Department of Respiratory Medicine, Copenhagen University Hospital - Hvidovre, Hvidovre, Denmark.
Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Chron Respir Dis. 2024 Jan-Dec;21:14799731241231816. doi: 10.1177/14799731241231816.
Asthma is the most common chronic illness in children, carrying a major burden. Socioeconomic position (SEP) affects adult asthma outcomes, but its impact on childhood asthma, particularly in primary versus specialist care, has not been studied thoroughly.
In a Danish cohort consisting of all children aged 2-17 years redeeming inhaled corticosteroids in 2015, parental SEP impact on asthma outcomes was investigated. Workforce attachment, income, education, and metropolitan residence were chosen as covariates in logistic regression. Outcomes were uncontrolled (excessive use of short-acting beta2-agonists), exacerbating (oral corticosteroid use or hospitalization), and severe asthma (according to GINA 2020).
The cohort comprised 29,851 children (median age 8.0, 59% boys). 16% had uncontrolled asthma, 8% had ≥1 exacerbation. Lower income and metropolitan residence correlated with higher odds of poor control, exacerbations, and severe asthma. Lower education correlated with worse asthma outcomes. Education and income were protective factors in primary care, but not in specialist care. Metropolitan residence was the sole factor linked to specialist care referral for severe asthma.
Low parental SEP and metropolitan residence associated with poor asthma outcomes. However, specialist care often mitigated these effects, though such care was less likely for at-risk children in non-metropolitan areas.
哮喘是儿童最常见的慢性病，负担沉重。社会经济地位（SEP）会影响成人哮喘的结果，但它对儿童哮喘的影响，特别是在初级保健与专科护理中的影响，尚未得到充分研究。
在丹麦的一个队列中，纳入了所有在 2015 年使用吸入皮质类固醇治疗的 2-17 岁儿童，研究了父母 SEP 对哮喘结果的影响。劳动力依附、收入、教育程度和都市区居住被选为逻辑回归的协变量。结果为未控制（短效β2 受体激动剂过度使用）、恶化（口服皮质类固醇使用或住院）和严重哮喘（根据 GINA 2020）。
该队列包含 29851 名儿童（中位数年龄 8.0 岁，59%为男性）。16%的儿童哮喘未得到控制，8%的儿童哮喘有≥1 次恶化。较低的收入和都市区居住与较差的控制、恶化和严重哮喘的几率较高相关。较低的教育程度与较差的哮喘结果相关。教育程度和收入在初级保健中是保护因素，但在专科保健中不是。都市区居住是与严重哮喘专科护理转诊相关的唯一因素。
父母 SEP 较低和都市区居住与哮喘结果较差相关。然而，专科护理通常减轻了这些影响，但在非都市区，高危儿童获得专科护理的可能性较小。
