Abstract
Objective: Low socioeconomic status based both on educational level and income has been associated with asthma and respiratory symptoms, but changes over time in these associations have rarely been studied. The aim was to study the associations between educational or income inequality and asthma and respiratory symptoms among women and men over a 20-year period in northern Sweden. Methods: The study was performed within the Obstructive Lung disease in Northern Sweden (OLIN) research program. Mailed questionnaire surveys were administered to a random sample of adults (20-69 years of age) living in Sweden, in 1996, 2006 and 2016. Data on educational level and income were collected from the national integrated database for labor market research. Results: The educational inequality associated with asthma and asthmatic wheeze tended to decrease from 1996 to 2016, while it increased for productive cough, the latter among men not among women. The income inequality decreased for productive cough, especially for women, while no clear overall trends were found for asthmatic wheeze and asthma, apart from a decrease in income inequality regarding asthma among men. Conclusion: The patterns for socioeconomic inequality differed for asthma and wheeze compared to productive cough, and the results emphasize that education and income do not mirror the same aspects of socioeconomic inequality in a high-income country. Our findings are important for decision makers, not the least on a political level, as reduced inequality, e.g. through education, could lead to reduced morbidity.
| Original language | English |
|---|---|
| Pages (from-to) | 185-194 |
| Journal | Journal of Asthma |
| Volume | 60 |
| Issue number | 1 |
| Early online date | 2022 |
| DOIs | |
| Publication status | Published - 2023 |
| Publication type | A1 Journal article-refereed |
Funding
The study data are derived from the epidemiological research program The Obstructive Lung disease in Northern Sweden (OLIN) studies. The study was undertaken within the framework of the Nordic EpiLung study, a consortium project funded by the Nordic Council to catalyze population-based investigations of the contribution of socioeconomic status (SES) to the burden of obstructive airway diseases across the Nordic countries. Three separate cross-sectional mailed questionnaire surveys were performed in 1996, 2006 and 2016. Random samples aged 20–69 y living in Norrbotten, the northernmost county in Sweden, were invited, and the response rates were 85% (n = 7104), 77% (n = 6165) and 53% (n = 5466), respectively (). Using the unique personal identification numbers assigned to all residents in Sweden, the questionnaire data were linked to register data from the integrated database for labor market research (LISA) of Statistics Sweden. Data were collected from the years preceding the questionnaire surveys, i.e. in 1995, 2005 and 2015, respectively. This register provided the source for assessment of SES by educational level and income. Researchers working on the project received anonymized data. Ethical approval was given by the Regional Ethical Review Board of Umeå.
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
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SDG 3 Good Health and Well-being -
SDG 4 Quality Education -
SDG 10 Reduced Inequalities
Keywords
- Asthma
- Epidemiology
- Respiratory symptoms
- Socioeconomic inequality
- Socioeconomic status
Publication forum classification
- Publication forum level 1
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Immunology and Allergy
- Pulmonary and Respiratory Medicine
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