Racial and Ethnic Minorities Have a Lower Prevalence of Airflow Obstruction than Non-Hispanic Whites

Akshay Sood, Hans Petersen, Congjian Liu, Orrin Myers, Xin Wang Shore, Bobbi A. Gore, Rodrigo Vazquez-Guillamet, Linda S. Cook, Paula Meek, Yohannes Tesfaigzi

Research output: Contribution to journalArticlepeer-review

Abstract

Racial and ethnic disparities in chronic obstructive pulmonary disease (COPD) are not well-studied. Our objective was to examine differences in limited COPD-related outcomes between three minority groups—African Americans (AAs), Hispanics, and American Indians (AIs) versus non-Hispanic Whites (NHWs), as the referent group, in separate cohorts. Separate cross-sectional evaluations were performed of three US-based cohorts of subjects at risk for COPD: COPDGene Study with 6,884 NHW and 3,416 AA smokers; Lovelace Smokers’ Cohort with 1,598 NHW and 378 Hispanic smokers; and Mining Dust Exposure in the United States Cohort with 2,115 NHW, 2,682 Hispanic, and 2,467 AI miners. Prebronchodilator spirometry tests were performed at baseline visits using standard criteria. The primary outcome was the prevalence of airflow obstruction. Secondary outcomes were self-reported physician diagnosis of COPD, chronic bronchitis, and modified Medical Research Council dyspnea score. All minority groups had a lower prevalence of airflow obstruction than NHWs (adjusted ORs varied from 0.29 in AIs to 0.85 in AAs; p < 0.01 for all analyses). AAs had a lower prevalence of chronic bronchitis than NHWs. In our study, all minority groups had a lower prevalence of airflow obstruction but a greater level of self-reported dyspnea than NHWs, and covariates did not explain this association. A better understanding of racial and ethnic differences in smoking-related and occupational airflow obstruction may improve prevention and therapeutic strategies.

Original languageEnglish
Pages (from-to)61-68
Number of pages8
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Volume19
Issue number1
DOIs
StatePublished - 2022

Keywords

  • African Americans
  • American Indians
  • COPD
  • Hispanic Americans
  • chronic bronchitis
  • emphysema
  • miners
  • racial and ethnic differences
  • spirometric diagnosis of airflow obstruction

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