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BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2015 | Research article

Socioeconomic status is associated with reduced lung function in China: an analysis from a large cross-sectional study in Shanghai

Authors: Adam W. Gaffney, Jing-qing Hang, Mi-Sun Lee, Li Su, Feng-ying Zhang, David C. Christiani

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

An inverse association between socioeconomic status and pulmonary function has emerged in many studies. However, the mediating factors in this relationship are poorly understood, and might be expected to differ between countries. We sought to investigate the relationship between socioeconomic status and lung function in China, a rapidly industrializing nation with unique environmental challenges, and to identify potentially-modifiable environmental mediators.

Methods

We used data from the Shanghai Putuo Study, a cross-sectional study performed in Shanghai, China. Participants completed a questionnaire and spirometry. The primary exposure was socioeconomic status, determined by education level. The primary outcomes were FEV1 and FVC percent predicted. Multiple linear regressions were used to test this association, and the percent explained by behavioral, environmental, occupational, and dietary variables was determined by adding these variables to a base model.

Results

The study population consisted of a total of 22,878 study subjects that were 53.3 % female and had a mean age of 48. In the final multivariate analysis, the effect estimates for FEV1 and FVC percent predicted for low socioeconomic status (compared to high) were statistically significant at a p-value of <0.01. Smoking, biomass exposure, mode of transportation to work, a diet low in fruits or vegetables, and occupational category partially attenuated the relationship between SES and lung function. In a fully-adjusted age-stratified analysis, the socioeconomic disparity in lung function widened with increasing age.

Conclusions

We found cross-sectional evidence of socioeconomic disparities in pulmonary function in Shanghai. These differences increased with age and were partially explained by potentially modifiable exposures.
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Metadata
Title
Socioeconomic status is associated with reduced lung function in China: an analysis from a large cross-sectional study in Shanghai
Authors
Adam W. Gaffney
Jing-qing Hang
Mi-Sun Lee
Li Su
Feng-ying Zhang
David C. Christiani
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-2752-3

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