A new report published in the Morbidity & Mortality Weekly Report (MMWR) notes that “rural U.S. residents experienced higher age-adjusted COPD prevalence, Medicare hospitalizations for COPD as the first-listed diagnosis, and deaths caused by COPD than did residents in micropolitan or metropolitan areas”. The authors of the report utilized data from the 2015 Behavioral Risk Factors Surveillance Sysetm survey, Medicare hospitalization records and death certificates from six geographical categories (large central metropolitan, large fringe metropolitan, medium metropolitan, small metropolitan, micropolitan, and rural*
One of the key findings of the report was that “rural U.S. residents experienced higher age-adjusted COPD prevalence, Medicare hospitalizations for COPD as the first-listed diagnosis, and deaths caused by COPD than did residents in micropolitan or metropolitan areas”. The report suggests that some of the reasons for the metropolitan-rural discrepancy in COPD burden may be because “these populations have a greater proportion with a history of smoking, more secondhand smoke exposure but less access to smoking cessation programs, and higher proportions of uninsured or lower socioeconomic residents, which might have limited access to early diagnosis, treatment, and management of COPD. Rural respiratory exposures might include mold spores, organic toxic dust, and nitrogen dioxide, which are associated with COPD risk”
The authors of the report make the case that work needs to be done to remove the known barriers to effective care in rural areas, which includes improving access to COPD treatment strategies such as pulmonary rehabilitation and appropriate oxygen therapy, along with better access to comprehensive chronic disease self management programs.
*For more information on how the geographical areas were categoroized for the study, see the Centers for Disease Control & Prevention’s National Center for Health Statistics’ report, 2013 NCHS Urban–Rural Classification Scheme for Counties.