Abstract
OBJECTIVES: Asthma pertains to both public health and social equality concerns. Yet, the extent to which social inequality is involved in the association of behavioural and psychological factors with new-onset asthma is not clear.
STUDY DESIGN: Cohort study.
METHODS: Using the UK Biobank cohort, an interactive measurement for asthma-related behavioural and psychological factors was constructed via Bayesian network-based TOPSIS. The Index of Multiple Deprivation (IMD) measured neighbourhood socioeconomic status. Cox regression assessed the association of behavioural and psychological engagement and IMD with the risk of new-onset asthma, with additive interaction analysis.
RESULTS: During follow-up, 7002 participants were diagnosed with asthma. Obesity contributed most to the network of seven interacted behavioural and psychological factors. Unhealthy behavioural and psychological engagement was associated with a 106 % (HR = 2.06, 95 % CI: 1.91-2.22) increase in the risk of new-onset asthma. The association was most pronounced in the high IMD group, in which the HR of unhealthy behavioural and psychological engagement reached 2.28 (95 % CI: 2.00-2.59). Significant additive interaction (RERI = 0.532, 95 % CI: 0.253-0.812) revealed potential socioeconomic inequality.
CONCLUSIONS: Deprived people suffer an additional risk of new-onset asthma associated with the engagement. Coordinating community-level action for socioeconomic improvements and promoting healthy behaviours should be proportionate to the needs.