• Rachel Holland, Cole Bowerman, and Sanja Stanojevic.
• Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
• Chest. 2022 Sep 1; 162 (3): 635646635-646.

BackgroundThe current approach to interpretation of lung function measurements assumes that differences in lung function between racial and ethnic groups represent inherent and biological differences. Observed differences in lung function between White and Black populations are often attributed to physiological differences in body proportions (eg, chest size, leg length); however, most studies investigating the observed differences have not considered the impact of socioeconomic status (SES).Research QuestionWhat proportion of the differences in lung function between Black and White populations can be attributed to SES and/or differences in body proportions?Study Design And MethodsPubMed and EMBASE were searched up to March 2022 for articles relating to Black race, SES, and lung function. A total of 4,673 titles and abstracts were screened, followed by assessment for extractable data; 11 articles were ultimately included in this systematic review.ResultsThere is substantial heterogeneity in the contribution of SES and body proportions to the observed differences in lung function between Black and White individuals. The proportion of differences between Black and White study participants attributable to SES factors ranged from 2.2% to 43.3% in FEV1 and from 4.1% to 41.9% for FVC. Studies that adjusted for sitting height explained 3% to 31.7% of the racial difference in lung function.InterpretationReproducible research aimed at explaining the etiology of the differences in lung function between populations is difficult to achieve. The evidence to support the use of race/ethnic specific equations is limited, and the practice needs to be re-evaluated.Copyright © 2022 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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