Vulnerability and asthma: the case of elderly women

A collaboration between French researchers, including some from Paris-Saclay University, recently focused on the influence of socio-economic factors on the control and treatment of asthma, a chronic and incurable respiratory disease. The scientists targeted their study on older women, who represented a population at risk and poorly investigated in this context.

Asthma is a chronic respiratory disease that currently affects more than 350 million people worldwide. Although the disease is incurable, treatments exist that relieve the symptoms and reduce inflammation, improving the general quality of life of asthmatics. However, between 45 and 60% of people affected in France are reported to experience non-controlled asthma, representing a significant health and socio-economic cost.

In order to better understand the reasons for this poor medical care, researchers at the Aging and Chronic Diseases - Epidemiological and Public Health Approaches Laboratory (VIMA - Université Paris-Saclay, UVSQ, Inserm) and at the Research Centre on Epidemiology and Population Health (CESP - Université Paris-Saclay, UVSQ, Université Paris-Sud, Inserm), in collaboration with their colleagues from Grenoble and Nanterre, interviewed 2,258 elderly French women with asthma belonging to the E3N cohort (an epidemiological study of women from the General Insurance Company of the French Education Ministry).

The results showed that a quarter of these women did not receive adequate care. Women with the least controlled asthma were also those with the most disadvantaged socio-economic status. Unlike previous studies, the work also included the environment in which participants lived, and not just individual socio-economic factors. The researchers showed that the economic and social context of the patients' home also played a role in controlling the disease. Women living in disadvantaged neighbourhoods, regardless of their individual socio-economic level, were those with the least well-controlled disease.

These disparities may be attributed to an inappropriate use of treatment and poorer access to care. Although asthma treatments and related care are funded in France, there are still patients who do not get the best care for their disease. To improve the care of asthma in elderly patients in particular, researchers stressed the need to pay particular attention to patients with a low socio-economic level living in disadvantaged neighbourhoods, or those living in wealthier neighbourhoods but without adequate support.

Temam, S. et al. Low socioeconomic position and neighborhood deprivation are associated with uncontrolled asthma in elderly. Respiratory Medicine. Volume 158, October - November 2019, Pages 70-77.