Lung health of Americans: The poor suffer the most


A new comprehensive study indicates that the health of your lungs may have a lot to do with the size of your bank account.

The finding follows a six-decade look disease risk among more than 215,000 American children and adults.

In general, poorer Americans continue to have worse lung health than their richer peers. In some cases, the gap between rich and poor widens.

“We examined the long-term trends in socioeconomic inequalities in the lung health of Americans,” explained the study’s lead author, Dr. Adam Gaffney. “Specifically, we examined the prevalence of lung symptoms such as shortness of breath, diagnoses of lung disease such as asthma, or COPD. [] and lung volumes. “(The latter refers to the amount of air retained in the lungs during the different phases of respiration.)

The end result: “The differences in lung health between rich and poor Americans have persisted over the past six decades, and in some cases have actually become larger,” said Gaffney, an assistant professor at medicine at Harvard Medical School and a pulmonary and critical care specialist at the Cambridge Health Alliance in Boston.

The study appears in the May 28 issue of JAMA Internal Medicine.

The researchers studied accumulated by the U.S. Centers for Disease Control between 1959 and 2018. Participants ranged in age from 6 to 74 years.

Surveys asked about smoking habits and lung health. Lung function tests were also performed.

After matching the answers to the income and , the study team concluded that while there were large disparities in lung health in the 1960s, the lack of risk has widened by certain measures.

A clear example: smoking. Gaffney and colleagues point out that smoking behavior actually had little to do with income level before the 1980s. But the team found a markedly changed landscape over time, with the wealthiest Americans the main beneficiaries: its smoking rate fell from 63% in 1971-1975 to 34% in 2018 alone.

In contrast, over the same period of time, smoking rates remained basically at 56% to 58%, among the lower fifths by income.

Following a similar trend, the risk of wheezing fell among those with larger paperbacks and greater educational attainment from the late 1980s, while poor Americans saw little change.

According to other criteria, in the early 1970s, approximately 45% of the poorest Americans reported having no air when exercising. Today this figure reaches 48%.

But only 26% of the wealthiest Americans said the same thing at the time, and today that figure stands at only 28%.

And while the risk of asthma among children has increased regardless of income, it has increased more dramatically among the poor. Today only 7% of the nation’s richest children fight respiratory disorder, compared to nearly 15% of the country’s poorest children.

Among adults, the long-standing wealth gap in terms of COPD risk and lung volume health has also worsened, the team noted.

“There is a growing class division in tobacco use in the U.S. that explains some, but not all, of the differences we saw,” Gaffney said. “Other factors, such as uneven exposure to air pollution or impure working conditions or uneven access to health care, may also contribute.”

“Overall, our findings suggest that while air pollution has improved in recent decades and access to health care has expanded, the means to achieve good lung health are not being equally enjoyed by all Americans, “Gaffney added.

Although the study was conducted before the advent of COVID-19, Gaffney said the pandemic has revealed the health division of millions of disadvantaged Americans. Long-standing inequalities in lung health left many people vulnerable to COVID pneumonia, he noted.

Dr. Sarath Raju, co-author of an editorial accompanying him, was not surprised by the findings. However, “it is still deep to see the breadth of these disparities and how they have only continued to grow over the years,” he said.

“These lung disparities they are likely to have a profound impact on people of all ages in the United States if no action is taken to address them, “said Raju, an assistant professor of pulmonary medicine and critical care at Johns Hopkins University in Baltimore. .

Raju said making resources to quit smoking and prevent tobacco more affordable would be helpful. But he warned that much more research will be needed to better understand the racial, environmental and institutional forces at play.

Another deadly disease for smokers: pulmonary fibrosis

More information:
There is more information on lung health at American Lung Association.

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