The association between chronic airflow obstruction and poverty in 12 sites of the multinational BOLD study

Poverty is strongly associated with mortality from COPD, but little is known of its relation to airflow obstruction. In a cross-sectional study of adults aged ≥40 years from 12 sites (N=9255), participating in the Burden of Obstructive Lung Disease (BOLD) study, poverty was evaluated using a wealth score (0–10) based on household assets. Obstruction, measured as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) (%) after administration of 200 μg salbutamol, and prevalence of FEV1/FVCAirflow obstruction is consistently associated with poverty at individual and community levels across several countries. Poverty is a strong predictor of chronic airflow obstruction independent of age, sex, smoking and tuberculosis