title: Relationship between COPD and lower socioeconomic status in farmers from South-Eastern Poland (Lublin region).
abstract: BACKGROUND
  Lower socioeconomic status is considered to be an independent risk factor of chronic conditions, such as chronic obstructive pulmonary disease (COPD). COPD, one of the major public health problems worldwide, is a chronic inflammatory lung disease of a multifactorial background. COPD morbidity in rural areas has been higher than in urban settings, as apart from the major causative factor, tobacco smoking, the burden of this disease in rural environments is also connected to additional occupational factors (organic dusts). The management of chronic diseases seems to be particularly difficult in rural areas. The aim of the study was to analyze the socioeconomic status of farmers suffering from COPD in comparison to healthy farmers.
  
  
  METHODS
  Thirty farmers with COPD and 34 healthy farmers from the Lublin region (Poland) were investigated based on the area of land they possessed (an indicator used in the health insurance system in Poland to classify farmers). The farmers from five rural communes were selected by general practitioners. Statistical analysis was performed by non-parametric Mann-Whitney U-test for the differences between area of farms. The p < 0.05 level was considered as significant.
  
  
  RESULTS
  Area of land (median: 1.5 ha, 25th-75th percentile: 1.0-4.0) owned by farmers with COPD was significantly lower than area of farms belonging to healthy farmers (median: 7.0 ha, 25th-75th percentile: 3.0-10.0) (p < 0001, Mann-Whitney U-test).
  
  
  CONCLUSIONS
  In rural areas individuals with COPD are characterized by significantly lower socioeconomic status than healthy persons. COPD is a major health problem, especially in rural areas, which may indicate that policy-makers should consider addressing equity in COPD management in rural areas.
authors.affiliation: Unit of Fibroproliferative Diseases, Institute of Rural Health, Lublin, Poland. msgolec@yahoo.com.
authors.forename: M
authors.initials: M
authors.lastname: Golec
authors.affiliation: Unit of Fibroproliferative Diseases, Institute of Rural Health, Lublin, Poland. skorska@op.pl.
authors.forename: C
authors.initials: C
authors.lastname: Skórska
authors.affiliation: Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland. b.mack@wp.pl.
authors.forename: B
authors.initials: B
authors.lastname: Mackiewicz
authors.affiliation: Department of Zoonoses, Institute of Rural Health, Lublin, Poland. dutkiewi@galen.imw.lublin.pl.
authors.forename: J
authors.initials: J
authors.lastname: Dutkiewicz
authors.affiliation: Department of Allergology and Environmental Hazards, Department of Internal Medicine and Occupational Diseases, Institute of Rural Health, Lublin, Poland. angora@vp.pl.
authors.forename: A
authors.initials: A
authors.lastname: Góra
authors.affiliation: Unit of Fibroproliferative Diseases, Institute of Rural Health, Lublin, Poland. martalemieszek@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Lemieszek
authors.affiliation: Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland. janusz.milanowski@am.lublin.pl.
authors.forename: J
authors.initials: J
authors.lastname: Milanowski
mesh_terms: D000328:Adult; D000368:Aged; D000383:Agriculture / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012424:Rural Population / Q000706:statistics & numerical data*; D012907:Smoking; D012959:Socioeconomic Factors