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How Does Socioeconomic Development Affect COPD Mortality? An Age-Period-Cohort Analysis from a Recently Transitioned Population in China

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  • Jing Chen
  • Catherine Mary Schooling
  • Janice Mary Johnston
  • Anthony Johnson Hedley
  • Sarah Morag McGhee

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death, particularly in developing countries. Little is known about the effects of economic development on COPD mortality, although economic development may potentially have positive and negative influences over the life course on COPD. We took advantage of a unique population whose rapid and recent economic development is marked by changes at clearly delineated and identifiable time points, and where few women smoke, to examine the effect of macro-level events on COPD mortality. Methods: We used Poisson regression to decompose sex-specific COPD mortality rates in Hong Kong from 1981 to 2005 into the effects of age, period and cohort. Results: COPD mortality declined strongly over generations for people born from the early to mid 20th century, which was particularly evident for the first generation to grow up in a more economically developed environment for both sexes. Population wide COPD mortality decreased when air quality improved and increased with increasing air pollution. COPD mortality increased with age, particularly after menopause among women. Conclusions: Economic development may reduce vulnerability to COPD by reducing long-lasting insults to the respiratory system, such as infections, poor nutrition and indoor air pollution. However, some of these gains may be offset if economic development results in increasing air pollution or increasing smoking.

Suggested Citation

  • Jing Chen & Catherine Mary Schooling & Janice Mary Johnston & Anthony Johnson Hedley & Sarah Morag McGhee, 2011. "How Does Socioeconomic Development Affect COPD Mortality? An Age-Period-Cohort Analysis from a Recently Transitioned Population in China," PLOS ONE, Public Library of Science, vol. 6(9), pages 1-7, September.
  • Handle: RePEc:plo:pone00:0024348
    DOI: 10.1371/journal.pone.0024348
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    References listed on IDEAS

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    1. Colin D Mathers & Dejan Loncar, 2006. "Projections of Global Mortality and Burden of Disease from 2002 to 2030," PLOS Medicine, Public Library of Science, vol. 3(11), pages 1-20, November.
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    1. Lan Wang & Rui Chen & Wenyao Sun & Xiaoming Yang & Xinhu Li, 2019. "Impact of High-Density Urban Built Environment on Chronic Obstructive Pulmonary Disease: A Case Study of Jing’an District, Shanghai," IJERPH, MDPI, vol. 17(1), pages 1-15, December.
    2. Peng-Ching Hsiao & Chi-Ming Chu & Pei-Yi Sung & Wann-Cherng Perng & Kwua-Yun Wang, 2014. "Differences in COPD Patient Care by Primary Family Caregivers: An Age-Based Study," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-10, September.

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