NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, UK.
Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
Eur J Public Health. 2018 Feb 1;28(1):134-138. doi: 10.1093/eurpub/ckx091.
Infectious intestinal diseases (IID) are common, affecting around 25% of people in UK each year at an estimated annual cost to the economy, individuals and the NHS of £1.5 billion. While there is evidence of higher IID hospital admissions in more disadvantaged groups, the association between socioeconomic status (SES) and risk of IID remains unclear. This study aims to investigate the relationship between SES and IID in a large community cohort.
Longitudinal analysis of a prospective community cohort in the UK following 6836 participants of all ages was undertaken. Hazard ratios for IID by SES were estimated using Cox proportional hazard, adjusting for follow-up time and potential confounding factors.
In the fully adjusted analysis, hazard ratio of IID was significantly lower among routine/manual occupations compared with managerial/professional occupations (HR 0.74, 95% CI 0.61-0.90).
In this large community cohort, lower SES was associated with lower IID risk. This may be partially explained by the low response rate which varied by SES. However, it may be related to differences in exposure or recognition of IID symptoms by SES. Higher hospital admissions associated with lower SES observed in some studies could relate to more severe consequences, rather than increased infection risk.
感染性肠道疾病（IID）很常见，每年估计有 25%的英国人受到影响，给经济、个人和 NHS 带来的年成本为 15 亿英镑。尽管有证据表明，在社会经济地位（SES）较低的人群中，IID 的住院率更高，但 SES 与 IID 风险之间的关联仍不清楚。本研究旨在调查 SES 与大型社区队列中 IID 之间的关系。
对英国一项前瞻性社区队列中的 6836 名各年龄段参与者进行了纵向分析。使用 Cox 比例风险分析估计 SES 与 IID 的风险比，调整随访时间和潜在混杂因素。
在完全调整的分析中，与管理/专业职业相比，常规/体力劳动者的 IID 风险显著降低（HR 0.74，95%CI 0.61-0.90）。
在这个大型社区队列中，较低的 SES 与较低的 IID 风险相关。这可能部分归因于 SES 之间的低响应率存在差异。然而，这可能与 SES 对 IID 症状的暴露或认识的差异有关。一些研究中观察到的与 SES 较低相关的较高住院率可能与更严重的后果有关，而不是感染风险增加。
