Prevalence and burden of obstructive lung disease in the urban poor population of Ottawa, Canada: a community-based mixed-method, observational study

Smita Pakhale,Nina Huynh,Joanne Haddad,Gonzalo Alvarez,Tina Kaur,Saania Tariq,Robert Boyd,Kelly Florence,Fozia Nur,Sadia Jama,Catherine Charron,Tetyana Kendzerska,Ted Bignell,Margaret ( Ella) Bustamante-Bawagan

doi:10.1186/s12889-021-10209-w

Abstract

BackgroundGlobally the burden of Obstructive Lung Diseases (OLD) is growing, however its effect on urban poor populations with the high prevalence of tobacco dependence is virtually unknown. The purpose of this project is to estimate the prevalence and burden of OLD in the urban, low-income populations of Ottawa, Canada.MethodsThe study presented in this paper was part of the PROMPT (Management and Point-of-Care for Tobacco Dependence) project; a prospective cohort study in a community-based setting (n = 80) with meaningful Patient Engagement from design to dissemination. Spirometry data, standardized questionnaires and semi-structured interviews from PROMPT were interpreted to understand the lung function, disease burden and social determinants (respectively) in this population.ResultsThe prevalence of OLD among those who completed spirometry (N = 64) was 45–59%. Generic and disease-specific quality of life was generally poor in all PROMPT participants, even those without OLD, highlighting the higher disease burden this vulnerable population faces. Quality of life was impacted by two major themes, including i) socioeconomic status and stress and ii) social networks and related experiences of trauma.ConclusionThe prevalence and disease burden of OLD is significantly higher in Ottawa’s urban poor population than what is observed in the general Canadian population who smoke, suggesting an etiological role of the social determinants of health. This urges the need for comprehensive care programs addressing up-stream factors leading to OLDs, including poor access and utilization of preventive healthcare addressing the social determinants of health.Trial registrationClinicalTrails.gov - NCT03626064, Retrospective registered: August 2018.

Highlights

The burden of Obstructive Lung Diseases (OLD) is growing, its effect on urban poor populations with the high prevalence of tobacco dependence is virtually unknown
The analysis was conducted with 64 participants with complete spirometry data
Post-study interviews were completed with 11 participants who had study spirometry diagnosed OLD

Summary

Introduction

The burden of Obstructive Lung Diseases (OLD) is growing, its effect on urban poor populations with the high prevalence of tobacco dependence is virtually unknown. Researchers have documented a growing socioeconomic inequity leading to poverty and homelessness among a group of people living in urban settings in wealthy countries (the urban poor) [1]. This characteristic low socioeconomic status (SES) in this population has been associated with co-addiction of licit and/or illicit drugs, including tobacco [2,3,4]. Due to the higher rates of tobacco and substance use, chronic Obstructive Lung Diseases (OLDs), such as Chronic Obstructive Pulmonary Disease (COPD), asthma, and bronchiectasis, are expected to be a growing problem in the urban poor [3, 4, 11]

Objectives

Methods

Results

Discussion

Conclusion