The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease
Panagis Galiatsatos,1 Han Woo,1 Laura M Paulin,2 Amy Kind,3,4 Nirupama Putcha,1 Amanda J Gassett,5 Christopher B Cooper,6 Mark T Dransfield,7 Trisha M Parekh,7 Gabriela R Oates,8 R Graham Barr,9 Alejandro P Comellas,10 Meilan K Han,11 Stephen P Peters,12 Jerry A Krishnan,13 Wassim W Labaki,11 Meredi...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2020-05-01
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| Series: | International Journal of COPD |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-association-between-neighborhood-socioeconomic-disadvantage-and-ch-peer-reviewed-article-COPD |
| _version_ | 1828765750614032384 |
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| author | Galiatsatos P Woo H Paulin LM Kind A Putcha N Gassett AJ Cooper CB Dransfield MT Parekh TM Oates GR Barr RG Comellas AP Han MK Peters SP Krishnan JA Labaki WW McCormack MC Kaufman JD Hansel NN |
| author_facet | Galiatsatos P Woo H Paulin LM Kind A Putcha N Gassett AJ Cooper CB Dransfield MT Parekh TM Oates GR Barr RG Comellas AP Han MK Peters SP Krishnan JA Labaki WW McCormack MC Kaufman JD Hansel NN |
| author_sort | Galiatsatos P |
| collection | DOAJ |
| description | Panagis Galiatsatos,1 Han Woo,1 Laura M Paulin,2 Amy Kind,3,4 Nirupama Putcha,1 Amanda J Gassett,5 Christopher B Cooper,6 Mark T Dransfield,7 Trisha M Parekh,7 Gabriela R Oates,8 R Graham Barr,9 Alejandro P Comellas,10 Meilan K Han,11 Stephen P Peters,12 Jerry A Krishnan,13 Wassim W Labaki,11 Meredith C McCormack,1 Joel D Kaufman,14 Nadia N Hansel1 1Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Pulmonary and Critical Care, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA; 3University of Wisconsin School of Medicine and Public Health, Department of Medicine Health Services and Care Research Program and Division of Geriatrics, Madison, WI, USA; 4Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA; 5Internal Medicine, University of Washington, Seattle, WA, USA; 6Department of Medicine, University of California Los Angeles School of Medicine, Los Angeles, CA, USA; 7Department of Medicine, University of Alabama Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA; 8Department of Medicine, University of Alabama Birmingham, Birmingham, AL, USA; 9Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA; 10Internal Medicine and Pulmonary, University of Iowa, Iowa City, IA, USA; 11Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA; 12Department of Medicine, Wake Forest University Health Sciences, Winston-Salem, NC, USA; 13Department of Medicine, University of Illinois, Chicago, IL, USA; 14Office of the Dean, University of Washington School of Public Health, Seattle, WA, USACorrespondence: Panagis GaliatsatosJohns Hopkins University School of Medicine, 4940 Eastern Avenue, Asthma and Allergy Building, 4th Floor, Baltimore, MD 21224, USATel +1410 550-0522Fax +1410 550-1094Email panagis@jhmi.eduRationale: 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.Methods: Residential addresses of SubPopulations and InteRmediate Outcome Measures in COPD Study (SPIROMICS) subjects with COPD (FEV1/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 (FEV1% predicted, body mass index) and neighborhood rural status.Results: 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.Conclusion: 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.Keywords: health disparities, COPD, area deprivation index |
| first_indexed | 2024-12-11T06:53:35Z |
| format | Article |
| id | doaj.art-ac172b236ba84f9381d461b0f1295fd4 |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-12-11T06:53:35Z |
| publishDate | 2020-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-ac172b236ba84f9381d461b0f1295fd42022-12-22T01:16:50ZengDove Medical PressInternational Journal of COPD1178-20052020-05-01Volume 1598199353548The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary DiseaseGaliatsatos PWoo HPaulin LMKind APutcha NGassett AJCooper CBDransfield MTParekh TMOates GRBarr RGComellas APHan MKPeters SPKrishnan JALabaki WWMcCormack MCKaufman JDHansel NNPanagis Galiatsatos,1 Han Woo,1 Laura M Paulin,2 Amy Kind,3,4 Nirupama Putcha,1 Amanda J Gassett,5 Christopher B Cooper,6 Mark T Dransfield,7 Trisha M Parekh,7 Gabriela R Oates,8 R Graham Barr,9 Alejandro P Comellas,10 Meilan K Han,11 Stephen P Peters,12 Jerry A Krishnan,13 Wassim W Labaki,11 Meredith C McCormack,1 Joel D Kaufman,14 Nadia N Hansel1 1Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Pulmonary and Critical Care, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA; 3University of Wisconsin School of Medicine and Public Health, Department of Medicine Health Services and Care Research Program and Division of Geriatrics, Madison, WI, USA; 4Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA; 5Internal Medicine, University of Washington, Seattle, WA, USA; 6Department of Medicine, University of California Los Angeles School of Medicine, Los Angeles, CA, USA; 7Department of Medicine, University of Alabama Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA; 8Department of Medicine, University of Alabama Birmingham, Birmingham, AL, USA; 9Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA; 10Internal Medicine and Pulmonary, University of Iowa, Iowa City, IA, USA; 11Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA; 12Department of Medicine, Wake Forest University Health Sciences, Winston-Salem, NC, USA; 13Department of Medicine, University of Illinois, Chicago, IL, USA; 14Office of the Dean, University of Washington School of Public Health, Seattle, WA, USACorrespondence: Panagis GaliatsatosJohns Hopkins University School of Medicine, 4940 Eastern Avenue, Asthma and Allergy Building, 4th Floor, Baltimore, MD 21224, USATel +1410 550-0522Fax +1410 550-1094Email panagis@jhmi.eduRationale: 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.Methods: Residential addresses of SubPopulations and InteRmediate Outcome Measures in COPD Study (SPIROMICS) subjects with COPD (FEV1/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 (FEV1% predicted, body mass index) and neighborhood rural status.Results: 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.Conclusion: 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.Keywords: health disparities, COPD, area deprivation indexhttps://www.dovepress.com/the-association-between-neighborhood-socioeconomic-disadvantage-and-ch-peer-reviewed-article-COPDhealth disparitiescopdarea deprivation index |
| spellingShingle | Galiatsatos P Woo H Paulin LM Kind A Putcha N Gassett AJ Cooper CB Dransfield MT Parekh TM Oates GR Barr RG Comellas AP Han MK Peters SP Krishnan JA Labaki WW McCormack MC Kaufman JD Hansel NN The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease International Journal of COPD health disparities copd area deprivation index |
| title | The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease |
| title_full | The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease |
| title_fullStr | The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease |
| title_full_unstemmed | The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease |
| title_short | The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease |
| title_sort | association between neighborhood socioeconomic disadvantage and chronic obstructive pulmonary disease |
| topic | health disparities copd area deprivation index |
| url | https://www.dovepress.com/the-association-between-neighborhood-socioeconomic-disadvantage-and-ch-peer-reviewed-article-COPD |
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