Hae Jung Lee; Chul Hong Kim; Ju Suk Lee

doi:10.4168/aard.2018.6.2.90

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Lee, Kim, and Lee: Association between social economic status and asthma in Korean children: An analysis of the Fifth Korea National Health and Nutrition Examination Survey (2010–2012)

Original Article

Allergy Asthma Respir Dis 2018;6(2):90-96.

Published online: 5 March 2018

DOI: https://doi.org/10.4168/aard.2018.6.2.90

Association between social economic status and asthma in Korean children: An analysis of the Fifth Korea National Health and Nutrition Examination Survey (2010–2012)

Hae Jung Lee, Chul Hong Kim, Ju Suk Lee

Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea

Correspondence to: Ju Suk Lee https://orcid.org/0000-0002-5600-3441 Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 158 Paryong-ro, Masanhoewon-gu, Changwon 51353, Korea Tel: +82-55-233-5932, Fax: +82-55-233-5329, E-mail: ljs8952194@nate.com

Received 17 July 20177 November 2017 Accepted 8 November 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Asthma is one of the most common chronic conditions, and its prevalence has been increasing in recent decades. Social economic status is a well-known risk factor for asthma. This study was performed to investigate the relationship between social economic status and asthma in Korean children.

Methods

Data were acquired from 4,397 children, aged under 18 years who participated in the Fifth Korea National Health and Nutrition Examination Surveys, which was conducted from 2010 to 2012. The presence of asthma was based on self-reported, physician-diagnosed asthma in the Health Interview Surveys.

Results

The prevalence of pediatric asthma was 5.3%, while the prevalence of atopic dermatitis in children was 14.0%. In univariate analysis, asthmatic children tended to be male, to be older, to have asthmatic mothers, to suffer from atopic dermatitis and to live in urban areas (P<0.05). The parents’ marital status, employment status, education level, and the number of household members were not associated with pediatric asthma. In logistic regression analysis, older age, male sex, maternal asthma, pediatric atopic dermatitis, and urban residence were associated with a higher prevalence of childhood asthma (P<0.01).

Conclusion

Socioeconomic status was not an important risk factor for asthma in Korean children in our study. It is conceivable that socioeconomic factor could affect the asthma prevalence in a different manner in each country. Further studies are warranted to ex-plore mechanisms responsible for the association between socioeconomic status and asthma in children.

Keywords: Asthma, Income, Education

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Fig. 1.

Adjusted odds ratios and 95% confidence intervals (CI) for the prevalence of pediatric asthma. Odd ratios for the prevalence of pediatric asthma were adjusted for maternal asthma, children's sex, children's age, pediatric atopic dermatitis, and residence area in the Korean National Health and Nutrition Examination Survey (KNHANES) 2010–2012.

Table 1.

Baseline characteristics of parents and children

Characteristic	Sample size	Estimate % (95% CI)
Parental factors
Marital status (n=2,566)
Single	568	20.3 (16.3–25.1)
Married	1,998	79.7 (74.9–83.7)
Maternal employment status (n=2,503)
Employed	1,217	47.8 (45.0–50.6)
Unemployed	1,286	52.2 (49.4–55.0)
Paternal employment status (n=2,061)
Employed	1,980	96.3 (95.1–97.2)
Unemployed	81	3.7 (2.8–4.9)
Maternal education level (n=2,503)
<High school	148	5.5 (4.5–6.7)
High school	1,160	46.4 (43.8–49.2)
>High school	1,195	48.1 (45.1–51.1)
Paternal education level (n=2,061)
<High school	160	7.4 (6.0–8.9)
High school	737	36.7 (34.1–39.4)
>High school	1,164	55.9 (52.9–58.9)
Maternal smoking history (n=2,503)
None	2,201	87.4 (85.5–89.1)
Current smoker	117	4.6 (3.7–5.7)
Ex-smoker	185	8.0 (6.6–9.7)
Paternal smoking history (n=2,061)
None	329	16.0 (14.6–17.6)
Current smoker	1,042	50.7 (48.2–53.2)
Ex-smoker	690	33.3 (31.0–35.7)
Maternal asthma (n=2,503)
Yes	52	2.1 (1.4–3.0)
No	2,451	97.9 (97.0–98.6)
Paternal asthma (n=2,061)
Yes	40	1.6 (1.1–2.4)
No	2,021	98.4 (97.6–98.9)
Maternal atopic dermatitis (n=2,503)
Yes	53	2.2 (1.5–3.1)
No	2,450	97.8 (96.9–98.5)
Paternal atopic dermatitis (n=2,061)
Yes	32	1.7 (1.2–2.6)
No	2,029	98.3 (97.4–98.8)
Children's factors (n=4,397)
Sex
Male	2,343	53.1 (51.3–54.9)
Female	2,054	46.9 (45.1–48.7)
Age (yr)
≤3	750	17.4 (15.8–19.2)
4–6	738	16.4 (15.1–17.7)
7–12	1,602	35.4 (33.5–37.3)
13–18	1,307	30.8 (28.6–33.1)
Asthma
Yes	235	5.3 (4.5–6.3)
No	4,162	97.4 (93.7–95.5)
Atopic dermatitis
Yes	618	14.0 (12.8–15.4)
No	3,779	86.0 (84.6–87.2)
Family factors (n=2,566)
Monthly family income (quartile)
1	171	6.4 (5.2–7.8)
2	715	28.1 (25.7–30.6)
3	908	34.0 (31.6–36.3)
4	772	31.5 (28.7–34.6)
No. of household members
2	56	2.3 (1.6–3.3)
3	616	22.8 (20.8–24.9)
4	1,309	51.1 (48.2–53.9)
≥5	585	23.8 (21.7–26.1)
Residence area
Urban	2,220	86.7 (82.7–89.8)
Rural	346	13.3 (10.2–17.3)

CI, confidence interval.

