Association between socioeconomic status, sex, and age at death from cystic fibrosis in England and Wales (1959 to 2008): cross sectional studyBMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d4662 (Published 23 August 2011) Cite this as: BMJ 2011;343:d4662
- Helen L Barr, clinical lecturer in respiratory medicine1,
- John Britton, professor of epidemiology2,
- Alan R Smyth, professor of child health3,
- Andrew W Fogarty, reader in clinical epidemiology2
- 1Nottingham Respiratory Biomedical Research Unit, Division of Respiratory Medicine, University of Nottingham, City Hospital Campus, Nottingham NG5 1PB, UK
- 2Nottingham Respiratory Biomedical Research Unit, Division of Epidemiology and Public Health, University of Nottingham
- 3Nottingham Respiratory Biomedical Research Unit, Division of Child Health, University of Nottingham, Nottingham University Hospitals NHS Trust, Queen’s Medical Centre, Nottingham
- Correspondence to: H L Barr
- Accepted 22 June 2011
Objective To determine the trend in the association between socioeconomic status and sex and median age at death from cystic fibrosis in England and Wales, over the past 50 years.
Design Series of annual cross sectional studies of all registered deaths with a diagnosis of cystic fibrosis in England and Wales, from 1959 to 2008.
Methods We obtained national mortality data for cystic fibrosis from the Office for National Statistics. From 1959 to 2000, the Registrar General’s Social Class coded socioeconomic status as manual or non-manual. From 2001 onwards, the National Statistics Socioeconomic Classification was implemented and socioeconomic status was split into three groups: professional and managerial, intermediate, and routine and manual. We calculated median age at death for every study year. We calculated the effects of sex and socioeconomic status on the odds of death above the median age at death for every study decade using logistic regression.
Results From 1959 to 2008, 6750 deaths were attributed to cystic fibrosis in England and Wales. Males were more likely to die above the annual median age at death than females (from 1959 to 1999, adjusted odds ratio for socioeconomic status 1.28, 95% confidence intervals 1.13 to 1.45; from 2000 to 2008, 1.57, 1.18 to 2.08). Individuals in the highest socioeconomic class were also more likely to die above the median age of death than those in the lowest socioeconomic class (from 1959 to 2000, adjusted odds ratio for sex 2.50, 2.16 to 2.90; from 2001 to 2008, 1.89, 1.20 to 2.97).
Conclusions Socioeconomic status and sex remain strong determinants of survival from cystic fibrosis in England and Wales, and the magnitude of these effects does not appear to have substantially reduced over time.
We thank Brian Johnson from the Office for National Statistics for supplying the data.
Contributors: HLB contributed to the acquisition of data, statistical analysis and interpretation of data, drafting the article, and final approval of the version to be published. JB contributed to the concept and design of the study, interpretation of the data, drafting the article, and final approval of the version to be published. ARS contributed to the interpretation of the data, drafting the article, and final approval of the version to be published. AWF contributed to the concept and design of the study, acquisition of data, statistical analysis and interpretation of data, drafting the article, and approval of the final version to be published. AWF is the data guarantor.
Funding: This research was funded by the Medical Research Council and the University of Nottingham.
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
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