The association between chronic airflow obstruction and poverty in 12 sites of the multinational BOLD study.

Townend, John, Minelli, Cosetta, Mortimer, Kevin ORCID: https://orcid.org/0000-0002-8118-8871, Obaseki, Daniel O, Al Ghobain, Mohammed, Cherkaski, Hamid, Denguezli, Myriam, Gunesekera, Kirthi, Hafizi, Hasan, Koul, Parvaiz A, Loh, Li C, Nejjari, Chakib, Patel, Jaymini, Sooronbayev, Talant, Buist, Sonia A and Burney, Peter G J (2017) 'The association between chronic airflow obstruction and poverty in 12 sites of the multinational BOLD study.'. European Respiratory Journal, Vol 49, Issue 6, e1601880.

Text Eur_Repir_J_June 2017_POVERTY and obstruction - accepted draft.docx - Accepted Version Download (1MB)

Abstract

Poverty is strongly associated with mortality from COPD, but little is known of its relation to airflow obstruction.In a cross-sectional study of adults aged ≥40 years from 12 sites (N=9255), participating in the Burden of Obstructive Lung Disease (BOLD) study, poverty was evaluated using a wealth score (0-10) based on household assets. Obstruction, measured as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) (%) after administration of 200 μg salbutamol, and prevalence of FEV1/FVC<lower limit of normal were tested for association with poverty for each site, and the results were combined by meta-analysis.Mean wealth scores ranged from 4 in Blantyre (Malawi) and Kashmir (India) to 10 in Riyadh (Saudi Arabia), and the prevalence of obstruction, from 16% in Kashmir to 3% in Riyadh and Penang (Malaysia). Following adjustments for age and sex, FEV1/FVC increased by 0.36% (absolute change) (95%CI: 0.22, 0.49; p<0.001) per unit increase in wealth score. Adjustments for other confounders reduced this effect to 0.23% (0.11, 0.34), but even this value remained highly significant (p<0.001). Results were consistent across sites (I(2)=1%; phet=0.44). Mean wealth scores explained 38% of the variation in mean FEV1/FVC between sites (r(2)=0.385, p=0.031).Airflow obstruction is consistently associated with poverty at individual and community levels across several countries.

Item Type:	Article
Additional Information:	“This is an author-submitted, peer-reviewed version of a manuscript that has been accepted for publication in the European Respiratory Journal, prior to copy-editing, formatting and typesetting. This version of the manuscript may not be duplicated or reproduced without prior permission from the copyright owner, the European Respiratory Society. The publisher is not responsible or liable for any errors or omissions in this version of the manuscript or in any version derived from it by any other parties. The final, copy-edited, published article, which is the version of record, is available without a subscription 18 months after the date of issue publication.”
Subjects:	WA Public Health > WA 20.5 Research (General) WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WF Respiratory System > Lungs > WF 600 Lungs
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1183/13993003.01880-2016
SWORD Depositor:	JISC Pubrouter
Depositing User:	Stacy Murtagh
Date Deposited:	12 Jul 2017 10:56
Last Modified:	12 Sep 2019 13:07
URI:	https://archive.lstmed.ac.uk/id/eprint/7222

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