For Release: April 21, 2003

Contact: DMS Communications (603) 650-1492

Income Level Tied to Cystic Fibrosis Deaths

HANOVER, NH - The risk of death from cystic fibrosis (CF) is related to the income level of the family, according to New England medical researchers. Their study, published in the April issue of Pediatrics, the journal of the American Academy of Pediatrics, reports those living with lower incomes are at a greater risk of death from this disease.

"Financial disadvantage has been shown to have a strong effect on the health status of individuals, but this effect has never been examined in cystic fibrosis," said head author, Dr. Gerald T. O'Connor, professor of medicine and of community and family medicine. He led a team of nine researchers from the Northern New England Cystic Fibrosis Consortium, a regional group of health care professionals that seeks to improve the quality of care for people with cystic fibrosis. Participating medical centers include DHMC, Central Maine Medical Center, Eastern Maine Medical Center, Fletcher Allen Health Care and Maine Medical Center.

Cystic fibrosis, considered the most frequently occurring lethal autosomal genetic disease in the white population, affects about 30,000 children and adults in the US. Patients produce abnormally thick mucus in the lungs and pancreas, which causes them to cough, wheeze and experience respiratory problems and infections. While there is no cure for the disease, CF patients are now living longer thanks to advanced treatments. The researchers wanted to determine if income was a factor.

For the study, the researchers selected records of white patients throughout the country who were diagnosed with CF before they reached the age of 18. Clinicians then linked these 23,817 patients with information from the US census. They adjusted the household incomes based on state differences in cost of living.

They found a strong association between household income and the death rate from CF. In the lowest income category, which included families who earned less than $20,000, the incidence of death was 90.3 per 10,000 person years compared to 62 per 10,000 person in the highest income group, which included families who made more than $50,000. This translates to a 44-percent increased risk of death among the lowest income category. Furthermore, those in the lowest income group had reduced pulmonary function and lower body weight.

"The strong effect of low income on outcomes is not yet fully understood," said O¹Connor. "Detailed studies are in progress to understand the mechanism by which socioeconomic status plays a role in clinical outcomes for CF patients."