COPD

COPD Rate Highest in Rural Communities

Published in partnership with ATS

 

 

People who live in poverty in rural communities—regardless of whether they are ever or never smokers—have the greatest risk of developing chronic obstructive pulmonary disease (COPD) in the United States, according to a new study published by the American Thoracic Society.

 

To reach these results, the researchers studied a nationally representative sample of adults from the National Health Interview Survey (NHIS) for the years 2012 through 2015, with data linkage between neighborhood data from the US Census American 2015 Community Survey and the 2013 National Center for Health Statistics Urban Rural Classification Scheme. Participants were categorized as having COPD by answering “yes” to having COPD or emphysema in the NIHS.

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In all, data from 90,334 participants aged 40 years or older, which was collected between 2012 and 2015, were analyzed.

 

The prevalence of COPD in poor, rural areas was nearly double that of the overall population (15.7% vs 8.4%). Of participants who lived in rural, non-poor communities, 12% had COPD.

 

While rural areas—specifically those in the South and Midwest—had the highest prevalence of COPD, non-poor, urban communities had the lowest prevalence with 6.1% of those participants having COPD.

 

“At an individual level, a 1 unit decrease in the household income to poverty ratio was associated with an 8% increase in the odds of having COPD,” the researchers wrote.

 

The study also shows that living in a community that uses coal for heating is an additional risk factor for the development of COPD among never smokers—a 1% increase in the number of homes using coal as a primary heating source is linked to a 9% increase in the odds of having COPD in never-smokers.

 

“This is the first study to report individual, community, and geographic risk factors for COPD in the United States,” the researchers wrote. “These results suggest that future studies and public health initiatives should investigate household and community-level environmental factors that contribute to COPD prevalence in rural parts of the US in order to reduce disparities.”

 

—Colleen Murphy

 

Reference:

 

Raju S, Keet CA, Paulin LM, et al. Rural residence and poverty are independent risk factors for COPD in the United States [published online November 2, 2018]. Am J Respir and Crit Care Med. https://doi.org/10.1164/rccm.201807-1374OC.