| Title: | Associations of socioeconomic status and health lifestyles with chronic obstructive pulmonary disease: two nationwide population-based studies |
| Journal: | BMC Public Health |
| Published: | 3 Jul 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40611139/ |
| DOI: | https://doi.org/10.1186/s12889-025-23568-5 |
| URL: | https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-025-23568-5 |
Publication 16337
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
BackgroundLow socioeconomic status (SES) is associated with increased chronic obstructive pulmonary disease (COPD) risk, with smoking and poor diet as major contributing factors. However, the impact of a comprehensive healthy lifestyle as a potential mediator between SES and COPD risk remains understudied.MethodsThis study analyzed data from 32,836 US adults in the NHANES (1999-2020) and 131,872 UK adults in the UK Biobank. SES was assessed via latent class analysis based on income, education, employment, and health insurance (NHANES). SES was categorized into high, middle, and low levels. Healthy lifestyle scores included nonsmoking, no heavy drinking, regular physical activity, and a high-quality diet. Weighted multivariable logistic regression (NHANES) and Cox proportional hazards models (UK Biobank) were used to assess the associations between SES and the prevalence (NHANES) or incidence (UK Biobank) of COPD.ResultsIn the UK Biobank, the incidences of newly diagnosed COPD in the high-, medium-, and low-SES groups were 1.27%, 2.92%, and 6.57%, respectively. In the U.S. NHANES, the prevalence rates of COPD were 2.55%, 2.53%, and 4.50%, respectively. Compared with the highest SES group, a low SES was a risk factor for both the incidence and prevalence of COPD (UK Biobank: HR = 3.27, 95% CI = 2.98 to 3.58; NHANES: OR = 1.61, 95% CI = 1.23 to 2.10). The percentages of the mediation effect of a healthy lifestyle in the UK Biobank and US NHANES were 2.81% and 37.27%, respectively. Additionally, compared with those in the group with the highest SES and the healthiest lifestyle, the risk of COPD incidence and prevalence increased by 950% (HR = 10.50, 95% CI = 9.04 to 12.20) and 641% (OR = 7.41, 95% CI = 5.10 to 10.78), respectively, in the group with the lowest SES and the unhealthiest lifestyle. Risk factor analysis for COPD revealed that, in addition to a low SES (HR = 2.55, 95% CI = 2.39 to 2.72; OR = 2.08, 95% CI = 1.76 to 2.46) and unhealthy lifestyle (HR = 2.92, 95% CI = 2.73 to 3.12; OR = 3.78, 95% CI = 3.13 to 4.57), smoking (HR = 5.23, 95% CI = 4.87 to 5.61; OR = 3.85, 95% CI = 3.23 to 4.59) was the most significant risk factor for COPD.ConclusionsLow SES significantly contributes to COPD risk, but a healthy lifestyle mediating this association. Promoting healthy lifestyle choices and addressing socioeconomic disparities are essential public health strategies for COPD prevention. Additionally, smoking cessation and increased early screening in smokers are strongly recommended.</p>
16 Keywords
- Adult
- Aged
- Female
- Healthy Lifestyle
- Humans
- Incidence
- Life Style
- Male
- Middle Aged
- Nutrition Surveys
- Prevalence
- Pulmonary Disease, Chronic Obstructive
- Risk Factors
- Social Class
- United Kingdom
- United States
10 Authors
- Siying Liu
- Tingting Liu
- Cihang Lu
- Jiahui Guo
- Jie Li
- Hanyu Wang
- Bingxin You
- Qiqiang Guo
- Jing Zhang
- Yongze Li
1 Application
| Application ID | Title |
|---|---|
| 206612 | Social, Economic, Lifestyle, and Environmental Factors in the Early and Late Onset of Chronic Non-Communicable Diseases |
Enabling scientific discoveries that improve human health