The Impact of Neighborhood Material and Social Disadvantage on Respiratory Health Across Canada

BACKGROUND: While smoking and genetic predisposition are known to confer an increased risk of lung diseases, less is known about the socioeconomic determinants of respiratory health. Disadvantages experienced at the neighborhood level may contribute to poor lung outcomes. OBJECTIVE: To quantify the impact of neighborhood disadvantage on respiratory outcomes in a general population cohort. METHODS: 1449 adults enrolled in the Canadian Cohort Obstructive Lung Disease (CanCOLD) Study were followed for three years with repeat pulmonary function and cardiopulmonary exercise testing. Chest computed tomographic (CT) imaging was obtained at baseline. The Material and Social Deprivation Index was used to measure neighborhood disadvantage. Regression models were used to quantify the association between neighborhood disadvantage and pulmonary function, peak exercise capacity, quantitative CT measures, respiratory symptom scores, respiratory-related exacerbation events, and mortality. RESULTS: , p=0.042) decline. There were no significant relationships between neighborhood disadvantage and quantitative CT measures, exacerbations, or mortality. CONCLUSIONS: Residence in the most materially and socially disadvantaged neighborhood is associated with worse lung function and exercise outcomes, highlighting a population particularly vulnerable to chronic airways diseases.