Low socioeconomic status relates to asthma and wheeze, especially in women.

Low socioeconomic status (SES) has been associated with asthma and wheezing. Occupational group, educational level and income are commonly used indicators for SES, but no single indicator can illustrate the entire complexity of SES. The aim was to investigate how different indicators of SES associate with current asthma, allergic and nonallergic, and asthmatic wheeze. In 2016, a random sample of the population aged 20-79 years in Northern Sweden were invited to a postal questionnaire survey, with 58% participating (n=6854). The survey data were linked to the national Integrated Database for Labour Market Research by Statistics Sweden for the previous calendar year, 2015. Included SES indicators were occupation, educational level and income. Manual workers had increased risk for asthmatic wheeze, and manual workers in service for current asthma, especially allergic asthma. Primary school education associated with nonallergic asthma, whereas it tended to be inversely associated with allergic asthma. Low income was associated with asthmatic wheeze. Overall, the findings were more prominent among women, and interaction analyses between sex and income revealed that women, but not men, with low income had an increased risk both for asthmatic wheeze and current asthma, especially allergic asthma. To summarise, the different indicators of socioeconomic status illustrated various aspects of associations between low SES and asthma and wheeze, and the most prominent associations were found among women.

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Conflict of interest: C. Schyllert reports grants from the Swedish Heart-Lung Foundation, the Swedish Asthma and Allergy Association, the Northern County Councils’ Regional Federation, the Swedish Foundation for Health Care Science and Allergy Research, Konsul Th.C. Berghs Stiftelse and NordForsk, during the conduct of the study. Conflict of interest: A. Lindberg reports personal fees for lectures and advisory boards from Boehringer Ingelheim and AstraZeneca, and personal fees for lectures from Novartis and Active Care, outside the submitted work. Conflict of interest: L. Hedman has nothing to disclose. Conflict of interest: C. Stridsman has nothing to disclose. Conflict of interest: M. Andersson has nothing to disclose. Conflict of interest: P. Ilmarinen reports personal fees for lectures from Astra Zeneca, Novartis, Mundipharma, Orion and GlaxoSmithKline, outside the submitted work. Conflict of interest: P. Piirilä has nothing to disclose. Conflict of interest: S. Krokstad has nothing to disclose. Conflict of interest: B. Lundbäck reports a grant for health economic study of asthma from AstraZeneca, and personal fees for lecturing and advisory board meeting participation from AstraZeneca, Novartis, GSK and Sanofi, outside the submitted work. Conflict of interest: E. Rönmark reports grants from NordForsk, the Swedish Heart-Lung Foundation, the Swedish Asthma and Allergy Association, and VISARE NORR (Northern County Councils’ Regional Federation), during the conduct of the study; and grants from AstraZeneca and Sanofi, and personal fees from AstraZeneca, outside the submitted work. Conflict of interest: H. Backman reports personal fees for speaking at scientific meeting about severe asthma from AstraZeneca outside the submitted work.