Abstract
The aim of our study was to examine sex-specific associations between different aspects of socioeconomic status (SES) (educational level, occupational status, income) and lung function in a general adult population. In the Hordaland County Cohort Study, 1,644 subjects aged 26-82 yrs at baseline answered questionnaires and performed post-bronchodilator spirometry both in 1996-1997 and in 2003-2006. We performed adjusted linear regression analysis on the effect of SES on decline in forced experimental volume in 1 s (FEV(1)), forced vital capacity (FVC) and FEV(1)/FVC. Mean annual decline in FEV(1) from baseline to follow-up was 57 mL (se 1.3) and 48 mL (se 1.0) for males and females, respectively. Males had a larger decline in FVC than females, while females had a larger decline in FEV(1)/FVC. Lower education and low occupational status were associated with larger male lung function decline. SES did not affect female lung function decline. However, marital status was a significant predictor; unmarried females had less decline than both married and widowed females in both FEV(1) (adjusted mean annual difference 8 mL and 16 mL) and FVC (adjusted mean annual difference 8 mL and 18 mL). Low SES was associated with increased lung function decline in males. For females, marital status was more important.
Highlights
Mean annual decline in forced experimental volume in 1 s (FEV1) from baseline to follow-up was 57 mL (SE 1.3) and 48 mL (SE 1.0) for males and females, respectively
The present study examined sex-specific associations between different aspects of socioeconomic status (SES) and lung function in a general adult population
We found that low SES was associated with increased lung function decline in males
Summary
Mean annual decline in FEV1 from baseline to follow-up was 57 mL (SE 1.3) and 48 mL (SE 1.0) for males and females, respectively. Lower education and low occupational status were associated with larger male lung function decline. Marital status was a significant predictor; unmarried females had less decline than both married and widowed females in both FEV1 (adjusted mean annual difference 8 mL and 16 mL) and FVC (adjusted mean annual difference 8 mL and 18 mL). Low SES was associated with increased lung function decline in males. Several studies have shown that there is an association between low SES and impaired lung function [2, 5,6,7,8,9] This association is significant after adjusting for common confounders like smoking habits and occupational exposures. It is likely that low SES is associated with further lifestyle factors that have a negative effect on lung function, such as air pollution, unhealthy diet, passive smoking and indoor climate [10,11,12]
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