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  4. COPD Trends Brief
  5. Risk Factors and Patient Characteristics

COPD Trends Brief: Risk Factors and Patient Characteristics

COPD rates are not the same across demographic groups. This page describes COPD rates in different categories.

COPD Rates

Cigarette Smoking Status
  • Most COPD cases are caused by cigarette smoking. Compared to never smokers, COPD rates are 7 times higher among current smokers and 5 times higher among former smokers.
Family Income
  • In 2020, COPD rates were lowest among those with a family income two times greater than the poverty threshold or more compared to those with lower family incomes.
Anxiety and Depression
  • Psychiatric comorbidities, such as depression and anxiety, are common among those with COPD. In 2020, 43.5% of those with COPD reported ever being diagnosed with anxiety or depression, compared to 20.5% among those without COPD.
Disabilities
  • COPD can severely limit one’s ability to work, get around, do chores, or manage personal care. In 2020, a third (33.1%) of those with COPD reported having at least one disability, compared to only 7.5% among those without COPD.

Vaccinations

Influenza
  • Those with COPD are at increased risk for complications from influenza and are recommended to receive annual vaccination against the seasonal flu. In 2020, close to two-thirds (61.8%) of those with COPD reported receiving a flu vaccination in the last year, compared to 46.1% among those without COPD.
Pneumonia
  • Those with COPD are at increased risk for pneumococcal pneumonia infection and are recommended to be vaccinated against it. In 2020, 62.0% of those with COPD had received a shot for pneumococcal pneumonia, compared to 22.8% among those without COPD.

COPD by State

  • In 2020, COPD rates among adults ranged from 3.7% in Hawaii to 13.6% in West Virginia.

COPD Prevalence Rates and Counts by State and Gender, 2020
  Male Female Total
State Percent Count Percent Count Percent Count
Alabama 9.0 163,600 10.7 213,300 9.9 376,900
Alaska 3.8 10,700 5.5 14,400 4.6 25,100
Arizona 5.6 157,600 6.4 187,100 6.0 344,700
Arkansas 7.9 88,600 10.0 120,300 9.0 209,000
California 4.7 715,600 6.1 950,800 5.4 1,666,400
Colorado 4.0 91,700 5.1 115,500 4.5 207,200
Connecticut 4.6 62,300 5.9 86,800 5.3 149,100
Delaware 6.4 23,700 6.0 24,500 6.2 48,200
District of Columbia 3.5 9,500 5.0 15,300 4.3 24,800
Florida 6.8 574,600 8.2 745,500 7.5 1,320,100
Georgia 5.9 231,300 7.3 311,500 6.6 542,700
Hawaii 3.7 20,700 3.7 20,700 3.7 41,400
Idaho 5.5 37,700 6.1 41,800 5.8 79,600
Illinois 5.2 246,900 7.0 351,800 6.1 598,700
Indiana 7.3 185,600 9.3 247,400 8.3 433,000
Iowa 6.2 74,200 6.3 76,900 6.2 151,100
Kansas 5.4 59,400 7.0 77,800 6.2 137,200
Kentucky 10.5 177,300 14.0 249,100 12.3 426,400
Louisiana 7.4 125,900 9.4 172,100 8.4 297,900
Maine 7.8 41,600 8.8 49,600 8.3 91,100
Maryland 4.3 97,300 5.3 131,100 4.8 228,500
Massachusetts 3.6 94,600 5.4 155,800 4.5 250,400
Michigan 7.1 270,800 9.5 382,600 8.3 653,400
Minnesota 4.1 88,000 5.0 109,700 4.5 197,700
Mississippi 7.0 76,100 10.1 119,400 8.6 195,400
Missouri 7.8 181,900 8.8 216,700 8.4 398,600
Montana 6.1 25,800 7.1 30,000 6.6 55,800
Nebraska 4.6 33,500 5.7 42,300 5.2 75,800
Nevada 7.3 88,700 7.2 87,700 7.2 176,400
New Hampshire 3.9 129,900 5.8 208,500 4.9 338,500
New Jersey 6.6 35,800 6.6 37,200 6.6 73,000
New Mexico 4.6 36,300 5.5 45,500 5.1 81,700
New York 4.5 330,300 5.4 431,700 5.0 762,100
North Carolina 5.9 236,800 6.9 299,900 6.5 536,700
North Dakota 4.6 13,800 6.5 18,400 5.5 32,200
Ohio 7.2 318,300 8.8 411,900 8.0 730,200
Oklahoma 7.4 108,100 9.7 148,500 8.5 256,500
Oregon 5.8 96,000 6.3 107,800 6.0 203,800
Pennsylvania 6.2 304,400 8.3 434,500 7.3 738,900
Rhode Island 6.1 25,000 7.7 34,200 6.9 59,200
South Carolina 7.6 148,500 8.6 184,100 8.1 332,600
South Dakota 6.4 21,600 6.2 20,600 6.3 42,200
Tennessee 7.9 206,400 11.0 306,300 9.5 512,700
Texas 4.4 470,700 5.8 644,200 5.1 1,114,900
Utah 3.7 42,700 4.6 53,600 4.1 96,400
Vermont 5.3 13,200 6.6 17,000 5.9 30,200
Virginia 5.0 163,500 6.5 223,500 5.8 386,900
Washington 4.5 134,500 6.2 186,800 5.3 321,400
West Virginia 12.7 87,600 14.5 104,500 13.6 192,100
Wisconsin 5.7 129,300 4.9 113,100 5.3 242,400
Wyoming 5.3 11,900 7.1 15,600 6.2 27,500
United States 5.5 7,120,000 6.8 9,394,900 6.2 16,515,000

Source:
Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System 2020, raw data analyzed by the American Lung Association Epidemiology and Statistics Unit.

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