Individuals with higher socioeconomic status may enjoy a longer life, but we haven’t precisely pinned down all the reasons why. Disparities in lung function may help explain the lifespan gap between the poorest and richest Americans, and in today’s episode we cover a recent study on that proposed association.
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Higher income is associated with a longer lifespan,
but we haven't fully outlined the many, many factors that contribute to this.
A recent study out in JAMA Internal Medicine examined socioeconomic disparities in lung
function as a potential contributor to this widening gap in lifespan between poor and
wealthy Americans. And that's the topic of this week's Healthcare Triage.
To the research!
In 2016, a JAMA article reported that the gap in life expectancy between the richest 1%
and the poorest 1% was 14.6 years for men and 10.1 years for women.
It also reported that this gap grew over the 14-year study period,
with longevity increasing far more for those in the top 5% than those in the bottom 5%.
Reduced lung function is associated with an increase in all-cause mortality,
and there are socioeconomic disparities in respiratory function and disease.
According to one systematic review and meta-analysis in the BMJ,
children, adolescents, and young adults from lower socioeconomic backgrounds
have lower respiratory function.
To the research again!
The study we're focusing on today, just published at the end of May,
examines the association between socioeconomic status and respiratory disease
and pulmonary symptoms and function over the last six decades using data from the
National Health and Nutrition Examination Surveys as well as its predecessor surveys.
These data included over 215,000 people and examined socioeconomic differences
in the prevalence of smoking, labored breathing upon exertion, coughing, wheezing, asthma,
chronic obstructive pulmonary disease, or COPD, and three measures of pulmonary function.
Given improvements in air quality and decreased smoking rates over the time period studied,
the authors aimed to understand if these improvements and related policies
had any effect on closing the socioeconomic gap in respiratory health.
Unfortunately, the answer appears to be no.
The disparities in respiratory symptoms either persisted or worsened over the study period,
with more respiratory symptoms reported among poorer and less educated individuals.
While the prevalence of asthma rose among children in all income groups after 1980,
that rise was more distinct among children from low-income backgrounds.
Before 1980, there were no significant differences in asthma occurrence between income groups,
but by 2017-2018, there was an almost 5% difference,
with asthma prevalence at 14.8% in the poorest group compared to 6.8% in the wealthiest group.
A similar pattern was seen in adults.
Disparities in COPD among low- and high-earners also rose,
with rates among the wealthiest group remaining steady,
while rates among the poorest group increased by almost 6%.
Two measures of pulmonary function also differed greatly between groups
and continued to widen over the time period examined.
These differences are likely due to factors such as exposure to cigarette smoke,
polluted air, workplace exposures, and access to quality medical care, among others.
While we can't determine causality using these data,
they seem to suggest that efforts to improve air quality, occupational safety,
and medical care, and efforts to decrease smoking,
have not equally benefited all socioeconomic groups.
Given the myriad of studies that support socioeconomic status
as a major determinant of disease,
these data may help light the way to understanding
and addressing these gaps in health and longevity,
something that clearly needs to be made a priority before they widen even further.
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You might enjoy the previous episodes that we did on CBD and health.
Go watch them both.
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We'd like to especially thank our research associates,
James Glasgow, Joe Sevitz, Josh Gister, Michael Chin,
and of course, Research Enamoral, Sam.
