Asthma is associated with impaired social functioning: findings from the World Health Survey

Background:

Asthma may impair social functioning as indicated by studies conducted in mainly pediatric populations in Western countries.

Objective:

We sought to investigate whether there are also associations between asthma and social functioning in adults from both Western and non-Western countries.

Methods:

We analyzed data on 231,816 individuals (94% aged 20+, 52% female) from 50 countries participating in the World Health Survey. Two separate definitions of asthma were used (i.e. self-reports of wheezing or of an asthma diagnosis). Social functioning was measured by two items assessing difficulties with personal relationships and with participation in the community. Reports of severe or extreme difficulties on any item were considered to signal impaired social functioning. Logistic regression, adjusted for socio-demographic factors, was used to estimate odds ratios (adjusted [a] ORs) and 95% confidence intervals (CIs) in the overall sample and by continents.

Results:

Wheezing was associated with impaired social functioning both in the overall sample (aOR = 2.40, 95%CI = 2.09 – 2.75) and in Africa, South America and Asia (aORs ≥2.47), but not in Europe (aOR = 1.26, 95%CI = 0.90 – 1.77). Analyses with self-reports of asthma diagnosis yielded similar, albeit weaker, patterns of associations (e.g. aOR for the overall sample = 1.63, 95%CI = 1.38 – 1.92).

Conclusions:

Self-reports of wheezing and of diagnosed asthma are associated with impaired social functioning among adults in Africa, South America and Asia, but less so in Europe. Our findings may partly be explained by regional variations in asthma control. The present study is the first to highlight the potential impact of adult asthma on people's social lives in under-researched non-Western regions of the world. Further research should elucidate the determinants and mechanisms of asthma-related impaired social functioning.