Poverty is strongly associated with all-cause and chronic obstructive pulmonary disease (COPD) mortality. Less is known about the contribution of poverty to spirometrically defined chronic airflow obstruction (CAO)—a key characteristic of COPD. Using cross-sectional data from an asset-based questionnaire to define poverty in 21 sites of the Burden of Obstructive Lung Disease study, we estimated the risk of CAO attributable to poverty. Up to 6% of the population over 40 years had CAO attributable to poverty. Understanding the relationship between poverty and CAO might suggest ways to improve lung health, especially in low-income and middle-income countries.
- COPD epidemiology
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Collaborators The BOLD (Burden of Obstructive Lung Disease) Collaborative Research Group members Albania: Hasan Hafizi (PI), Anila Aliko, Donika Bardhi, Holta Tafa, Natasha Thanasi, Arian Mezini, Alma Teferici, Dafina Todri, Jolanda Nikolla and Rezarta Kazasi (Tirana University Hospital Shefqet Ndroqi, Albania); Algeria: Hamid Hacene Cherkaski (PI), Amira Bengrait, Tabarek Haddad, Ibtissem Zgaoula, Maamar Ghit, Abdelhamid Roubhia, Soumaya Boudra, Feryal Atoui, Randa Yakoubi, Rachid Benali, Abdelghani Bencheikh and Nadia Ait-Khaled (Faculté de Médecine Annaba, Service de Epidémiologie et Médecine Préventive, El Hadjar, Algeria); Benin: Herve Lawin (PI), Arsene Kpangon, Karl Kpossou, Gildas Agodokpessi, Paul Ayelo and Benjamin Fayomi (Unit of Teaching and Research in Occupational and Environmental Health, University of Abomey Calavi, Cotonou, Benin); Cameroon: Bertrand Mbatchou (PI) and Atongno Humphrey Ashu (Douala General Hospital, Douala, Cameroon); India: Mahesh Rao (PI) (JSS Medical College, Mysuru, India), Parvaiz A Koul (PI), Sajjad Malik, Nissar A Hakim and Umar Hafiz Khan (Sher-i-Kashmir Institute of Medical Sciences, Srinagar, J&K, India); Jamaica: Althea Aquart-Stewart (PI) and Akosua Francia Aikman (University of the West Indies, Kingston, Jamaica); Kyrgyzstan: Talant M Sooronbaev (PI), Bermet M Estebesova, Meerim Akmatalieva, Saadat Usenbaeva, Jypara Kydyrova, Eliza Bostonova, Ulan Sheraliev, Nuridin Marajapov, Nurgul Toktogulova, Berik Emilov, Toktogul Azilova, Gulnara Beishekeeva, Nasyikat Dononbaeva and AijamalTabyshova (Pulmunology and Allergology Department, National Centre of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan); Malawi: Kevin Mortimer (PI), Wezzie Nyapigoti, Ernest Mwangoka, Mayamiko Kambwili, Martha Chipeta, Gloria Banda, Suzgo Mkandawire and Justice Banda (the Malawi Liverpool Wellcome Trust, Blantyre, Malawi); Malaysia: Li-Cher Loh (PI), Abdul Rashid and Siti Sholehah (RCSI & UCD Malaysia Campus, Penang, Malaysia); Morocco: Mohamed C Benjelloun (PI), Chakib Nejjari, Mohamed Elbiaze and Karima El Rhazi (Laboratoire d’épidémiologie, Recherche Clinique et Santé Communautaire, Fès, Morocco); Nigeria: Daniel Obaseki (PI), Gregory Erhabor, Olayemi Awopeju and Olufemi Adewole (Obafemi Awolowo University, Ile-Ife, Nigeria); Pakistan: Asaad A Nafees (PI) Muhammad Irfan, Zafar Fatmi, Aysha Zahidie, Natasha Shaukat and Meesha Iqbal (Aga Khan University, Karachi, Pakistan); Saudi Arabia: M Al Ghobain (PI), H Alorainy (PI), E. El-Hamad, M Al Hajjaj, A Hashi, R Dela, R Fanuncio, E Doloriel, I Marciano and L Safia (Saudi Thoracic Society, Riyadh, Saudi Arabia); Sri Lanka: Kirthi Gunasekera (PI), Rajitha Wickremasinghe (Medical Research Institute, Central Chest Clinic, Colombo, Sri Lanka); Sudan: Asma Elsony (PI), Hana A Elsadig, Nada Bakery Osman, Bandar Salah Noory, Monjda Awad Mohamed, Hasab Alrasoul Akasha Ahmed Osman, Namarig Moham ed Elhassan, Abdel Mu‘is El Zain, Marwa Mohamed Mohamaden, Suhaiba Khalifa, Mahmoud Elhadi, Mohand Hassan and Dalia Abdelmonam (the Epidemiological Laboratory, Khartoum, Sudan); Trinidad and Tobago: Terence Seemungal (PI), Fallon Lutchmansingh and Liane Conyette (University of the West Indies, St Augustine, Trinidad and Tobago); Tunisia: Imed Harrabi (PI), Myriam Denguezli, Zouhair Tabka, Hager Daldoul, Zaki Boukheroufa, Firas Chouikha and Wahbi Belhaj Khalifa (University Hospital Farhat Hached, Faculté de Médecine, Sousse, Tunisia); UK: Peter GJ Burney (PI), Anamika Jithoo, Louisa Gnatiuc, Hadia Azar, Jaymini Patel, Caron Amor, James Potts, Michael Tumilty, and Fiona McLean, Risha Dudhaiya and Andre Amaral (National Heart and Lung Institute, Imperial College London, London, UK).
Contributors PGJB and SB: involved in the initial design of the study. JHP and AFSA: drafted the initial manuscript. JHP, CM and FGE: analysed the data. PGJB, SB, JHP, AFSA, CM, FGE, KM, AES, KER, TARS, PAM, DOO, MD, RA, HC, PK, AR, RLCL, HL, MAG, AAN, AA-S and IH: discussed the results, read and approved and contributed to developing the final version of manuscript.
Funding The work is supported by Wellcome Trust (grant number: 085790/Z/08/Z) for the Burden of Obstructive Lung Disease (BOLD) study. The initial BOLD programme was funded in part by unrestricted educational grants to the Operations Center in Portland, Oregon, from Altana, Aventis, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Merck, Novartis, Pfizer and Schering-Plough, Sepracor, and the University of Kentucky (Lexington, KY). A full list of local funders can be found at https://www.boldstudy.org.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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