Table 2.

Demographic characteristics according to the presence of pediatric asthma

Characteristic	Pediatric asthma, estimate % (95% CI)		P-value	Crude OR (95% CI)
Characteristic	Yes	No	P-value	Crude OR (95% CI)
Parental factors
Marital status (n=2,566)			0.72
Single	5.5 (3.1–9.6)	94.5 (90.4–96.9)		1.124 (0.595–2.124)
Married	5.0 (4.0–6.2)	95.0 (93.8–96.0)		1
Maternal employment status (n=2,503)			0.28
Employed	4.6 (3.4–6.2)	95.4 (93.8–96.6)		1
Unemployed	5.7 (4.3–7.5)	94.3 (92.5–95.7)		1.249 (0.833–1.872)
Paternal employment status (n=2,061)			0.86
Employed	4.9 (3.9–6.1)	95.1 (93.9–96.4)		1
Unemployed	4.4 (1.3–14.2)	95.6 (85.8–98.7)		0.881 (0.238–3.270)
Maternal education level (n=2,503)			0.50
<High school	7.7 (3.7–15.4)	92.3 (93.3–96.2)		1.605 (0.721–3.571)
High school	5.1 (3.8–6.7)	94.9 (93.3–96.2)		1.022 (0.656–1.592)
>High school	5.0 (3.5–6.9)	95.0 (93.1–96.5)		1
Paternal education level (n=2,061)			0.74
<High school	4.1 (1.8–9.0)	95.9 (91.0–98.2)		0.864 (0.373–2.003)
High school	5.4 (3.8–7.6)	94.6 (92.4–96.2)		1.164 (0.683–1.985)
>High school	4.7 (3.3–6.4)	95.3 (93.6–96.7)		1
Maternal smoking history (n=2,503)			0.42
None	5.2 (4.1–6.5)	94.8 (93.5–95.9)		1
Current smoker	2.5 (0.7–8.0)	97.5 (92.0–99.3)		0.458 (0.133–1.575)
Ex-smoker	6.2 (3.2–11.7)	93.8 (88.3–96.8)		1.196 (0.578–2.475)
Paternal smoking history (n=2,061)			0.50
None	4.1 (2.3–7.2)	95.9 (92.8–97.7)		1
Current smoker	4.5 (3.3–6.2)	95.5 (93.8–96.7)		1.122 (0.557–2.258)
Ex-smoker	5.8 (3.9–8.3)	94.2 (91.7–96.1)		1.442 (0.708–2.934)
Maternal asthma (n=2,503)			0.03
Yes	13.5 (5.3–30.1)	86.5 (69.9–94.7)		2.978 (1.039–8.533)
No	5.0 (4.0–6.2)	95.0 (93.8–96.0)		1
Paternal asthma (n=2,061)			0.65
Yes	3.4 (0.7–15.0)	96.6 (85.0–99.3)		0.685 (0.130–3.601)
No	4.9 (3.9–6.1)	95.1 (93.9–96.1)		1
Maternal atopic dermatitis (n=2,503)			0.09
Yes	10.6 (4.6–22.7)	89.4 (77.3–95.4)		2.243 (0.870–5.779)
No	5.0 (4.0–6.3)	95.0 (93.7–96.0)		1
Paternal atopic dermatitis (n=2,061)			0.36
Yes	2.0 (0.3–14.0)	98.0 (86.0–99.7)		0.430 (0.053–3.087)
No	4.9 (3.9–6.1)	95.1 (93.9–96.1)		1
Children's factors (n=4,397)
Sex			<0.01
Male	6.7 (5.4–8.2)	93.3 (91.8–94.6)		2.156 (1.349–3.445)
Female	3.7 (2.9–4.8)	96.3 (95.2–97.1)		1
Age (yr)			<0.01
≤3	2.3 (1.2–4.1)	97.7 (95.9–98.8)		1
4–6	8.0 (5.8–11.0)	92.0 (89.0–94.2)		2.848 (1.303–6.225)
7–12	5.7 (4.4–7.3)	94.3 (92.7–95.6)		2.725 (1.267–5.862)
13–18	5.2 (3.8–7.0)	94.8 (93.0–96.2)		2.345 (1.092–5.038)
Atopic dermatitis			<0.01
Yes	10.6 (8.1–13.9)	89.4 (86.1–91.9)		2.769 (1.791–4.280)
No	4.4 (3.6–5.4)	95.6 (94.6–96.4)		1
Family factors (n=2,566)
Monthly family income (quartile)			0.73
1	6.7 (3.3–13.1)	93.3 (86.9–96.7)		1.325 (0.606–2.897)
2	4.4 (2.9–6.5)	95.6 (93.5–97.1)		0.841 (0.495–1.428)
3	5.3 (3.6–7.7)	94.7 (92.3–96.4)		1.034 (0.598–1.788)
4	5.1 (3.7–7.2)	94.9 (92.8–96.3)		1
No. of household members			0.19
2	10.7 (3.3–29.7)	89.3 (70.3–96.7)		1
3	3.5 (2.0–5.8)	96.5 (94.2–98.0)		0.299 (0.079–1.131)
4	5.6 (4.3–7.3)	94.4 (92.7–95.7)		0.496 (0.143–1.727)
≥5	5.0 (3.3–7.5)	95.0 (92.5–96.7)		0.436 (0.119–1.606)
Residence area			0.03
Urban	5.5 (4.4–6.8)	94.5 (93.2–95.6)		2.393 (1.051–5.444)
Rural	2.4 (1.1–5.2)	97.6 (94.8–98.9)		1

OR, odds ratio; CI, confidence interval.

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