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Absolute rather than relative income is a better socioeconomic predictor of chronic obstructive pulmonary disease in Swedish adults.
Int J Equity Health. 2017 05 04; 16(1):70
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Sten Axelsson Fisk
Juan Merlo
Author Affiliation
Unit for Social Epidemiology, Faculty of Medicine, Lund University, CRC, Jan Waldeströms gata, 35, S-205 02, Malmö, Sweden.
Int J Equity Health. 2017 05 04; 16(1):70
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Income - statistics & numerical data
Logistic Models
Middle Aged
Odds Ratio
Poverty - statistics & numerical data
Pulmonary Disease, Chronic Obstructive - economics - epidemiology
Risk assessment
Social Class
Socioeconomic Factors
Sweden - epidemiology
While psychosocial theory claims that socioeconomic status (SES), acting through social comparisons, has an important influence on susceptibility to disease, materialistic theory says that socioeconomic position (SEP) and related access to material resources matter more. However, the relative role of SEP versus SES in chronic obstructive pulmonary disease (COPD) risk has still not been examined.
We investigated the association between SES/SEP and COPD risk among 667 094 older adults, aged 55 to 60, residing in Sweden between 2006 and 2011. Absolute income in five groups by population quintiles depicted SEP and relative income expressed as quintile groups within each absolute income group represented SES. We performed sex-stratified logistic regression models to estimate odds ratios and the area under the receiver operator curve (AUC) to compare the discriminatory accuracy of SES and SEP in relation to COPD.
Even though both absolute (SEP) and relative income (SES) were associated with COPD risk, only absolute income (SEP) presented a clear gradient, so the poorest had a three-fold higher COPD risk than the richest individuals. While the AUC for a model including only age was 0.54 and 0.55 when including relative income (SES), it increased to 0.65 when accounting for absolute income (SEP). SEP rather than SES demonstrated a consistent association with COPD.
Our study supports the materialistic theory. Access to material resources seems more relevant to COPD risk than the consequences of low relative income.
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PubMed ID
28472960 View in PubMed
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