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.