Dataset Information

Socioeconomic status is positively associated with percent emphysema on CT scan: The MESA lung study.

ABSTRACT:

Rationale and objectives

Higher socioeconomic status (SES) has been associated with lower respiratory mortality and better lung function, but whether a similar gradient exists for computed tomography (CT) measures of subclinical emphysema is unknown.

Materials and methods

The Multi-Ethnic Study of Atherosclerosis (MESA) recruited African-American, Chinese, Hispanic, and white participants, ages 45 to 84 years, without clinical cardiovascular disease, from six US sites between 2000 and 2002. The MESA Lung Study assessed percent emphysema, defined based on the proportion of pixels below an attenuation threshold of 910 HU from lung windows of cardiac CT scans. Generalized linear models were adjusted for demographic characteristics, height, body mass index, history of respiratory illness, occupational and residential exposures, tobacco use, and CT scanner type.

Results

Among 3706 participants with a mean age of 61 (±10), the median value for percent emphysema was 18 (interquartile range = 20). Compared with those who did not complete high school, participants with a graduate degree had a higher percent emphysema (difference of 4; P < .001). Income and wealth were also positively associated with percent emphysema. In contrast, higher SES was associated with better lung function. Descriptive and subgroup analyses were used to explore potential explanations for divergent results, including the possibility that suboptimal inspiration during CT scanning would decrease percent emphysema, making the lungs appear healthier when effort is relatively poor.

Conclusion

Although SES indicators were positively associated with subclinical emphysema detectable on CT scan, this unexpected association may highlight potential bias because of effort dependence of both CT measures and spirometry.

SUBMITTER: Lovasi GS

PROVIDER: S-EPMC3038582 | biostudies-literature | 2011 Feb

REPOSITORIES: biostudies-literature

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Publications

Socioeconomic status is positively associated with percent emphysema on CT scan: The MESA lung study.

Lovasi Gina S GS Diez Roux Ana V AV Hoffman Eric A EA Smith Lewis J LJ Jiang Rui R Carr J Jeffrey JJ Barr R Graham RG

Academic radiology 20110201 2

<h4>Rationale and objectives</h4>Higher socioeconomic status (SES) has been associated with lower respiratory mortality and better lung function, but whether a similar gradient exists for computed tomography (CT) measures of subclinical emphysema is unknown.<h4>Materials and methods</h4>The Multi-Ethnic Study of Atherosclerosis (MESA) recruited African-American, Chinese, Hispanic, and white participants, ages 45 to 84 years, without clinical cardiovascular disease, from six US sites between 2000 ...[more]

PMID: 21232685

Similar Datasets

Project description:Recent publications reported that children in disadvantaged areas undergo more CT scanning than others. The present study is aimed to assess the potential differences in CT imaging by socioeconomic status (SES) in Spanish young scanned subjects and if such differences vary with different indicators or different time point SES measurements. The associations between CT scanning and SES, and between the CT scan rate per patient and SES were investigated in the Spanish EPI-CT subcohort. Various SES indicators were studied to determine whether particular SES dimensions were more closely related to the probability of undergoing one or multiple CTs. Comparisons were made with indices based on 2001 and 2011 censuses. We found evidence of socio-economic variation among young people, mainly related to autonomous communities of residence. A slightly higher rate of scans per patient of multiple body parts in the less affluent categories was observed, possibly reflecting a higher rate of accidents and violence in these groups. The number of CT scans per patient was higher both in the most affluent and the most deprived categories and somewhat lower in the intermediate groups. This relation varied with the SES indicator used, with lower CT scans per patients in categories of high unemployment and temporary work, but not depending on categories of unskilled work or illiteracy. The relationship between these indicators and number of CTs in 2011 was different than that seen with the 2001 census, with the number of CTs increasing with higher unemployment. Overall we observed some differences in the SES distribution of scanned patients by Autonomous Community in Spain. There was, however, no major differences in the frequency of CT scans per patient by SES overall, based on the 2001 census. The use of different indicators and of SES data collected at different time points led to different relations between SES and frequency of CT scans, outlining the difficulty of adequately capturing the social and economic dimensions which may affect health and health service utilisation.

Dataset Information

Socioeconomic status is positively associated with percent emphysema on CT scan: The MESA lung study.

Rationale and objectives

Materials and methods

Results

Conclusion

Publications

Socioeconomic status is positively associated with percent emphysema on CT scan: The MESA lung study.

Similar Datasets

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