Epidemiology a.k.a. Who, What, Where and Why of Cystic Fibrosis!

What we learned last time:

• CF research and treatments have led to an increase in survival rates of those diagnosed early on..  = LONGER LIVES!
• Currently there are about 30,000 people living with CF in the US
• CF is genetic and affects families of every race.. but it can affect some more than others
• caucasians/northern europeans: 1 in 2,500 
• african americans: 1 in 15,100
• hispanic/latino: 1 in 13,500
• asian american/native hawaiian/pacific islanders: 1 in 31,000

**Statistics courtesy of the American Lung Association.

What we will learn today:

Although we know CF is genetic and passed on from parent to child, the severity of each patient's illness differs.  We know there are other NON-GENETIC FACTORS that can INCREASE the SEVERITY of the disease.. 

Some studies showed that CF patient's with low SOCIOECONOMIC STATUS, or income low enough to qualify for the government health insurance, MEDICAID, had significantly worsened lung function, more frequent outpatient visits and almost double the amount of hospitalizations for worsened lung functioning. Although this is a relationship seen from National Registries, it does not discuss why lower SES would influence lung function in CF patients.. so they looked further.

With a lower SES, CF patients may have experienced some of the things listed below which could increase the risk of worsening symptoms.

• Exposure to tobacco smoke
• Increased exposure to other infectious agents, viruses, bacteria affecting airways
• STRESS... when kids are sick, parents are stressed, families suffer, kids get sicker
• PoorER nutrition, increased variety of healthy foods can improve immune system!
• Lack of health care system resources, how far away is the clinic?  Is the primary caregiver educated enough to follow a rigorous medication program?  How similar is their access to clinical trials or new drugs that may improve lung function?

Diagram courtesy of Schlechter via PubMed

These questions are just a few that epidemiologists look at to understand the CF population and differences in individual signs and symptoms.

References:

 Schechter MS. Non-genetic influences on cystic fibrosis lung disease: the role of sociodemographic characteristics, environmental exposures, and healthcare interventions. Semin Respir Crit Care Med. 2003;24:639–652. 

n.d.). Retrieved January 26, 2015, from http://www.lung.org/assets/documents/publications/solddc-chapters/cf.pdf