Vânia Rocha1,2, Sílvia Fraga1,3,2, Carla Moreira1,4, Cristian Carmeli5, Alexandra Lenoir6, Andrew Steptoe7, Graham Giles8, Marcel Goldberg9,10, Marie Zins9,10, Mika Kivimäki11, Paolo Vineis12, Peter Vollenweider13, Henrique Barros1,3, Silvia Stringhini14,15. 1. EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal. 2. These authors contributed equally. 3. Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal. 4. Centre of Mathematics, University of Minho, Braga, Portugal. 5. Population Health Laboratory, Dept of Community Health, University of Fribourg, Fribourg, Switzerland. 6. Dept of Medicine, Respiratory Medicine, Lausanne University Hospital, Lausanne, Switzerland. 7. Dept of Behavioural Science and Health, University College London, London, UK. 8. Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia. 9. Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France. 10. Paris Descartes University, Paris, France. 11. Dept of Epidemiology and Public Health, University College London, London, UK. 12. MRC Centre for Environment and Health, School of Public Health, Dept of Epidemiology and Biostatistics, Imperial College London, London, UK. 13. Dept of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. 14. Center for Primary Care and Public Health (UNISANTE), University of Lausanne, Lausanne, Switzerland. 15. Unit of Population Epidemiology, Dept of Primary Care, Geneva University Hospitals, Geneva, Switzerland.
Abstract
BACKGROUND: Lung function is an important predictor of health and a marker of physical functioning at older ages. This study aimed to quantify the years of lung function lost according to disadvantaged socioeconomic conditions across the life-course. METHODS: This multicohort study used harmonised individual-level data from six European cohorts with information on life-course socioeconomic disadvantage and lung function assessed by forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). 70 496 participants (51% female) aged 18-93 years were included. Socioeconomic disadvantage was measured in early life (low paternal occupational position), early adulthood (low educational level) and adulthood (low occupational position). Risk factors for poor lung function (e.g. smoking, obesity, sedentary behaviour, cardiovascular and respiratory diseases) were included as potential mediators. The years of lung function lost due to socioeconomic disadvantage were computed at each life stage. RESULTS: Socioeconomic disadvantage during the life-course was associated with a lower FEV1. By the age of 45 years, individuals experiencing disadvantaged socioeconomic conditions had lost 4-5 years of healthy lung function versus their more advantaged counterparts (low educational level -4.36 (95% CI -7.33--2.37) for males and -5.14 (-10.32--2.71) for females; low occupational position -5.62 (-7.98--4.90) for males and -4.32 (-13.31--2.27) for females), after accounting for the risk factors for lung function. By the ages of 65 years and 85 years, the years of lung function lost due to socioeconomic disadvantage decreased by 2-4 years, depending on the socioeconomic indicator. Sensitivity analysis using FVC yielded similar results to those using FEV1. CONCLUSION: Life-course socioeconomic disadvantage is associated with lower lung function and predicts a significant number of years of lung function loss in adulthood and at older ages.
BACKGROUND: Lung function is an important predictor of health and a marker of physical functioning at older ages. This study aimed to quantify the years of lung function lost according to disadvantaged socioeconomic conditions across the life-course. METHODS: This multicohort study used harmonised individual-level data from six European cohorts with information on life-course socioeconomic disadvantage and lung function assessed by forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). 70 496 participants (51% female) aged 18-93 years were included. Socioeconomic disadvantage was measured in early life (low paternal occupational position), early adulthood (low educational level) and adulthood (low occupational position). Risk factors for poor lung function (e.g. smoking, obesity, sedentary behaviour, cardiovascular and respiratory diseases) were included as potential mediators. The years of lung function lost due to socioeconomic disadvantage were computed at each life stage. RESULTS: Socioeconomic disadvantage during the life-course was associated with a lower FEV1. By the age of 45 years, individuals experiencing disadvantaged socioeconomic conditions had lost 4-5 years of healthy lung function versus their more advantaged counterparts (low educational level -4.36 (95% CI -7.33--2.37) for males and -5.14 (-10.32--2.71) for females; low occupational position -5.62 (-7.98--4.90) for males and -4.32 (-13.31--2.27) for females), after accounting for the risk factors for lung function. By the ages of 65 years and 85 years, the years of lung function lost due to socioeconomic disadvantage decreased by 2-4 years, depending on the socioeconomic indicator. Sensitivity analysis using FVC yielded similar results to those using FEV1. CONCLUSION: Life-course socioeconomic disadvantage is associated with lower lung function and predicts a significant number of years of lung function loss in adulthood and at older ages.
Authors: Nirav R Bhakta; David A Kaminsky; Christian Bime; Neeta Thakur; Graham L Hall; Meredith C McCormack; Sanja Stanojevic Journal: Chest Date: 2021-08-24 Impact factor: 9.410