Associations between income level and health outcomes in people with cystic fibrosis in Turkey

Background: Our study aimed to identify the social domains that pose the greatest barriers to managing and supporting pwCF, particularly in relation to income levels.

Methods: To identify associations between income and health outcomes in pwCF in our center the shorter form of the survey "Your Current Life Situation" (YCLS) was used in face-to-face interviews. Participants were also asked to complete the validated Turkish versions of the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder scale (GAD-7) to assess depression and anxiety, respectively.

Results: In total, 282 pwCF were included in this study. 51.1 % were female (n = 144), mean (±SD) age was 13.8 (±8.7) years and 75 % (n = 211) were <18 years old. The median (IQR) values of pwCF; FEV_1pp (percent predictive) 83 % (41-97), BMI (body mass index) 17 kg/m² (15∼20), BMI z-score -0.1 (-1∼0.3). Of the pwCF in the study 89 % (n = 251) had an income below the poverty threshold and 21 % (n = 60) of them had an income below the hunger threshold. The results of YCLS survey showed that the highest level of insecurity was in the social domain (68.5 %, n = 193); this was followed by health and clinical care (62.1 %, n = 173), financial (37.9 %, n = 106), and food insecurity (37.2 %, n = 103). All individuals experiencing housing insecurity stated that they had requested help from local organisations.

Conclusion: The study highlights the substantial socioeconomic challenges faced by pwCF, a significant majority live below the poverty threshold and experience high levels of social and health insecurity, underscoring the need for comprehensive support systems to address these issues.