Do Biomarkers Vary by Social Class, Education and Region and Is Migration Important? Evidence From a Cohort of British Adults

Krzyzanowska, Monika K.; Mascie‐Taylor, C. G. N.

doi:10.1017/s0021932017000700

Cited by 3 publications

(4 citation statements)

References 83 publications

(88 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast to indices such as the Area Deprivation Index (ADI), which summarizes contemporary neighborhood exposures, our Adversity-Opportunity Index (AOI) incorporates the measurement of historic, cumulative experiences, focused at the individual level. Paralleling prior work (21), we equally weighted and summed household income (22), education (23), in utero tobacco smoke exposures (24), occupational respiratory exposures (25), and access to fresh and healthy food (26,27) as five representative indicators of social and structural determinants of health to create the AOI. Lower scores represent more adverse conditions.…”

Section: Adversity-opportunity Indexmentioning

confidence: 99%

Reconsidering the Utility of Race-Specific Lung Function Prediction Equations

Baugh

Shiboski

Hansel

et al. 2022

Am J Respir Crit Care Med

View full text Add to dashboard Cite

Rationale: African American individuals have worse outcomes in chronic obstructive pulmonary disease (COPD).Objectives: To assess whether race-specific approaches for estimating lung function contribute to racial inequities by failing to recognize pathological decrements and considering them normal.Methods: In a cohort with and at risk for COPD, we assessed whether lung function prediction equations applied in a racespecific versus universal manner better modeled the relationship between FEV 1 , FVC, and other COPD outcomes, including the COPD Assessment Test, St. George's Respiratory Questionnaire, computed tomography percent emphysema, airway wall thickness, and 6-minute-walk test. We related these outcomes to differences in FEV 1 using multiple linear regression and compared predictive performance between fitted models using root mean squared error and Alpaydin's paired F test.Measurements and Main Results: Using race-specific equations, African American individuals were calculated to have better lung function than non-Hispanic White individuals (FEV 1 , 76.8% vs. 71.8% predicted; P = 0.02). Using universally applied equations, African American individuals were calculated to have worse lung function. Using Hankinson's Non-Hispanic White equation, FEV 1 was 64.7% versus 71.8% (P , 0.001). Using the Global Lung Initiative's Other race equation, FEV 1 was 70.0% versus 77.9% (P , 0.001). Prediction errors from linear regression were less for universally applied equations compared with race-specific equations when examining FEV 1 % predicted with the COPD Assessment Test (P , 0.01), St. George's Respiratory Questionnaire (P , 0.01), and airway wall thickness (P , 0.01). Although African American participants had greater adversity (P , 0.001), less adversity was only associated with better FEV 1 in non-Hispanic White participants (P for interaction = 0.041).Conclusions: Race-specific equations may underestimate COPD severity in African American individuals.Clinical trial registered with www.clinicaltrials.gov (NCT01969344).

show abstract

Section: Adversity-opportunity Indexmentioning

confidence: 99%

Reconsidering the Utility of Race-Specific Lung Function Prediction Equations

Baugh

Shiboski

Hansel

et al. 2022

Am J Respir Crit Care Med

View full text Add to dashboard Cite

show abstract

“…Occupational respiratory exposure was recorded as never, ever, or unsure [23,24]. Maximal educational attainment [25] was recorded as less than high school diploma, greater than higher school diploma, or high school diploma. Household income was reported as high, low, or unreported, with a threshold set at $50 000/year to approximate 200% of the federal poverty line for a family of four [26,27].…”

Section: Socio-environmental Exposuresmentioning

confidence: 99%

Risk of COPD exacerbation is increased by poor sleep quality and modified by social adversity

