title: Area-level socio-economic status and health status among adults with asthma and rhinitis.
abstract: Socio-economic status (SES) may affect health status in airway disease at the individual and area level. In a cohort of adults with asthma, rhinitis or both conditions, questionnaire-derived individual-level SES and principal components analysis (PCA) of census data for area-level SES factors were used. Regression analysis was utilised to study the associations among individual- and area-level SES for the following four health status measures: severity of asthma scores and the Short Form-12 Physical Component Scale (SF-12 PCS) (n = 404); asthma-specific quality of life (QoL) scores (n = 340); and forced expiratory volume in one second (FEV1) per cent predicted (n = 218). PCA yielded a two-factor solution for area-level SES. Factor 1 (lower area-level SES) was significantly associated with poorer SF-12 PCS and worse asthma QoL. These associations remained significant after adding individual-level SES. Factor 1 was also significantly associated with severity of asthma scores, but not after addition of the individual-level SES. Factor 2 (suburban area-level SES) was associated with lower FEV1 per cent predicted in combined area-level and individual SES models. In conclusion, area-level socio-economic status is linked to some, but not all, of the studied health status measures after taking into account individual-level socio-economic status.
authors.affiliation: Dept of Medicine, University of California San Francisco, San Francisco, CA, USA. blancp@itsa.ucsf.edu
authors.forename: P D
authors.initials: PD
authors.lastname: Blanc
authors.forename: I H
authors.initials: IH
authors.lastname: Yen
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.forename: P P
authors.initials: PP
authors.lastname: Katz
authors.forename: G
authors.initials: G
authors.lastname: Earnest
authors.forename: J R
authors.initials: JR
authors.lastname: Balmes
authors.forename: L
authors.initials: L
authors.lastname: Trupin
authors.forename: N
authors.initials: N
authors.lastname: Friedling
authors.forename: E H
authors.initials: EH
authors.lastname: Yelin
authors.forename: M D
authors.initials: MD
authors.lastname: Eisner
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D019352:Censuses; D005260:Female; D005541:Forced Expiratory Volume; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D012220:Rhinitis / Q000453:epidemiology*; D012720:Severity of Illness Index; D012923:Social Class; D013147:Spirometry; D011795:Surveys and Questionnaires