Related Experiment Video
Updated: Aug 18, 2026
Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Low socioeconomic status as a risk factor for asthma, rhinitis and sensitization at 4 years in a birth cohort
C Almqvist1, G Pershagen, M Wickman
1Department of Occupational and Environmental Health, Karolinska Hospital, Stockholm, Sweden. catarina.almqvist@kbh.ki.se
Insights
Children from lower socioeconomic status backgrounds have a higher risk of developing asthma, rhinitis, and sensitization. This study highlights the link between socioeconomic factors and allergic diseases in childhood.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Epidemiology
- Social Determinants of Health
Background:
- The relationship between socioeconomic status (SES) and childhood allergic diseases is complex and debated.
- Previous research suggests asthma is more prevalent in lower SES, while airborne allergen sensitization is higher in elevated SES.
Purpose of the Study:
- To investigate the association between socioeconomic status and the incidence of asthma, rhinitis, and allergic sensitization in a prospective birth cohort.
- To clarify the role of SES as a risk factor for allergic conditions in children.
Main Methods:
- A cohort of 4,089 children born between 1994-1996 in Stockholm was followed.
- Parental occupation-based SES, environmental factors, and allergic disease symptoms were recorded via questionnaires up to age 4.
- Specific IgE levels to common allergens were measured in 2,614 children at age 4; logistic regression adjusted for confounders.
Main Results:
- A significant inverse relationship was observed between increasing SES and the risk of asthma and rhinitis.
- The odds ratio for asthma was 0.33 and for rhinitis was 0.50 when comparing the highest to the lowest SES groups.
- Sensitization to food allergens decreased with higher SES (OR 0.65), but this trend was not significant for airborne allergens.
Conclusions:
- Lower socioeconomic status is associated with a higher prevalence of asthma, rhinitis, and sensitization in children, even after accounting for known risk factors.
- Unmeasured lifestyle and environmental exposures may contribute to these disparities.
- Further research is warranted to elucidate the underlying mechanisms and identify targeted interventions.
Background:
The relation between socioeconomic status and allergic diseases in childhood is controversial. Some studies have proposed childhood asthma to be more common in families with low socioeconomic status, while sensitization to airborne allergens seems to be more frequent in individuals with higher socioeconomic status in childhood.
Objective:
To assess the relation between socioeconomic status and asthma, rhinitis and sensitization in an unselected prospective birth cohort.
Methods:
Four thousand and eighty-nine families with children born 1994-1996 in predefined areas of Stockholm answered questionnaires on environmental factors, socioeconomic status (parental occupation), and symptoms of allergic disease at birth, 1, 2 and 4 years of age. Blood samples taken at 4 years from 2614 children were analysed for specific IgE to common airborne and food allergens. Odds ratios (OR) and 95% confidence intervals (CI) for various outcomes in relation to socioeconomic status were estimated with a multiple logistic regression model, adjusting for potential confounders such as heredity for allergic diseases, maternal smoking, short duration of breastfeeding and house construction.
Results:
There was a decreasing risk of asthma and rhinitis with increasing socioeconomic status. The OR for asthma was 0.33 (95% CI 0.17-0.66) and for rhinitis 0.50 (0.32-0.79) comparing the highest and the lowest socioeconomic groups, with a tendency to stronger effects in those with heredity for allergic disease. The risk of sensitization to food allergens also decreased with increasing socioeconomic status; OR 0.65 (0.41-1.02) in the highest socioeconomic group (Ptrend=0.03), which was not clearly seen for airborne allergens.
Conclusion:
Asthma, rhinitis and sensitization is more common in lower than in higher socioeconomic groups after adjustment for traditional risk factors. This may be related to additional uncontrolled differences in life style and environmental exposures between the groups, and calls for further studies.
Related Concept Videos
01:28Asthma I: Introduction
01:29Asthma-I: Introduction
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:13Asthma III: Clinical Manifestations