Backman Helena, Bhatta Laxmi, Hedman Linnea, Brumpton Ben, Vähätalo Iida, Lassmann-Klee Paul G, Nwaru Bright I, Ekerljung Linda, Krokstad Steinar, Aalberg Vikjord Sigrid Anna, Lindberg Anne, Kankaanranta Hannu, Rönmark Eva, Langhammer Arnulf
Section of Sustainable Health/ the OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology NTNU, Trondheim, Norway.
J Asthma Allergy. 2024 Mar 18;17:209-218. doi: 10.2147/JAA.S450103. eCollection 2024.
The relationship between socioeconomic status (SES), asthma and mortality is complex and multifaceted, and it is not established if educational level modifies the association between asthma and mortality. The aim was to study the association between asthma and mortality in Sweden and Norway and to what extent educational level modifies this association.
Within the Nordic EpiLung Study, >56,000 individuals aged 30-69 years participated in population-based surveys on asthma and associated risk factors in Sweden and Norway during 2005-2007. Data on educational level and 10-year all-cause mortality were linked by national authorities. The fraction of mortality risk attributable to asthma was calculated, and Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for mortality related to asthma, stratified by educational level.
In total, 5.5% of all deaths was attributed to asthma. When adjusted for potential confounders, the HR for mortality related to asthma was 1.71 (95% CI 1.52-1.93). Those with primary level of education had higher hazard of all-cause death related to asthma than those with tertiary level (HR 1.80, 95% CI 1.48-2.18, vs HR 1.39, 95% CI 0.99-1.95).
Asthma was associated with an overall 71% increased all-cause mortality and 5.5% of deaths can be attributed to asthma. Educational levels modified the risk of mortality associated with asthma, with the highest risk among those with primary education.
社会经济地位（SES）、哮喘与死亡率之间的关系复杂且多面，教育水平是否会改变哮喘与死亡率之间的关联尚未明确。本研究旨在探讨瑞典和挪威哮喘与死亡率之间的关联，以及教育水平在多大程度上改变这种关联。
在北欧肺部流行病学研究中，2005 - 2007年期间，瑞典和挪威超过56,000名年龄在30 - 69岁的个体参与了关于哮喘及相关危险因素的基于人群的调查。国家当局将教育水平数据与10年全因死亡率数据进行了关联。计算了可归因于哮喘的死亡风险比例，并采用Cox回归按教育水平分层估计哮喘相关死亡率的风险比（HR）和95%置信区间（95%CI）。
所有死亡中，5.5%归因于哮喘。在对潜在混杂因素进行调整后，哮喘相关死亡率的HR为1.71（95%CI 1.52 - 1.93）。小学教育水平的人群因哮喘导致的全因死亡风险高于高等教育水平人群（HR 1.80，95%CI 1.48 - 2.18，对比HR 1.39，95%CI 0.99 - 1.95）。
哮喘与全因死亡率总体增加71%相关，5.5%的死亡可归因于哮喘。教育水平改变了与哮喘相关的死亡风险，小学教育水平人群风险最高。
