Associations of Combined Socioeconomic Status and Healthy Lifestyle With Incidence of Chronic Respiratory Diseases: A Prospective Cohort Study

IF 3.6 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of Evidence‐Based Medicine Pub Date : 2025-06-01 DOI:10.1111/jebm.70035

Jin Yang, Jilong Huang, Jian Gao, Wenfang Zhong, Peiliang Chen, Qingmei Huang, Yixin Zhang, Fangfei You, Huan Chen, Chuan Li, Weiqi Song, Dong Shen, Jiaojiao Ren, Dan Liu, Zhihao Li, Chen Mao

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引用次数: 0

Abstract

Objectives

To evaluate the relationship between socioeconomic status (SES), lifestyle factors, and their combined impact on chronic respiratory diseases (CRDs).

Methods

Participants were from the UK Biobank and were categorized into SES groups using latent class analysis based on family income, education, and employment status. Lifestyle factors were assessed via 24-hour dietary recalls and structured questionnaires. Each criterion scored 1 (healthy) or 0 (unhealthy), creating a total score from 0 to 4. Multivariable Cox proportional hazards models, interaction analyses, and mediation analyses were conducted.

Results

Among 296,731 participants, 12,128 (4.1%) participants were diagnosed with CRDs. Among low SES groups, healthy lifestyle groups with scores 2, 1, and 0 showed significantly increased hazard ratios of 1.32 (95% CI: 1.21–1.44), 1.77 (95% CI: 1.63–1.93) and 2.36 (95% CI: 2.15–2.60) compared with the healthy lifestyle scores ≥3. The combined effect of SES and healthy lifestyle increased the risk of CRDs by 15% over the risk expected from simply adding their respective effects. The proportion of SES on CRDs incidence mediated by healthy lifestyle factors was statistically significant (p < 0.001), accounting for about 2%.

Conclusions

The risk of incident CRDs in the low SES population with an unhealthy lifestyle increased by 32%–136%. Unhealthy lifestyles significantly affect the incidence of CRDs in different SES subgroups. About 2% of the risk between SES and incident CRDs was mediated by lifestyle factors. These findings highlight the importance of addressing socioeconomic disparities and unhealthy lifestyle behaviors in public health strategies aimed at preventing CRDs.

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综合社会经济地位和健康生活方式与慢性呼吸系统疾病发病率的关联：一项前瞻性队列研究

目的探讨社会经济地位（SES）、生活方式因素及其对慢性呼吸系统疾病（CRDs）的综合影响。方法研究对象来自英国生物银行，根据家庭收入、教育程度和就业状况，采用潜类分析将其分为社会经济地位组。生活方式因素通过24小时饮食回顾和结构化问卷进行评估。每个标准得分为1（健康）或0（不健康），总分从0到4。进行了多变量Cox比例风险模型、相互作用分析和中介分析。结果在296731名参与者中，12128名（4.1%）参与者被诊断为CRDs。在低SES组中，评分为2、1和0分的健康生活方式组与评分≥3分的健康生活方式组相比，风险比分别为1.32 （95% CI: 1.21-1.44）、1.77 （95% CI: 1.63-1.93）和2.36 （95% CI: 2.15-2.60）显著增加。SES和健康生活方式的综合影响使CRDs的风险比简单地增加它们各自的影响所预期的风险高出15%。SES对健康生活方式因素介导的CRDs发病率的影响有统计学意义(p <；0.001)，约占2%。结论生活方式不健康的低社会经济地位人群发生冠心病的风险增加32% ~ 136%。不健康的生活方式显著影响不同社会地位亚组的CRDs发病率。SES和突发CRDs之间约2%的风险由生活方式因素介导。这些发现强调了在旨在预防慢性阻塞性肺病的公共卫生战略中解决社会经济差异和不健康生活方式行为的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Evidence‐Based Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

11.20

自引率

1.40%

发文量

期刊介绍： The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.