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ORIGINAL RESEARCH article

Front. Public Health
Sec. Life-Course Epidemiology and Social Inequalities in Health
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1472074
This article is part of the Research Topic World Health Day 2024: Frontiers in Public Health presents: "My Health, My Right" View all 11 articles

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

Provisionally accepted
Zhuo ZHANG Zhuo ZHANG 1Guoshuai Shi Guoshuai Shi 2*Faguang Jin Faguang Jin 3*Yan Zhang Yan Zhang 3*
  • 1 School of Health Services Management, Xi’an Medical University, Xi'an, China
  • 2 School of Public Health, Xi’an Medical University, Xi’an, China
  • 3 Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xi'an, China

The final, formatted version of the article will be published soon.

    Objective: Research 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. Methods: This 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. Results: The 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). Conclusion: Inequalities 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.

    Keywords: Inequality, Chronic respiratory disease, Asthma, chronic obstructive pulmonary disease, All-cause mortality

    Received: 28 Jul 2024; Accepted: 19 Dec 2024.

    Copyright: © 2024 ZHANG, Shi, Jin and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Guoshuai Shi, School of Public Health, Xi’an Medical University, Xi’an, China
    Faguang Jin, Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xi'an, China
    Yan Zhang, Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xi'an, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.