RT Journal Article
SR Electronic
T1 Association of low income with pulmonary disease progression in smokers with and without chronic obstructive pulmonary disease
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00069-2018
DO 10.1183/23120541.00069-2018
VO 4
IS 4
A1 Katherine E. Lowe
A1 Barry J. Make
A1 James D. Crapo
A1 Gregory L. Kinney
A1 John E. Hokanson
A1 Victor Kim
A1 Anand S. Iyer
A1 Surya P. Bhatt
A1 Karin F. Hoth
A1 Kristen E. Holm
A1 Robert Wise
A1 Dawn DeMeo
A1 Marilyn G. Foreman
A1 Thomas J. Stone
A1 Elizabeth A. Regan
A1 ,
YR 2018
UL http://openres.ersjournals.com/content/4/4/00069-2018.abstract
AB Low socioeconomic status has been associated with chronic obstructive pulmonary disease (COPD) but little is known about its impact on disease progression. We assessed the association of income to symptoms, pulmonary disease severity and progression in smokers with and without COPD.The COPDGene cohort of 4826 smokers who reported annual income in phase 2 was analysed. Those who reported annual income <USD 15 000 per year were “low-income” and the remainder “higher income”. Baseline demographics, symptoms, computed tomography (CT) imaging, and 5-year change in spirometry and CT metrics were characterised by group.The low income group was younger (55.7 versus 61.7, p<0.0001), had more current smokers (73% versus 36%, p<0.0001), higher rates of severe exacerbations (13% versus 7%, p<0.0001), more chronic bronchitis (22% versus 14%, p<0.0001), reduced access to preventative care and lower quality of life, but less emphysema (4.7% versus 6.2%, p<0.0001). After 5 years the low-income group had more smoking-related disease progression, without significant change in exacerbations or symptoms, than higher-income subjects. Low income was an independent predictor of decreasing forced expiratory volume in 1 s (FEV1) (p=0.001) and increased airway disease (p=0.007) after adjusting for baseline FEV1, age, sex, race, exposures and current smoking.Income disparity beyond the effects of race and current smoking is an important factor for disease progression. Worldwide, poverty and its consequences: associated respiratory exposures, limited healthcare access, and inadequate education about smoking risks, may exacerbate chronic lung disease.Income is a factor in predicting pulmonary disease progression in smokers with and without COPD; those with lower income experience faster progression and worse symptoms http://ow.ly/1SSe30lU1cX