Socioeconomic Status Has Direct Impact on Asthma Control: Turkish Adult Asthma Registry

Background: Asthma is one of the most common causes of chronic respiratory disease, and countries with low socioeconomic status have both a high prevalence of asthma and asthma-related death.

Objective: In this study, we aimed to determine socioeconomic levels of asthmatic patients according to a national database and investigate the effects of social markers on disease control in our region.

Methods: This is an analysis of data from 2053 adult asthma patients from a multicentre chart study in Turkey. Socioeconomic status (SES) data were collected from questionnaires and this form was sent to the patients via e-mail. Parameters related to social status and poor disease control were analyzed.

Results: Illiteracy (OR:2.687 [95% CI: 1.235-5.848]; p = 0.013) and lower household income (OR:1,76 [95% CI: 1.002-3.09]; p = 0.049) were found as independent risk factors for hospitalization in the multivariate logistic regression analysis. Therewithal, being aged between 40 and 60 (OR: 1.435 [95% CI: 1.074-1.917]; p = 0.015), illiteracy (OR: 2.188 [95% CI: 1.262-3.795]; p = 0.005) and being employed (OR: 1.466 [95% CI: 1.085-1.847]; p = 0.011) were considered as independent risk factors for systemic corticosteroid use at least 3 days within last 1 year.

Conclusion: As a result of our national database, education level, household income and working status briefly socioeconomic status have impacts on asthma control. Identification of social markers in asthma and better recognition of risk factors based on the population gives us clues to provide better asthma control in the future.

Citing Articles

Socioeconomic status has direct impact on asthma control: Turkish adult asthma registry.

Arslan B, Turk M, Hayme S, Aydin O, Gokmen D, Koycu Buhari G Clin Transl Allergy. 2025; 15(1):e70018.

PMID: 39865387 PMC: 11761715. DOI: 10.1002/clt2.70018.

References

Basagana X, Sunyer J, Kogevinas M, Zock J, Duran-Tauleria E, Jarvis D . Socioeconomic status and asthma prevalence in young adults: the European Community Respiratory Health Survey. Am J Epidemiol. 2004; 160(2):178-88. DOI: 10.1093/aje/kwh186. View

Agarwal A . Social classification: the need to update in the present scenario. Indian J Community Med. 2009; 33(1):50-1. PMC: 2782230. DOI: 10.4103/0970-0218.39245. View

Gordon S, Bruce N, Grigg J, Hibberd P, Kurmi O, Hubert Lam K . Respiratory risks from household air pollution in low and middle income countries. Lancet Respir Med. 2014; 2(10):823-60. PMC: 5068561. DOI: 10.1016/S2213-2600(14)70168-7. View

Williams M, Baker D, Honig E, Lee T, Nowlan A . Inadequate literacy is a barrier to asthma knowledge and self-care. Chest. 1998; 114(4):1008-15. DOI: 10.1378/chest.114.4.1008. View

Valet R, Perry T, Hartert T . Rural health disparities in asthma care and outcomes. J Allergy Clin Immunol. 2009; 123(6):1220-5. PMC: 2738930. DOI: 10.1016/j.jaci.2008.12.1131. View

Bacon S, Bouchard A, Loucks E, Lavoie K . Individual-level socioeconomic status is associated with worse asthma morbidity in patients with asthma. Respir Res. 2009; 10:125. PMC: 2806364. DOI: 10.1186/1465-9921-10-125. View

Ganti P, Suman A, Chaudhary S, Sangha B, David L, Sekhsaria S . The effect of the socioeconomic status on the measurement of asthma control. Allergy Asthma Proc. 2022; 43(1):e11-e16. PMC: 8749239. DOI: 10.2500/aap.2022.43.210103. View

Eagan T, Gulsvik A, Eide G, Bakke P . The effect of educational level on the incidence of asthma and respiratory symptoms. Respir Med. 2004; 98(8):730-6. DOI: 10.1016/j.rmed.2004.02.008. View

Arslan B, Turk M, Hayme S, Aydin O, Gokmen D, Koycu Buhari G . Socioeconomic status has direct impact on asthma control: Turkish adult asthma registry. Clin Transl Allergy. 2025; 15(1):e70018. PMC: 11761715. DOI: 10.1002/clt2.70018. View

10.

Trikamjee T, Comberiati P, Peter J . Pediatric asthma in developing countries: challenges and future directions. Curr Opin Allergy Clin Immunol. 2022; 22(2):80-85. DOI: 10.1097/ACI.0000000000000806. View

11.

Temam S, Chanoine S, Bedard A, Dumas O, Sanchez M, Boutron-Ruault M . Low socioeconomic position and neighborhood deprivation are associated with uncontrolled asthma in elderly. Respir Med. 2019; 158:70-77. DOI: 10.1016/j.rmed.2019.09.010. View

12.

. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018; 392(10159):1736-1788. PMC: 6227606. DOI: 10.1016/S0140-6736(18)32203-7. View

13.

Brehm J, Schuemann B, Fuhlbrigge A, Hollis B, Strunk R, Zeiger R . Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol. 2010; 126(1):52-8.e5. PMC: 2902692. DOI: 10.1016/j.jaci.2010.03.043. View

14.

Yawn B, Ericson B, Cui J, Israel E, Maher N, Pace W . Comparing asthma control assessment using the Asthma Control Test and the Asthma APGAR in African American/Black and Hispanic/Latinx populations. J Asthma. 2023; 60(8):1592-1600. DOI: 10.1080/02770903.2022.2164201. View

15.

Nathan R, Sorkness C, Kosinski M, Schatz M, Li J, Marcus P . Development of the asthma control test: a survey for assessing asthma control. J Allergy Clin Immunol. 2004; 113(1):59-65. DOI: 10.1016/j.jaci.2003.09.008. View

16.

Ellison-Loschmann L, Sunyer J, Plana E, Pearce N, Zock J, Jarvis D . Socioeconomic status, asthma and chronic bronchitis in a large community-based study. Eur Respir J. 2007; 29(5):897-905. DOI: 10.1183/09031936.00101606. View

17.

von Hertzen L, Haahtela T . Disconnection of man and the soil: reason for the asthma and atopy epidemic?. J Allergy Clin Immunol. 2006; 117(2):334-44. DOI: 10.1016/j.jaci.2005.11.013. View

18.

Lee W, Hwang J, Ryu J, Choi Y, Oh J, Kim C . The relationship between childhood asthma and socioeconomic status: a Korean nationwide population-based study. Front Public Health. 2023; 11:1133312. PMC: 10167280. DOI: 10.3389/fpubh.2023.1133312. View

19.

Ozden Sertcelik U, Damadoglu E, Karakaya G, Demir A, Kalyoncu A . Impact of socioeconomic factors and house cleaning on asthma control in women. Allergy Asthma Proc. 2022; 43(2):140-147. DOI: 10.2500/aap.2022.43.210003. View

20.

Almqvist C, Pershagen G, Wickman M . Low socioeconomic status as a risk factor for asthma, rhinitis and sensitization at 4 years in a birth cohort. Clin Exp Allergy. 2005; 35(5):612-8. DOI: 10.1111/j.1365-2222.2005.02243.x. View