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Food Insecurity is Associated with COPD Prevalence and Mortality: Evidence from U.S. County-Level Data.

Katherine E Goodenberger1, Swaraj Bose2, Susan K Murray2

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Annals of the American Thoracic Society
|April 25, 2026
PubMed
Summary
This summary is machine-generated.

Food insecurity is linked to increased prevalence and mortality of Chronic Obstructive Pulmonary Disease (COPD). Addressing unreliable food access may improve population-level COPD outcomes and reduce respiratory disease burden.

Keywords:
COPDFood desertFood insecurityepidemiology

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Area of Science:

  • Environmental Health
  • Epidemiology
  • Public Health

Background:

  • Unreliable access to healthy food is associated with adverse respiratory outcomes in individuals with Chronic Obstructive Pulmonary Disease (COPD).
  • The association between food insecurity and COPD prevalence and mortality remains understudied.
  • Food deserts and food insecurity are significant public health concerns impacting chronic disease burden.

Purpose of the Study:

  • To determine the associations between food insecurity and COPD prevalence at the county level in the United States.
  • To investigate the relationship between food insecurity and COPD-related mortality.
  • To examine the impact of food deserts on COPD prevalence and mortality.

Main Methods:

  • Utilized U.S. county-level data from 2018 for food insecurity prevalence (FI%) and the Food Environment Index (FEI).
  • Queried CDC databases for county-level COPD prevalence (2018) and COPD-related mortality (2018-2020).
  • Employed negative binomial regression models, adjusting for demographic, socioeconomic, and health factors, to analyze associations.

Main Results:

  • Higher food insecurity prevalence (FI%) and worse Food Environment Index (FEI) were associated with socioeconomic and environmental disadvantages.
  • A 1% increase in FI% correlated with a 1.62% rise in COPD prevalence, and a 1-unit decrease in FEI correlated with a 1.85% rise.
  • A 1% increase in FI% was linked to a 3.54% increase in COPD mortality, and a 1-unit decrease in FEI to a 10.05% increase.

Conclusions:

  • Unreliable food access is significantly associated with higher COPD prevalence and mortality at the county level.
  • These findings highlight the role of food insecurity as a social determinant of health in COPD.
  • Improving food access presents a potential strategy for enhancing population-level COPD outcomes.