Prevalence of COPD and its association with socioeconomic status in China: Findings from China Chronic Disease Risk Factor Surveillance 2007

Abstract

BackgroundSocioeconomic status is likely an independent risk factor for Chronic Obstructive Pulmonary Disease (COPD), but little research has been done in China to study this association in a nationwide sample.MethodsWe used data from the 2007 China Chronic Disease Risk Factor Surveillance of 49,363 Chinese men and women aged 15-69 years to examine the association between the prevalence of self-reported physician diagnosed COPD and socioeconomic status defined by both educational level and annual household income. Multivariable logistic regression modelling was performed with adjustement for potential confounders.ResultsBoth low educational attainment and low household income were independently associated with higher risk of physician-diagnosed COPD. Compared to subjects with high educational level, subjects with low educational level had a significantly increased risk of COPD (OR 1.67, 95%CI 1.32-2.13, p for trend< 0.001 for urban, OR 1.76, 95%CI 1.34-2.30, p for trend < 0.001 for rural) after adjusting for age, sex, smoking status, passive smoking and geographic regions. Similarly increased risk was observed for household income and COPD in urban (OR 1.64, 95%CI 1.28-2.09, P for trend< 0.001) but not rural areas. Among never smokers, low educational level and household income were still associated with a significant higher prevalence of COPD (OR 1.77, 95%CI 1.40-2.25, OR 1.31, 95%CI 1.05-1.62). Removal of those with asthma diagnosis did not alter the observed associations.ConclusionsSocioeconomic status is a risk factor for self-reported physician-diagnosed COPD independently of current or passive smoking. Prospective studies are needed in China to better understand the association between socioeconomic status and COPD.

Risk factors for chronic obstructive pulmonary disease among never-smokers in Korea

“…Previous studies have reported a positive relationship between a lower educational level and the prevalence of COPD,13,25,26 although others have reported contradictory results 27,28. A large study of 49,363 participants in The People’s Republic of China showed relationships among low education, low familial income, and COPD, regardless of residing in a rural or urban area 18. However, familial income was not a risk factor for COPD in our study.…”

“…A low level of education, employment as a manual laborer, and a history of tuberculosis or bronchiectasis were associated with an increased prevalence of COPD in never-smokers. In previous studies, the parameters of socioeconomic status such as education, occupation, marital status, and familial income were closely related to health condition and affected the onset and prognosis of COPD, particularly in never-smokers 9,12,14,17,18. There is no doubt that smoking is a major risk factor for COPD.…”

Impact of Socio-Economic Status, Rural Background and Gender on the Prevalence of Chronic Obstructive Pulmonary Disease

“…Former smokers had a higher prevalence of COPD (9.0%) compared to current smokers (3.3%) and never smokers (2.3%). [9] In another study conducted in china the results were similar where overall prevalence of COPD in the two areas (Liwang and Yunyan) was 9.4%. The prevalence of COPD in both the whole population and a subpopulation of nonsmoking women in rural Yunyan was significantly higher than in urban Liwang (12.0% vs 7.4%, and 7.2% vs 2.5%, respectively).…”

Risk Factors for Small Airway Obstruction among Chinese Island Residents: A Case-Control Study

“…Previous epidemiological studies in China identified risk factors for COPD, such as smoking and solid fuel use [5] and socioeconomic status [6]. Yet, as in other countries in which these types of surveys have been conducted, differences in disease incidence and the contributing factors may differ between urban and rural areas [7]–[9]; although, a common factor appears to be air quality, either within the home or the environment in general.…”