Available online 16 April 2024

What is already known about this topic?

Disadvantaged socioeconomic status and unhealthy lifestyles have been associated with asthma risk. However, whether and to what extent lifestyle factors might modify socioeconomic inequalities in asthma remains a controversial topic.

What does this article add to our knowledge?

This study reveals the disproportionate risk of unhealthy lifestyles associated with asthma in populations with different socioeconomic status. In particular, adherence to a healthy lifestyle may have higher health benefits for disadvantaged socioeconomic groups.

How does this study impact current management guidelines?

This study contributes to the improvement of scalable and sustainable asthma prevention measures and the development of targeted health promotion strategies for populations with different social and behavioral characteristics.

The prevalence of asthma is gradually increasing worldwide and there are socioeconomic inequalities in the risk of developing asthma.

This study aimed to evaluate whether the lifestyle is associated with asthma in adults, as well as whether and to what extent healthy lifestyles may modify socioeconomic status (SES) inequities in asthma.

This study included a total of 223951 participants from the UK Biobank. Smoking, physical activity, alcohol consumption, healthy diet patterns, sedentary time, and sleep duration items were used to construct the lifestyle score. Income, education, and occupation were used to assess SES. Cases of adult-onset asthma were identified based on electronic health records. The Cox proportional hazards regression was used to explore the association of socioeconomic inequality and lifestyle factors with asthma.

Compared with the most healthy lifestyle category, the HRs (95% CIs) of the moderately healthy lifestyle and least healthy lifestyle categories for asthma were 1.08 (1.01-1.15) and 1.29 (1.20-1.39), respectively. A significant interaction (P interaction< 0.05) was found between lifestyle categories and socioeconomic status, and the association between them was more pronounced in participants with low socioeconomic status (HR least healthy vs most healthy: 1.58, 95%CI: 1.40-1.80). The joint analysis revealed that the risk of asthma was highest among participants with the lowest SES and the least healthy lifestyles (HR: 2.02, 95%CI: 1.74-2.33).

Unhealthy lifestyle factors are associated with an increased risk of asthma in adults, and socioeconomically disadvantaged groups are more negatively affected by unhealthy lifestyles. Public health strategies for asthma prevention may need to be tailored according to socioeconomic status, and social policies to reduce poverty are needed alongside lifestyle interventions in areas of deprivation.

© 2024 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology