Effect of Socioeconomic Status on Lung Function in the Korean General Population

Socioeconomic status (SES) significantly influences the incidence and severity of chronic obstructive pulmonary disease. This study investigated the impact of SES on incidence of airflow obstruction and lung function decline within a general population cohort in Republic of Korea (South Korea).

We utilized data from the Korean Genome and Epidemiology Study Ansan-Ansung Cohort, collected between 2001 and 2014. A total of 10,030 participants were included in the longitudinal analysis. Socioeconomic status was classified using four key indicators: area of residence (urban, n = 5,012; rural, n = 5,018), marital status (single, n = 974; married, n = 8,987), education level (elementary school, n = 3,355; middle or high school, n = 5,287; college or above, n = 1,305), and income (< $1,460, n = 6,413; $1,460-2,920, n = 2,705; > $2,920, n = 729), among participants with available data.

Over a 12-year follow-up period, individuals living in rural areas experienced a more rapid decline in both mean forced expiratory volume in 1 second (FEV₁) and forced vital capacity (FVC) compared to those in urban areas (P < 0.001). Participants with the lowest levels of education and income experienced significantly faster declines in both FVC and FEV₁ (all P < 0.001, except for medium vs. high income). The risk of developing airflow obstruction was significantly higher for participants from rural areas, with lower education levels, and lower income.

This study demonstrated a significant association between lower SES and incidence of airflow obstruction and progression in Korea. Lower SES, characterized by rural residence, lower educational status, and lower income, was associated with poorer baseline health, higher comorbidity rates, and more rapid lung function decline over a 12-year period.