Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
COPD. 2012 Jun;9(3):216-26. doi: 10.3109/15412555.2011.648030. Epub 2012 Apr 12.
Along with age and sex, socioeconomic status is one of the most powerful determinants of health. We conducted a systematic review to examine the consistency and magnitude of the association between socioeconomic status and COPD health outcomes to determine the potential impact of SES disparity on the COPD population.
Electronic databases to October 2011 were searched for studies of adults who had or were at risk for COPD that quantified an association between a measure of socioeconomic status and at least one COPD health outcome. Two authors independently reviewed studies, assessed study quality, and for eligible studies, extracted data.
Regardless of the population, socioeconomic status measure or COPD outcome examined, with few exceptions, consistent significant inverse associations between socioeconomic status and COPD outcomes were found. Most studies found that individuals of the lowest socioeconomic strata were at least twice as likely to have poor outcomes as those of the highest (range from no difference to 10-fold difference).
Social and economic disadvantage appears to have a significant consistent impact on COPD mortality and morbidity. These findings point to the need for public health strategies and research to address socioeconomic status disparity in individuals with COPD.
与年龄和性别一样，社会经济地位是健康的最重要决定因素之一。我们进行了一项系统评价，以检查社会经济地位与 COPD 健康结局之间的一致性和关联程度，以确定 SES 差异对 COPD 人群的潜在影响。
检索了截至 2011 年 10 月的电子数据库，以寻找研究成年人的研究，这些研究定量评估了社会经济地位衡量标准与至少一种 COPD 健康结局之间的关联。两位作者独立审查了研究，评估了研究质量，并对符合条件的研究提取了数据。
无论研究人群、社会经济地位衡量标准或 COPD 结局如何，除了少数例外，社会经济地位与 COPD 结局之间存在一致的显著负相关关系。大多数研究发现，社会经济地位最低的个体发生不良结局的可能性至少是最高个体的两倍（从无差异到 10 倍差异）。
社会和经济劣势似乎对 COPD 的死亡率和发病率有重大而一致的影响。这些发现表明，需要制定公共卫生策略和研究，以解决 COPD 患者中社会经济地位的差异。
