Contribution of Individual and Neighborhood Factors to Racial Disparities in Respiratory Outcomes

Area of Science:

• Pulmonary Medicine
• Health Disparities Research
• Sociomedical Sciences

Background:

• Black adults experience poorer health outcomes in chronic obstructive pulmonary disease (COPD) compared to white adults.
• Racial disparities in COPD are a significant public health concern requiring investigation into contributing factors.

Purpose of the Study:

• To investigate the extent to which individual and neighborhood socioeconomic status (SES) contribute to racial disparities in COPD outcomes.
• To analyze the impact of SES on symptom burden, functional status, imaging metrics, and exacerbation risk in Black versus white individuals with COPD.

Main Methods:

• Analysis of sociodemographic data from 2,649 current or former smokers in the SPIROMICS study.
• Comparison of respiratory outcomes (symptoms, quality of life, exacerbations, CT scan metrics) between Black and white participants.
• Regression modeling to assess the influence of individual and neighborhood SES on racial differences in COPD outcomes.

Main Results:

• Black participants exhibited worse respiratory symptoms, quality of life, and higher severe exacerbation risk.
• CT scans revealed greater emphysema, air trapping, and airway wall thickness in Black participants.
• Individual SES explained 12-35% and neighborhood SES explained 26-54% of racial disparities in COPD outcomes, with significant disparities persisting even after SES adjustment.

Conclusions:

• Both individual and neighborhood socioeconomic disadvantages are significant contributors to racial disparities in COPD outcomes.
• Addressing socioeconomic disparities is crucial for reducing race-related health inequities in COPD.
• Additional factors beyond SES likely contribute to the persistent disparities observed in Black individuals with COPD.