HMN 2025: How Rural health disparities need greater focus in COPD research

COPD research needs to increase focus on rural health disparities and consider the impact of sociocultural and environmental exposures on health outcomes, according to a new perspective in the September 2025 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation.

COPD encompasses conditions including emphysema and chronic bronchitis. It is caused by irritants like smoke or pollution, and even genetics. There are an estimated 30 million Americans affected by COPD, yet only half of those people know they have the disease.

Previous research shows that the prevalence of COPD and COPD mortality is higher in rural areas and continues to increase. People with COPD in rural areas also tend to have higher symptom burden, more frequent exacerbations, and decreased lung function.

In this new perspective, the COPD Foundation’s Medical and Scientific Advisory Committee emphasizes the need to redefine rurality in COPD care and research to include distance and geographic isolation, access to broadband internet, and sociocultural and environmental exposures that impact health behaviors.

The authors also highlight the importance of examining the racial, ethnic, and socioeconomic disparities that influence rural health outcomes. These social determinants of health must be intentionally studied in COPD research in rural cohorts.

In addition, COPD research recruitment must address and overcome the key structural and rural-specific barriers that individuals in these communities face when participating. Developing research recruitment efforts guided by this information can improve rural resident participation, producing more informative data to address the ongoing disparities in rural COPD care and outcomes.

“There are a wide range of challenges when examining the impact of rurality on people with COPD,” said M. Bradley Drummond, M.D., MHS, professor of medicine in the Division of Pulmonary Diseases and Critical Care Medicine at the University of North Carolina at Chapel Hill.

“In order to address the rural-urban disparity as it relates to the risk and progression of COPD, we must continue to adjust and refine how we define rurality to ensure research examines all the contributing factors faced by people in rural areas.”

Provided by
COPD Foundation

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