Baugh

Buhr

Quibrera

et al. 2022

Sleep

View full text Add to dashboard Cite

Study Objectives Sleep is an important dimension in the care of chronic obstructive pulmonary disease (COPD), but its relevance to exacerbations is unclear. We wanted to assess whether sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) is associated with an increased risk of COPD exacerbations and does this differ by socio-environmental exposures. Methods We included 1647 current and former smokers with spirometrically confirmed COPD from the SPIROMICS cohort. We assessed incidence rate ratios for exacerbation using zero-inflated negative binomial regression adjusting for demographics, medical comorbidities, and multiple metrics of disease severity, including respiratory medications, airflow obstruction, and symptom burden. Our final model adjusted for socio-environmental exposures using the Area Deprivation Index, a composite measure of contemporary neighborhood quality, and Adversity–Opportunity Index, a composite measure of individual-level historic and current socioeconomic indicators. We used a pre-determined threshold of 20% missingness to undertake multiple imputation by chained equations. As sensitivity analyses, we repeated models in those with complete data and after controlling for prior exacerbations. As an exploratory analysis, we considered an interaction between socio-environmental condition and sleep quality. Results After adjustment for all co-variates, increasing PSQI scores (range 0–21) were associated with a 5% increased risk for exacerbation per point (p = .001) in the imputed dataset. Sensitivity analyses using complete cases and after controlling for prior exacerbation history were similar. Exploratory analysis suggested less effect among those who lived in poor-quality neighborhoods (p-for-interaction = .035). Conclusions Poor sleep quality may contribute to future exacerbations among patients with COPD. This represents one target for improving disease control. Clinical Trial Registration Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS). ClinicalTrials.gov Identifier# NCT01969344. Registry URL: https://clinicaltrials.gov/ct2/show/.

show abstract

“…Recent longitudinal and cross-sectional research suggests that upward, or positive, change in SES from childhood to adulthood (i.e., upward mobility [UM]), may mitigate some of these negative effects (11,13,(19)(20)(21)(22)(23). Conversely, downward SES mobility (or negative change in SES from childhood to adulthood) has been found to be associated with negative mental health, physical health, and cognitive outcomes (e.g., Refs.…”

Section: Introductionmentioning

confidence: 99%

“…(11,19,22)). For example, a study in the United Kingdom found that upward changes in SES were related to better cardiovascular and respiratory health outcomes, whereas downward changes in SES were associated with poorer health outcomes (21). Another large study using Health and Retirement Study data found that those who experienced UM from childhood to adulthood had fewer depressive symptoms, better cognitive functioning (based on a telephone screen), and fewer chronic health conditions than those with similar childhood SES who did not experience UM (11).…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic Mobility and Psychological and Cognitive Functioning in a Diverse Sample of Adults With and Without HIV

et al. 2021

View full text Add to dashboard Cite

Objective: This cross-sectional study examined the effects of socioeconomic status (SES) mobility from childhood to adulthood on psychological and cognitive well-being in African American and non-Hispanic White HIV-positive (HIV+) and HIV-seronegative (HIV−) adults who are part of an ongoing study investigating psychosocial and neurobehavioral effects of HIV. Methods: Participants (N = 174, 24.1% female, 59.2% African American, 67.8% HIV+) were categorized into four groups (upward mobility, downward mobility, stable-not-poor, chronic-poverty) based on self-reported childhood and current community SES (which were correlated with objective measures of SES and proxies of childhood SES). SES groups were compared on self-report measures of psychological well-being, subjective executive functioning ratings, and performance across six cognitive domains. Primary analyses were stratified by HIV status. Results: For the HIV+ group, SES mobility was associated with psychological well-being (chronic burden of stress:

show abstract

Do Biomarkers Vary by Social Class, Education and Region and Is Migration Important? Evidence From a Cohort of British Adults

Cited by 3 publications

References 83 publications

Reconsidering the Utility of Race-Specific Lung Function Prediction Equations

Reconsidering the Utility of Race-Specific Lung Function Prediction Equations

Risk of COPD exacerbation is increased by poor sleep quality and modified by social adversity

Socioeconomic Mobility and Psychological and Cognitive Functioning in a Diverse Sample of Adults With and Without HIV

Contact Info

Product

Resources

About