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Disparities in lung function trajectories among tobacco-exposed individuals
Benjamin Grobman1, Amy L Non2, Elizabeth Baker3
1Harvard Medical School, Boston, Massachusetts, USA bgrobman@hms.harvard.edu.
Thorax
|January 6, 2026
Summary
Social determinants and environmental exposures significantly impact lung function trajectories, particularly for non-Hispanic Black adults. Understanding these factors is crucial for developing targeted lung health prevention strategies.
Area of Science:
- Pulmonary Medicine
- Public Health
- Health Disparities
Background:
- Lung function trajectories are influenced by social determinants of health (SDOH), environmental exposures, and medical history, yet these relationships remain underexplored.
- Understanding these factors is critical for developing effective preventive strategies for lung health.
Purpose of the Study:
- To investigate the association of SDOH, environmental exposures, and medical history with lung function trajectories in a US cohort.
- To identify disparities in lung function trajectories among different demographic groups.
Main Methods:
- Analysis of longitudinal data from the COPDGene study, including 2990 males and 2945 females aged 45-80 years with a history of tobacco exposure.
- Bayesian trajectory modeling was used to analyze post-bronchodilator forced expiratory volume in one second (FEV1) and forced vital capacity (FVC).
- Multinomial logistic regression assessed the association of SDOH, environmental exposures, and medical history with identified lung function trajectories.
Main Results:
- Six distinct lung function trajectories were identified for each sex.
- Non-Hispanic Black adults were more prevalent in lower lung function trajectories compared to non-Hispanic White adults.
- Factors associated with lower lung function included non-Hispanic Black race, residence in the Southeastern USA, lifetime asthma, and paternal history of COPD. Higher income and private insurance were inversely associated with lower lung function.
Conclusions:
- Significant disparities in lung function trajectories exist between non-Hispanic Black and non-Hispanic White adults.
- Individual and community-level factors, including SDOH and environmental exposures, are associated with reduced lung function in tobacco-exposed individuals.
- Findings highlight the need for targeted interventions addressing socioeconomic and environmental factors to improve lung health outcomes.
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