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23-12-2009 | Respiratory | Article

Socioeconomic status linked to asthma control



MedWire News: People with a low socioeconomic status (SES), as measured according to education level, tend to have poorer asthma control than those with a higher SES, research shows.

“Low 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 (eg, cockroaches, tobacco smoke) and outdoor (eg, urban pollution) allergens, thus increasing risk for exacerbations,” explain Kim Lavoie (Hôpital du Sacre-Coeur de Montreal, Quebec, Canada) and team.

To investigate, the researchers studied 781 adults, aged between 18 and 75 years, with doctor-diagnosed asthma who were recruited from an outpatient asthma clinic in Montreal. The mean duration of asthma was 18.6 years, and 71% of participants were atopic.

All the patients were interviewed about their education history, as a proxy measure of SES, and underwent pulmonary function tests. They also completed a battery of questionnaires, including the Asthma Control Questionnaire, the Asthma Quality of Life Questionnaire, and the Asthma Self-Efficacy Scale.

The participants had an education duration ranging from 2 to 23 years, with the average level being 12.9 years.

After accounting for factors such as age, gender, asthma severity, current smoking, body mass index, and the presence of mood and/or anxiety disorder, the researchers found that lower SES was associated with worse asthma control, greater emergency health service use, and worse asthma self-efficacy, compared with higher SES.

Indeed, patients with less than 12 years of education were 55% more likely to report an asthma-related emergency health service visit in the previous year than those with more than 12 years of education.

However, participants with a lower education level did not have a worse asthma-related quality of life than those with a higher education level, the researchers note in the journal Respiratory Research.

Lavoie and team conclude: “This study found evidence for an association between education level (which is indicative of SES) and asthma morbidity and health in a large tertiary-care sample of Canadian adults with asthma, with lower education levels being related to worse levels of asthma control and asthma self efficacy, and higher rates of emergency health care use for asthma in the past year.”

They add that “interventions need to be developed to improve asthma outcomes in low SES patients.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Mark Cowen

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