ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
The mediating role of healthy lifestyle in the association between higher socioeconomic status and an increased risk of allergic rhinitis: an analysis of NHANES.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe association between socioeconomic status (SES) and allergic rhinitis (AR) remains inconsistent, and the role of healthy lifestyle in mediating or modifying this relationship is not well characterized.
methodsThis cross-sectional study analyzed NHANES data from 3,463 U.S. adults collected in 2005-2006. Latent class analysis using education, PIR, occupation, health insurance, and marital status assessed SES. Healthy lifestyle scores were derived from smoking, drinking, physical activity, and diet. Associations were examined using logistic regression, interaction analysis, and mediation analysis.
resultsAmong 3,463 participants, 616 had AR, yielding an approximate prevalence of 17.8%. After adjusting for covariates as well as lifestyle scores or SES, individuals with high socioeconomic status (SES) (OR: 1.323, 95% CI: 1.074-1.632) and those with 3 or 4 healthy lifestyle factors (OR: 1.396, 95% CI: 1.082-1.811) showed a higher risk of AR. No interaction was observed. The highest risk was observed among individuals with both high SES and 3-4 healthy lifestyle factors, compared to those with medium SES and 0-1 healthy lifestyle behavior. A healthy lifestyle statistically accounted for the association between SES and AR, explaining 28.57% of the total effect. This mediating role remained significant among subgroups including individuals aged under 47 years, males, Non-Hispanic whites, and those with comorbidities.
conclusionsOur findings indicated that higher SES and higher healthy lifestyle scores were both positively associated with the risk of AR, and that a healthy lifestyle statistically explained the observed the association between SES and AR.
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