Socioeconomic status and prognosis of COPD in Denmark

Peter Lange; Jacob Louis Marott; Jørgen Vestbo; Truls Sylvan Ingebrigtsen; Børge Grønne Nordestgaard

doi:10.3109/15412555.2013.869580

Socioeconomic status and prognosis of COPD in Denmark

Peter Lange, Jacob Louis Marott, Jørgen Vestbo, Truls Sylvan Ingebrigtsen, Børge Grønne Nordestgaard

23 Citations (Scopus)

Abstract

We investigated the association between length of school education and 5-year prognosis of chronic obstructive lung disease (COPD), including exacerbations, hospital admissions and survival. We used sample of general population from two independent population studies: The Copenhagen City Heart Study and Copenhagen General Population Study. A total of 6,590 individuals from general population of Copenhagen with COPD defined by the Global initiative for obstructive lung disease criteria were subdivided into 4 groups based on the length of school education: 1,590 with education < 8 years; 3,131 with education 8-10 years, 1,244 with more than 10 years, but no college/university education and 625 with college/university education. Compared with long education, short education was associated with current smoking (p < 0.001), higher prevalence of respiratory symptoms (p < 0.001) and lower forced expiratory volume in the first second in percent of predicted value (FEV1%pred) (p < 0.001). Adjusting for sex, age, FEV1%pred, dyspnea, frequency of previous exacerbations and smoking we observed that shortest school education (in comparison with university education), was associated with a higher risk of COPD exacerbations (hazards ratio 1.65, 95% CI 1.15-2.37) and higher risk of all-cause mortality (hazards ratio 1.96, 95% CI 1.28-2.99). We conclude that even in an economically well-developed country with a health care system (which is largely free of charge), low socioeconomic status, assessed as the length of school education, is associated with a poorer clinical prognosis of COPD.

Original language	English
Journal	C O P D
Volume	11
Issue number	4
Pages (from-to)	431-437
Number of pages	7
ISSN	1541-2555
DOIs	https://doi.org/10.3109/15412555.2013.869580
Publication status	Published - Aug 2014

Keywords

Aged
Aged, 80 and over
Denmark
Disease Progression
Dyspnea
Educational Status
Female
Forced Expiratory Volume
Hospitalization
Humans
Income
Male
Middle Aged
Prevalence
Prognosis
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Severity of Illness Index
Smoking
Social Class
Urban Population

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@article{6f26f46440084b0d884b642b07cfee2a,

title = "Socioeconomic status and prognosis of COPD in Denmark",

abstract = "We investigated the association between length of school education and 5-year prognosis of chronic obstructive lung disease (COPD), including exacerbations, hospital admissions and survival. We used sample of general population from two independent population studies: The Copenhagen City Heart Study and Copenhagen General Population Study. A total of 6,590 individuals from general population of Copenhagen with COPD defined by the Global initiative for obstructive lung disease criteria were subdivided into 4 groups based on the length of school education: 1,590 with education < 8 years; 3,131 with education 8-10 years, 1,244 with more than 10 years, but no college/university education and 625 with college/university education. Compared with long education, short education was associated with current smoking (p < 0.001), higher prevalence of respiratory symptoms (p < 0.001) and lower forced expiratory volume in the first second in percent of predicted value (FEV1%pred) (p < 0.001). Adjusting for sex, age, FEV1%pred, dyspnea, frequency of previous exacerbations and smoking we observed that shortest school education (in comparison with university education), was associated with a higher risk of COPD exacerbations (hazards ratio 1.65, 95% CI 1.15-2.37) and higher risk of all-cause mortality (hazards ratio 1.96, 95% CI 1.28-2.99). We conclude that even in an economically well-developed country with a health care system (which is largely free of charge), low socioeconomic status, assessed as the length of school education, is associated with a poorer clinical prognosis of COPD.",

keywords = "Aged, Aged, 80 and over, Denmark, Disease Progression, Dyspnea, Educational Status, Female, Forced Expiratory Volume, Hospitalization, Humans, Income, Male, Middle Aged, Prevalence, Prognosis, Prospective Studies, Pulmonary Disease, Chronic Obstructive, Severity of Illness Index, Smoking, Social Class, Urban Population",

