Trends in Socioeconomic Status–related Differences in Mortality among People with Chronic Obstructive Pulmonary Disease

Gershon, Andrea S.; Hwee, Jeremiah; Victor, J. Charles; Wilton, Andrew S.; To, Teresa

doi:10.1513/annalsats.201403-094oc

Cited by 35 publications

(36 citation statements)

References 20 publications

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“…In a study by Gershon et al [28], based purely on household income in a single payer healthcare system, it was found that there was statistically significant difference in the mortality difference between the lowest and highest income quintiles. Mortality increased from 67 per 10,000 individuals in 1996-1997 to 86 per 10,000 individuals representing a 28% relative increase.…”

Section: Chronic Obstructive Pulmonary Disease (Copd)mentioning

confidence: 99%

“…It was also observed that mortality in people with COPD has decreased faster in people with the highest compared with the lowest SES, causing increased disparity between rich and poor. Further study and strategies are needed to explore and address factors responsible for this increasing disparity in the COPD population [28]. Lewis et al [25] analyzed traditional markers of SES as well as other contextual measures and determined that a lower household income and educational status were independent risk factors for mortality due to COPD.…”

Section: Chronic Obstructive Pulmonary Disease (Copd)mentioning

confidence: 99%

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Socioeconomic Status and Its Relationship to Chronic Respiratory Disease

Sahni

Talwar

Khanijo

et al. 2017

Advances in Respiratory Medicine

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Socioeconomic status (SES) is defined as an individual's social or economic standing, and is a measure of an individual's or family's social or economic position or rank in a social group. It is a composite of several measures including income, education, occupation, location of residence or housing. Studies have found a lower SES has been linked to disproportionate access to health care in many diseases. There is emerging data in pulmonary diseases such as COPD, asthma, cystic fibrosis, pulmonary hypertension and other chronic respiratory conditions that allude to a similar observation noted in other chronic diseases. In the setting of COPD, SES has an inverse relationship with COPD prevalence, mortality, health utilization costs and HRQoL. Asthma and cystic fibrosis show an increased severity and hospitalizations in relationship to a lower SES. Similar observations were seen in sarcoidosis, PHTN and obstructive sleep apnea. There remains a limited data on non-CF bronchiectasis and interstitial lung diseases. Population SES may be gauged by various measures such as education, occupation, marital status but no value is more indicative than income. Currently guidelines and management algorithms do not factor the effect of SES in the disease process. Despite the great amount of data available, a standardized method must be created to include SES in the prognostic calculations and management of chronic pulmonary diseases.

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Section: Chronic Obstructive Pulmonary Disease (Copd)mentioning

confidence: 99%

Section: Chronic Obstructive Pulmonary Disease (Copd)mentioning

confidence: 99%

Socioeconomic Status and Its Relationship to Chronic Respiratory Disease

Sahni

Talwar

Khanijo

et al. 2017

Advances in Respiratory Medicine

View full text Add to dashboard Cite

show abstract

“…[2] Even in high-income countries, there is a definite trend in socioeconomic related outcome with those in the lower socioeconomic status faring worse. [3] The high economic burden this disease imposes on the individual, and the health care delivery system of a nation needs to be emphasized. [4]…”

Section: Introductionmentioning

confidence: 99%

Predictors of outcome in patients admitted with acute exacerbation of chronic obstructive pulmonary disease in a rural Tertiary Care Center

Ittyachen

Krishnamoorthy

Bhatt

et al. 2016

J Family Med Prim Care

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Background:Chronic obstructive pulmonary disease (COPD) is associated with a high degree of mortality and morbidity around the world with the burden of the disease being more in the developing countries. In the Indian context data is limited. This study was carried out to determine the predictors of outcome in patients admitted with acute exacerbation of COPD in a rural Tertiary Care Center in the state of Kerala.Materials and Methods:This was a prospective cohort study. Patients admitted with acute exacerbation of COPD in the Intensive Care Unit between August 2013 and July 2014 was included in the study. Sociodemographic data, clinical variables, and investigations were collected. Mortality with respect to relevant risk factors was compared using Kaplan–Meier method and Cox proportional hazard model.Results:Seventy patients were enrolled in the study of whom 58 (82.9%) were above the age of 60 years. Majority of the patients (87.1%) were males. Tobacco smoking was the main risk factor in them. All the females had a history of exposure to biomass fuel in the form of firewood; none of them were smokers. Majority of patients (80.0%) had a history of one or more co-existing illnesses. Anemia was found to be an independent risk factor for mortality (adjusted hazard ratio: 3.167, 95% confidence interval: 1.516–6.616). Risk factors for poor outcome in COPD patients reported from other centers in India were not found to be relevant in this study.Conclusions:Anemia could be an independent risk factor for mortality in COPD patients. India already has a high prevalence of iron deficiency anemia especially in the rural area and in the geriatric population. Henceforth, family practitioners and primary care physicians may remain vigilant regarding the development of anemia in their COPD patients and institute remedial measures without delay. Futhermore, the wide variation reported in the predictors of outcome of COPD along with the finding of this study calls for an urgent need for more studies.

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“…A low SES affects not only the risk of developing COPD but is linked to poorer outcomes. It has been associated with decreased lung function and performance, lower rates of medication use, higher rates of hospitalization, and increased mortality [4-7]. COPD patients with a low SES may also have a lower degree of health literacy; i.e., the ability to obtain, process, and understand basic health-related information, which is needed to make appropriate healthcare decisions [8].…”

Section: Change Your View On Patientsmentioning

confidence: 99%

COPD: Rethinking Patient Management – How to Approach a Challenging Patient Group Successfully

et al. 2019

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In comparison to other chronically ill people, patients suffering from chronic obstructive pulmonary disease (COPD) have many additional difficulties to face and conquer. Due to the contribution of avoidable causes of their illness (“smokers’ lung”), society holds people with COPD responsible for their disease, which in return often leads to stigmatization and social isolation. In addition, COPD patients commonly belong to a less privileged social class, own a low socioeconomic status, and lower education. Their physical symptoms are easily observable and – by employing moderate adherence – treatable. Nonetheless, the influence of COPD on a patient’s psyche often plays an overly prominent role during therapy. “There is only half a patient laying on the examination table,” a revelation that sums up the current state of COPD research and the result of the expert meeting “Luftschlösser” (“castles in the clouds”), which took place in spring 2018. Within the limits of the meeting, participants identified practically applicable approaches aiming to enhance the patient management of this challenging patient group. These considerations are supposed to support healthcare professionals in their daily work and aim to improve the therapy as well as the outcome for COPD patients.

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Trends in Socioeconomic Status–related Differences in Mortality among People with Chronic Obstructive Pulmonary Disease

Cited by 35 publications

References 20 publications

Socioeconomic Status and Its Relationship to Chronic Respiratory Disease

Socioeconomic Status and Its Relationship to Chronic Respiratory Disease

Predictors of outcome in patients admitted with acute exacerbation of chronic obstructive pulmonary disease in a rural Tertiary Care Center

COPD: Rethinking Patient Management – How to Approach a Challenging Patient Group Successfully

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