = 0.72 in college graduates vs those with less than high-school education
Lee et al40 Korean never smokers with COPD (N=3,473) Educational level, occupation COPD prevalence Low education level and manual labor were risk factors for COPD
Tan et al41 Canadian cross-sectional study in general adult population (N=5,176) Educational level COPD prevalence in ever and never-smokers Low education level associated with higher prevalence in both never and ever-smokers

Abbreviations: CB, chronic bronchitis; CBE, chronic bronchitis/emphysema; COPD, chronic obstructive pulmonary disease; GNI, gross national income; OR, odds ratio; SES, socioeconomic status.