Journal Article

Explaining the social patterning of lung function in adulthood at different ages: the roles of childhood precursors, health behaviours and environmental factors

Gray, Linsay A, Leyland, Alastair H, Benzeval, Michaela, Watt, Graham C M

2013

Overview

Background Lung function successfully predicts subsequent health. Although lung function is known to decline over age, little is known about changes in association with socioeconomic status (SES) throughout life, and whether explanatory factors for association vary with age or patterns for non smokers. Methods Analyses were based on data on 24 500 participants aged ≥18 years from the 1995, 1998 and 2003 Scottish Health Surveys who were invited to provide 1 s forced expiratory volume (FEV1) and forced vital capacity (FVC) lung measurements. Sex-stratified multiple linear regression assessed lung function–SES (occupational social class) associations and attenuation by covariates in three age groups (2003 data (n=7928)). Results The FEV1–SES patterns were clear (p<0.001) and constant over time. Relative to the least disadvantaged, FEV1 in the most disadvantaged was lower by 0.28 L in men and 0.20 L in women under 40 years compared with differences of 0.51 L in men and 0.25 L in women over 64 years (pinteraction<0.001 men, pinteraction=0.004 women). The greatest attenuation of these results was seen by height, parental social class and smoking, especially among the under 65s. Second-hand smoke exposure and urban/rural residence had some impact among older groups. Adjusting for physical activity and weight had little effect generally. Similar patterns were seen for FVC and among never smokers. Conclusions We found cross-sectional evidence that SES disparity in lung function increases with age, especially for men. Our findings indicate that early-life factors may predict inequity during younger adulthood, with environmental factors becoming more important at older ages.

• Publisher: BMJ Publishing Group Ltd,BMJ Publishing Group,BMJ Publishing Group LTD
• Subject: Adult / Age Factors / Age groups / Aged / Aged, 80 and over / Ageing / Aging - physiology / Air Pollution - adverse effects / Biological and medical sciences / Child and Life Course / Childhood / Cigarette smoking / Cigarettes / Cross-Sectional Studies / Environment. Living conditions / Environmental Exposure / Environmental factors / Environmental Health / Exercise / Female / Forced Expiratory Volume - physiology / General aspects / Health Behavior / Health Surveys / Humans / Interviews as Topic / Linear Models / Lung - physiology / Lung - physiopathology / Lungs / Male / Medical sciences / Men / Middle Aged / Miscellaneous / Mortality / Passive smoking / Polls & surveys / Public health. Hygiene / Public health. Hygiene-occupational medicine / Regression Analysis / Respiratory Di / Respiratory diseases / Respiratory function / Risk Factors / Rural areas / Scotland / Secondhand smoke / Smoking / Smoking - adverse effects / Smoking - physiopathology / Social Class / Social classes / Social Inequalities / Socioeconomic Factors / Socioeconomic status / Socioeconomics / Tobacco smoke / Vital Capacity - physiology / Young Adult