author = "Peter Lange and Marott, {Jacob Louis} and J{\o}rgen Vestbo and Ingebrigtsen, {Truls Sylvan} and Nordestgaard, {B{\o}rge Gr{\o}nne}",

year = "2014",

month = aug,

doi = "10.3109/15412555.2013.869580",

language = "English",

volume = "11",

pages = "431--437",

journal = "COPD: Journal of Chronic Obstructive Pulmonary Disease",

issn = "1541-2555",

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TY - JOUR

T1 - Socioeconomic status and prognosis of COPD in Denmark

AU - Lange, Peter

AU - Marott, Jacob Louis

AU - Vestbo, Jørgen

AU - Ingebrigtsen, Truls Sylvan

AU - Nordestgaard, Børge Grønne

PY - 2014/8

Y1 - 2014/8

N2 - We investigated the association between length of school education and 5-year prognosis of chronic obstructive lung disease (COPD), including exacerbations, hospital admissions and survival. We used sample of general population from two independent population studies: The Copenhagen City Heart Study and Copenhagen General Population Study. A total of 6,590 individuals from general population of Copenhagen with COPD defined by the Global initiative for obstructive lung disease criteria were subdivided into 4 groups based on the length of school education: 1,590 with education < 8 years; 3,131 with education 8-10 years, 1,244 with more than 10 years, but no college/university education and 625 with college/university education. Compared with long education, short education was associated with current smoking (p < 0.001), higher prevalence of respiratory symptoms (p < 0.001) and lower forced expiratory volume in the first second in percent of predicted value (FEV1%pred) (p < 0.001). Adjusting for sex, age, FEV1%pred, dyspnea, frequency of previous exacerbations and smoking we observed that shortest school education (in comparison with university education), was associated with a higher risk of COPD exacerbations (hazards ratio 1.65, 95% CI 1.15-2.37) and higher risk of all-cause mortality (hazards ratio 1.96, 95% CI 1.28-2.99). We conclude that even in an economically well-developed country with a health care system (which is largely free of charge), low socioeconomic status, assessed as the length of school education, is associated with a poorer clinical prognosis of COPD.

AB - We investigated the association between length of school education and 5-year prognosis of chronic obstructive lung disease (COPD), including exacerbations, hospital admissions and survival. We used sample of general population from two independent population studies: The Copenhagen City Heart Study and Copenhagen General Population Study. A total of 6,590 individuals from general population of Copenhagen with COPD defined by the Global initiative for obstructive lung disease criteria were subdivided into 4 groups based on the length of school education: 1,590 with education < 8 years; 3,131 with education 8-10 years, 1,244 with more than 10 years, but no college/university education and 625 with college/university education. Compared with long education, short education was associated with current smoking (p < 0.001), higher prevalence of respiratory symptoms (p < 0.001) and lower forced expiratory volume in the first second in percent of predicted value (FEV1%pred) (p < 0.001). Adjusting for sex, age, FEV1%pred, dyspnea, frequency of previous exacerbations and smoking we observed that shortest school education (in comparison with university education), was associated with a higher risk of COPD exacerbations (hazards ratio 1.65, 95% CI 1.15-2.37) and higher risk of all-cause mortality (hazards ratio 1.96, 95% CI 1.28-2.99). We conclude that even in an economically well-developed country with a health care system (which is largely free of charge), low socioeconomic status, assessed as the length of school education, is associated with a poorer clinical prognosis of COPD.

KW - Aged

KW - Aged, 80 and over

KW - Denmark

KW - Disease Progression

KW - Dyspnea

KW - Educational Status

KW - Female

KW - Forced Expiratory Volume

KW - Hospitalization

KW - Humans

KW - Income

KW - Male

KW - Middle Aged

KW - Prevalence

KW - Prognosis

KW - Prospective Studies

KW - Pulmonary Disease, Chronic Obstructive

KW - Severity of Illness Index

KW - Smoking

KW - Social Class

KW - Urban Population

U2 - 10.3109/15412555.2013.869580

DO - 10.3109/15412555.2013.869580

M3 - Journal article

C2 - 24568315

SN - 1541-2555

VL - 11

SP - 431

EP - 437

JO - COPD: Journal of Chronic Obstructive Pulmonary Disease

JF - COPD: Journal of Chronic Obstructive Pulmonary Disease

IS - 4

ER -

Socioeconomic status and prognosis of COPD in Denmark

Abstract

Keywords

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