An Update in Health Disparities in COPD in the USA

Abstract

COPD is a prevalent, highly morbid, but manageable disease. Challenges exist in diagnosis that leads to both missed and inappropriate diagnosis with apparent ethnic, sex, and socioeconomic disparities. Disease management is possible with medications and intensive efforts such as pulmonary rehabilitation, but as these interventions are become increasingly expensive, the divide in socioeconomic outcomes expands. Health systems have increasingly focused resources on COPD, but the efforts have not been equally implemented. There is increasing prevalence of COPD in women, patients with low socioeconomic status, and minorities attributable to higher burden of tobacco, occupational, and rural exposure. Recent mortality estimates suggest a growing socioeconomic divide. As providers and healthcare systems work to improve the diagnosis and care of COPD patients, biases and disparities must be measured, appreciated, and addressed to assure just implementation.