The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease

Panagis Galiatsatos; Han Woo; Laura M Paulin; Amy Kind; Nirupama Putcha; Amanda J Gassett; Christopher B Cooper; Mark T Dransfield; Trisha M Parekh; Gabriela R Oates; R Graham Barr; Alejandro P Comellas; Meilan K Han; Stephen P Peters; Jerry A Krishnan; Wassim W Labaki; Meredith C McCormack; Joel D Kaufman; Nadia N Hansel

doi:10.2147/COPD.S238933

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The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease

Journal article

Open access

The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease

Panagis Galiatsatos, Han Woo, Laura M Paulin, Amy Kind, Nirupama Putcha, Amanda J Gassett, Christopher B Cooper, Mark T Dransfield, Trisha M Parekh, Gabriela R Oates, …

International journal of chronic obstructive pulmonary disease, Vol.15, pp.981-993

2020

DOI: 10.2147/COPD.S238933

PMCID: PMC7211318

PMID: 32440110

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Abstract

Individual socioeconomic status has been shown to influence the outcomes of patients with chronic obstructive pulmonary disease (COPD). However, contextual factors may also play a role. The objective of this study is to evaluate the association between neighborhood socioeconomic disadvantage measured by the area deprivation index (ADI) and COPD-related outcomes. Residential addresses of SubPopulations and InteRmediate Outcome Measures in COPD Study (SPIROMICS) subjects with COPD (FEV /FVC <0.70) at baseline were geocoded and linked to their respective ADI national ranking score at the census block group level. The associations between the ADI and COPD-related outcomes were evaluated by examining the contrast between participants living in the most-disadvantaged (top quintile) to the least-disadvantaged (bottom quintile) neighborhood. Regression models included adjustment for individual-level demographics, socioeconomic variables (personal income, education), exposures (smoking status, packs per year, occupational exposures), clinical characteristics (FEV % predicted, body mass index) and neighborhood rural status. A total of 1800 participants were included in the analysis. Participants residing in the most-disadvantaged neighborhoods had 56% higher rate of COPD exacerbation (P<0.001), 98% higher rate of severe COPD exacerbation (P=0.001), a 1.6 point higher CAT score (P<0.001), 3.1 points higher SGRQ (P<0.001), and 24.6 meters less six-minute walk distance (P=0.008) compared with participants who resided in the least disadvantaged neighborhoods. Participants with COPD who reside in more-disadvantaged neighborhoods had worse COPD outcomes compared to those residing in less-disadvantaged neighborhoods. Neighborhood effects were independent of individual-level socioeconomic factors, suggesting that contextual factors could be used to inform intervention strategies targeting high-risk persons with COPD.

area deprivation index

health disparities

COPD

Details

Title: Subtitle: The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease
Creators: Panagis Galiatsatos - Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Han Woo - Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Laura M Paulin - Pulmonary and Critical Care, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
Amy Kind - Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
Nirupama Putcha - Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Amanda J Gassett - Internal Medicine, University of Washington, Seattle, WA, USA
Christopher B Cooper - Department of Medicine, University of California Los Angeles School of Medicine, Los Angeles, CA, USA
Mark T Dransfield - Department of Medicine, University of Alabama Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
Trisha M Parekh - Department of Medicine, University of Alabama Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
Gabriela R Oates - Department of Medicine, University of Alabama Birmingham, Birmingham, AL, USA
R Graham Barr - Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
Alejandro P Comellas - Internal Medicine and Pulmonary, University of Iowa, Iowa City, IA, USA
Meilan K Han - Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
Stephen P Peters - Department of Medicine, Wake Forest University Health Sciences, Winston-Salem, NC, USA
Jerry A Krishnan - Department of Medicine, University of Illinois, Chicago, IL, USA
Wassim W Labaki - Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
Meredith C McCormack - Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Joel D Kaufman - Office of the Dean, University of Washington School of Public Health, Seattle, WA, USA
Nadia N Hansel - Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Resource Type: Journal article
Publication Details: International journal of chronic obstructive pulmonary disease, Vol.15, pp.981-993
DOI: 10.2147/COPD.S238933
PMID: 32440110
PMCID: PMC7211318
NLM abbreviation: Int J Chron Obstruct Pulmon Dis
ISSN: 1178-2005
eISSN: 1178-2005
Publisher: New Zealand
Grant note: P30 ES005605 / NIEHS NIH HHS R01 ES023500 / NIEHS NIH HHS U01 HL137880 / NHLBI NIH HHS P30 ES007033 / NIEHS NIH HHS
Language: English
Date published: 2020
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
Record Identifier: 9984066106502771

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