Exploring the association between socioeconomic inequalities in chronic respiratory disease and all-cause mortality in China: findings from the China Health and Retirement Longitudinal Study

ObjectiveResearch on the inequality of chronic respiratory disease (CRD) is limited, and the association between CRD and all-cause mortality is not well-established. Investigating the distribution of CRD and its associated mortality risks is essential for improving CRD conditions and developing targ...

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Main Authors: Zhuo Zhang, Guoshuai Shi, Faguang Jin, Yan Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1472074/full
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author Zhuo Zhang
Guoshuai Shi
Faguang Jin
Yan Zhang
author_facet Zhuo Zhang
Guoshuai Shi
Faguang Jin
Yan Zhang
author_sort Zhuo Zhang
collection DOAJ
description ObjectiveResearch on the inequality of chronic respiratory disease (CRD) is limited, and the association between CRD and all-cause mortality is not well-established. Investigating the distribution of CRD and its associated mortality risks is essential for improving CRD conditions and developing targeted intervention measures. This study aimed to explore the relationship between inequalities in CRD and all-cause mortality in China.MethodsThis study utilized nationally representative baseline data from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2020, wave 1–wave 5), including a total of 14,743 subjects. The concentration index was employed to measure socioeconomic-related inequality in CRD, and the concentration index decomposition method was used to describe its influencing factors. Cox proportional hazards regression model was employed to examine the association between CRD and all-cause mortality.ResultsThe prevalence of CRD was 11.79% (95% CI: 10.98, 12.66) in China. The concentration index for CRD was −0.050 (95% CI: −0.075, −0.026), indicating a certain degree of inequality in its prevalence. Chronic lung disease (concentration index = −0.046, 95% CI: −0.073, −0.019), asthma (concentration index = −0.102, 95% CI: −0.148, −0.056), and asthma-chronic obstructive pulmonary disease overlap syndrome (concentration index = −0.114, 95% CI: −0.173, −0.055) also exhibited a pro-poor distribution. The decomposition analysis of the concentration index for CRD revealed that age, education level, and economic status played substantial roles in contributing to the observed inequality. Additionally, Cox regression analysis showed that participants with CRD had an increased risk of all-cause mortality (HR = 1.49, 95% CI: 1.34, 1.65).ConclusionInequalities exists in CRDs in China, with the prevalence of these diseases primarily concentrated among economically disadvantaged groups. Additionally, CRD increases the risk of all-cause mortality. Addressing the root causes of economic inequalities and enhancing the educational attainment of individuals with low socioeconomic status can help improve the situation.
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spelling doaj-art-e019e9475f7649ba8729b1ab3295deae2025-08-20T02:26:27ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011210.3389/fpubh.2024.14720741472074Exploring the association between socioeconomic inequalities in chronic respiratory disease and all-cause mortality in China: findings from the China Health and Retirement Longitudinal StudyZhuo Zhang0Guoshuai Shi1Faguang Jin2Yan Zhang3School of Health Services Management, Xi’an Medical University, Xi'an, ChinaSchool of Public Health, Xi’an Medical University, Xi’an, ChinaDepartment of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xian, ChinaDepartment of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xian, ChinaObjectiveResearch on the inequality of chronic respiratory disease (CRD) is limited, and the association between CRD and all-cause mortality is not well-established. Investigating the distribution of CRD and its associated mortality risks is essential for improving CRD conditions and developing targeted intervention measures. This study aimed to explore the relationship between inequalities in CRD and all-cause mortality in China.MethodsThis study utilized nationally representative baseline data from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2020, wave 1–wave 5), including a total of 14,743 subjects. The concentration index was employed to measure socioeconomic-related inequality in CRD, and the concentration index decomposition method was used to describe its influencing factors. Cox proportional hazards regression model was employed to examine the association between CRD and all-cause mortality.ResultsThe prevalence of CRD was 11.79% (95% CI: 10.98, 12.66) in China. The concentration index for CRD was −0.050 (95% CI: −0.075, −0.026), indicating a certain degree of inequality in its prevalence. Chronic lung disease (concentration index = −0.046, 95% CI: −0.073, −0.019), asthma (concentration index = −0.102, 95% CI: −0.148, −0.056), and asthma-chronic obstructive pulmonary disease overlap syndrome (concentration index = −0.114, 95% CI: −0.173, −0.055) also exhibited a pro-poor distribution. The decomposition analysis of the concentration index for CRD revealed that age, education level, and economic status played substantial roles in contributing to the observed inequality. Additionally, Cox regression analysis showed that participants with CRD had an increased risk of all-cause mortality (HR = 1.49, 95% CI: 1.34, 1.65).ConclusionInequalities exists in CRDs in China, with the prevalence of these diseases primarily concentrated among economically disadvantaged groups. Additionally, CRD increases the risk of all-cause mortality. Addressing the root causes of economic inequalities and enhancing the educational attainment of individuals with low socioeconomic status can help improve the situation.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1472074/fullinequalitychronic respiratory diseaseasthmachronic obstructive pulmonary diseaseall-cause mortality
spellingShingle Zhuo Zhang
Guoshuai Shi
Faguang Jin
Yan Zhang
Exploring the association between socioeconomic inequalities in chronic respiratory disease and all-cause mortality in China: findings from the China Health and Retirement Longitudinal Study
Frontiers in Public Health
inequality
chronic respiratory disease
asthma
chronic obstructive pulmonary disease
all-cause mortality
title Exploring the association between socioeconomic inequalities in chronic respiratory disease and all-cause mortality in China: findings from the China Health and Retirement Longitudinal Study
title_full Exploring the association between socioeconomic inequalities in chronic respiratory disease and all-cause mortality in China: findings from the China Health and Retirement Longitudinal Study
title_fullStr Exploring the association between socioeconomic inequalities in chronic respiratory disease and all-cause mortality in China: findings from the China Health and Retirement Longitudinal Study
title_full_unstemmed Exploring the association between socioeconomic inequalities in chronic respiratory disease and all-cause mortality in China: findings from the China Health and Retirement Longitudinal Study
title_short Exploring the association between socioeconomic inequalities in chronic respiratory disease and all-cause mortality in China: findings from the China Health and Retirement Longitudinal Study
title_sort exploring the association between socioeconomic inequalities in chronic respiratory disease and all cause mortality in china findings from the china health and retirement longitudinal study
topic inequality
chronic respiratory disease
asthma
chronic obstructive pulmonary disease
all-cause mortality
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1472074/full
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