Important Differences in Pulmonary Diseases

Abstract

Disparities in outcomes for pulmonary diseases are the most evident of all chronic diseases. Because of disproportional poverty and urban living, African Americans have an increased exposure to indoor and outdoor pollution, occupational and environmental hazards, and tobacco smoke, which contribute to disparities in prevalence and outcomes of COPD. African American patients had a higher rate of asthma-COPD overlap with asthma as a predominant cause for resistant treatment and hospital re-admission. African Americans also have a higher rate of chronic bronchitis and a lower rate of emphysema when compared to European Americans. African Americans with COPD are significantly younger, smoke less, report concurrent asthma more frequently, and have less radiographic emphysema on volumetric computed tomography. There is more obstructive sleep apnea, interrupted sleep, and daytime sleepiness in African Americans. Finally, sarcoidosis and its increased severity in African Americans is discussed.