Neighbourhood socioeconomic inequality in risk of new-onset asthma associated with an interaction of seven behavioural and psychological factors

Objectives

Asthma pertains to both public health and social equality concerns. Yet, the extent to which social inequality is involved in the association of behavioural and psychological factors with new-onset asthma is not clear.

Study design

Cohort study.

Methods

Using the UK Biobank cohort, an interactive measurement for asthma-related behavioural and psychological factors was constructed via Bayesian network-based TOPSIS. The Index of Multiple Deprivation (IMD) measured neighbourhood socioeconomic status. Cox regression assessed the association of behavioural and psychological engagement and IMD with the risk of new-onset asthma, with additive interaction analysis.

Results

During follow-up, 7002 participants were diagnosed with asthma. Obesity contributed most to the network of seven interacted behavioural and psychological factors. Unhealthy behavioural and psychological engagement was associated with a 106 % (HR = 2.06, 95 % CI: 1.91–2.22) increase in the risk of new-onset asthma. The association was most pronounced in the high IMD group, in which the HR of unhealthy behavioural and psychological engagement reached 2.28 (95 % CI: 2.00–2.59). Significant additive interaction (RERI = 0.532, 95 % CI: 0.253–0.812) revealed potential socioeconomic inequality.

Conclusions

Deprived people suffer an additional risk of new-onset asthma associated with the engagement. Coordinating community-level action for socioeconomic improvements and promoting healthy behaviours should be proportionate to the needs.