COPD More Common In Rural Than Urban America Says CDChttps://www.acsh.org/news/2018/02/23/copd-more-common-rural-urban-america-says-cdc-12614
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They found that the age-adjusted prevalence of diagnosed COPD among adults (18+ years) was 4.7 percent in populations inhabiting large metropolitan areas, compared to 8.2 percent in those living in rural areas. Seven states had the highest reported prevalence: Alabama, Arkansas, Indiana, Kentucky, Mississippi, Tennessee and West Virginia. Of these, Arkansas, Kentucky, Mississippi and West Virginia had the highest percentages of rural areas.
The authors hypothesized that these results could be related to a variety of factors in addition to the major known risks such as tobacco smoking, environmental and occupational exposures. These additional correlates included older ages, low socioeconomic status and a history of asthma. Also, they suggested that rural populations might have a greater proportion with a smoking history, more exposure to secondhand smoke, but less access to smoking cessation programs. Rural populations might have unique exposures to "mold spores, organic toxic dust, and nirtrogen dioxide which are associated with COPD risk."
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While there are pulmonary rehabilitation programs, the authors also said that rural residents might not have them easily accesible, thus they suggested
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These data indicate which populations should be targeted for additional assistance to better reduce the burden of COPD on individuals as well as on the health care system.