Author:
Bacon Simon L,Bouchard Anne,Loucks Eric B,Lavoie Kim L
Abstract
Abstract
Background
Low socioeconomic status (SES) has been linked to higher morbidity in patients with chronic diseases, but may be particularly relevant to asthma, as asthmatics of lower SES may have higher exposures to indoor (e.g., cockroaches, tobacco smoke) and outdoor (e.g., urban pollution) allergens, thus increasing risk for exacerbations.
Methods
This study assessed associations between adult SES (measured according to educational level) and asthma morbidity, including asthma control; asthma-related emergency health service use; asthma self-efficacy, and asthma-related quality of life, in a Canadian cohort of 781 adult asthmatics. All patients underwent a sociodemographic and medical history interview and pulmonary function testing on the day of their asthma clinic visit, and completed a battery of questionnaires (Asthma Control Questionnaire, Asthma Quality of Life Questionnaire, and Asthma Self-Efficacy Scale). General Linear Models assessed associations between SES and each morbidity measure.
Results
Lower SES was associated with worse asthma control (F = 11.63, p < .001), greater emergency health service use (F = 5.09, p = .024), and worse asthma self-efficacy (F = 12.04, p < .01), independent of covariates. Logistic regression analyses revealed that patients with <12 years of education were 55% more likely to report an asthma-related emergency health service visit in the last year (OR = 1.55, 95%CI = 1.05-2.27). Lower SES was not related to worse asthma-related quality of life.
Conclusions
Results suggest that lower SES (measured according to education level), is associated with several indices of worse asthma morbidity, particularly worse asthma control, in adult asthmatics independent of disease severity. Results are consistent with previous studies linking lower SES to worse asthma in children, and add asthma to the list of chronic diseases affected by individual-level SES.
Publisher
Springer Science and Business Media LLC
Reference50 articles.
1. Asthma prevalence, health care use and mortality: United States, 2003–05
[http://www.cdc.gov/nchs/data/hestat/asthma03–05/asthma03–05.htm]
2. GINA Dissemination Committee: Dissemination and Implementation of Asthma Guidelines. Global Initiative For Asthma; 2003.
3. Bateman ED, Boushey HA, Bousquet J, Busse WW, Clark TJH, Pauwels RA, Pedersen SE, for the GOAL Investigators Group: Can Guideline-defined Asthma Control Be Achieved?: The Gaining Optimal Asthma ControL Study.
Am J Respir Crit Care Med 2004, 170:836–844.
4. Table 102–0552 - Deaths, by selected grouped causes and sex, Canada, provinces and territories, annual, CANSIM (database)
[http://cansim2.statcan.gc.ca/cgi-win/cnsmcgi.exe?Lang=E&CNSM-Fi=CII/CII_1-eng.htm]
5. Aboussafy D, Balter M, Godin G, Lavoie KL, Koley S: Asthma: The Psychology of Compromise. Ottawa: Canadian Lung Association; 2004.
Cited by
102 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献