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The association between chronic airflow obstruction and poverty in 12 sites of the multinational BOLD study

Title: The association between chronic airflow obstruction and poverty in 12 sites of the multinational BOLD study
Authors: Townend, J
Minelli, C
Mortimer, K
Obaseki, DO
Al Ghobain, M
Cherkaski, H
Denguezli, M
Gunesekera, K
Hafizi, H
Koul, PA
Loh, LC
Nejjari, C
Patel, JH
Sooronbayev, T
Buist, SA
Burney, P
Item Type: Journal Article
Abstract: Poverty is strongly associated with mortality from COPD, but little is known of its relation to airflow obstruction. In a cross-sectional study of adults aged ≥40 years from 12 sites (N=9255), participating in the Burden of Obstructive Lung Disease (BOLD) study, poverty was evaluated using a wealth score (0–10) based on household assets. Obstruction, measured as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) (%) after administration of 200 μg salbutamol, and prevalence of FEV1/FVC<lower limit of normal were tested for association with poverty for each site, and the results were combined by meta-analysis. Mean wealth scores ranged from 4 in Blantyre (Malawi) and Kashmir (India) to 10 in Riyadh (Saudi Arabia), and the prevalence of obstruction, from 16% in Kashmir to 3% in Riyadh and Penang (Malaysia). Following adjustments for age and sex, FEV1/FVC increased by 0.36% (absolute change) (95%CI: 0.22, 0.49; p<0.001) per unit increase in wealth score. Adjustments for other confounders reduced this effect to 0.23% (0.11, 0.34), but even this value remained highly significant (p<0.001). Results were consistent across sites (I2=1%; phet=0.44). Mean wealth scores explained 38% of the variation in mean FEV1/FVC between sites (r2=0.385, p=0.031). Airflow obstruction is consistently associated with poverty at individual and community levels across several countries.
Issue Date: 1-Jun-2017
Date of Acceptance: 28-Feb-2017
URI: http://hdl.handle.net/10044/1/45994
DOI: https://dx.doi.org/10.1183/13993003.01880-2016
ISSN: 1399-3003
Publisher: European Respiratory Society: ERJ
Journal / Book Title: European Respiratory Journal
Volume: 49
Issue: 6
Copyright Statement: © ERS 2017
Sponsor/Funder: Wellcome Trust
Funder's Grant Number: 085790/Z/08/Z
Keywords: Respiratory System
11 Medical And Health Sciences
Publication Status: Published
Article Number: 1601880
Appears in Collections:Infectious Disease Epidemiology
National Heart and Lung Institute
Faculty of Medicine



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