Poor asthma control is associated with low socio-economic status: Results from a nationwide cross sectional study of Danish patients with asthma

Abstract

Introduction: Low socio-economic status (SES) is often associated with general health problems, but the association between SES and poor asthma control in a population is only poorly investigated. Aims &Objectives: Based on register data from a nationwide population, we investigated whether there was a relation between low SES and poor asthma control? Methods: Using a nationwide prescription database we performed a cross-sectional register study. We identified current asthmatics (18-44 years) in 2010. Poor asthma control was defined as high use of short-acting β2-agonist (SABA) and asthma exacerbations (emergency department visits, hospitalizations or redemption of oral prednisolone prescriptions). SES was defined on the basis of income, level of education and occupation. Results: The study-population consisted of 60,488 Danish asthmatics. Low income was associated with high SABA use (OR 1.12 (1.05-1.21)) and exacerbations (OR 1.14 (1.03-1.26)). Low educational level was associated with poor asthma control (primary education only: High SABA use: OR 1.80 (1.69-1.92) and exacerbation: OR 1.60 (1.47-1.74), respectively). Regarding occupation, being unemployed was associated with high SABA use (OR 1.36 (1.20-1.55), as well as receiving welfare benefits (OR 1.70 (1.56-1.85) and early retirement pension (OR 1.41 (1.30-1.53)). Receiving welfare benefits and early retirement pension were also significantly correlated with exacerbations (OR 1.47 (1.31-1.65) vs. 1.56 (1.41-1.74)). Conclusion: Low SES in young adult asthma patients is associated with poor asthma control, and assessment of SES should be included in the management of problematic asthma.