COPD more prevalent in poor, rural areas of US

DENVER — People living in rural or small metropolitan areas nationwide had a more than 20% increased risk for COPD than people living in larger, nonrural metro regions, according to study data presented at the American Thoracic Society International Conference.

Sarath Raju, MD, MPH, Johns Hopkins School of Medicine, and colleagues reviewed data from 55,131 adults aged older than 40 years from the National Health Interview Survey from 2009 to 2011. The survey was linked with the Census Bureau, the National Center for Health Statistics Urban-Rural Classification Scheme and the American Community Survey.

The goal, Raju said during a presentation, was to determine COPD prevalence in urban and rural communities and whether the impact of community and individual risk factors for COPD varied by region. Community variables included region of residence, community poverty and the use of solid fuels. Age, sex, smoking status, household poverty and education status were among the individual variables.

Overall COPD prevalence was 7.2% (95% CI, 7-7.6) nationwide, but it increased to 11.9% (95% CI, 10-14.1) for participants living in rural-poor areas. Living in a rural or small metropolitan area resulted in the highest increased risk for COPD (OR = 1.21; P < .01), as did living in the South (OR = 1.26; P < .01).

Regional fuel use in the South and Midwest also were associated with more than ninefold and fivefold increased risks, respectively, for COPD.

“Living in a rural poor community is an independent predictor for COPD,” Raju said. “There is significant regional variation in COPD prevalence and that community level risk factors may differ by region.”

These regional differences have the potential to influence future interventions, he said.

“I think this is particularly important as these are things we still need to untangle as they may provide opportunities for future interventions to reduce COPD disparities and for public health initiatives in the future,” Raju said. – by Ryan McDonald

Reference:

Raju S, et al. Abstract 63441. Presented at: American Thoracic Society International Conference; May 15-20, 2015; Denver.

Disclosure: Raju reports no relevant financial disclosures.