Targeting Persons With or At High Risk for Chronic Obstructive Pulmonary Disease by State-based Surveillance

Figures & data

Table 1.  Percentage of respiratory symptoms and chronic obstructive pulmonary disease (COPD) among South Carolina adults aged ≥35 years by selected characteristics–BRFSS, 2012^a

Characteristic		Frequent productive cough^b		Frequent shortness of breath (SOB)^c		Agree breathing problems limited physical activity^d			COPD^e
N^a	%	(95% CI)	%	(95% CI)	%	(95% CI)	%	(95% CI)	Total
9438	10.6	(9.8–11.5)	5.2	(4.6–5.9)	17.3	(16.2–18.4)	9.1	(8.3–10.0)	Sociodemographics
Sociodemographics
Sex
Men	3580	11.4	(10.1–12.9)	5.2	(4.3–6.4)	18.2	(16.4–20.1)	8.1	(6.9–9.4)
Women	5858	9.9	(8.8–11.1)	5.1	(4.4–6.0)	16.5	(15.1–17.9)	9.9	(8.9–11.1)
Age (years)
35–44	1342	6.8	(5.2–8.9)	2.8	(1.8–4.3)	10.7	(8.7–13.1)	5.3	(3.7–7.5)
45–54	1870	11.2	(9.4–13.3)	5.8	(4.5–7.4)	17.1	(14.8–19.7)	8.8	(7.2–10.6)
55–64	2559	11.9	(10.2–13.9)	6.2	(5.0–7.7)	21.4	(19.0–23.9)	11.2	(9.5–13.1)
65–74	2178	10.9	(9.1–13.0)	5.6	(4.4–7.2)	18.0	(15.8–20.5)	10.7	(8.9–12.7)
≥75	1489	14.4	(12.1–17.2)	6.1	(4.5–8.3)	22.4	(19.5–25.6)	11.2	(9.2–13.6)
Race
White	6554	10.9	(9.9–12.0)	4.7	(4.0–5.5)	15.9	(14.6–17.3)	9.8	(8.8–10.9)
African American	2497	9.5	(7.9–11.4)	6.5	(5.2–8.2)	21.5	(19.1–24.1)	7.2	(5.8–8.8)
Other/multiracial	322	12.2	(7.3–19.7)	–^f		16.2	(10.8–23.6)	7.1	(4.2–11.7)
Education
Less than high school diploma	1062	19.3	(16.2–22.9)	13.2	(10.7–16.2)	34.5	(30.4–38.7)	17.5	(14.4–21.0)
High school graduate or GED	2876	11.5	(9.9–13.2)	5.0	(4.0–6.2)	19.7	(17.7–21.9)	9.9	(8.5–11.5)
At least some college	5487	7.7	(6.8–8.7)	3.0	(2.4–3.7)	11.1	(9.9–12.3)	6.2	(5.4–7.2)
Other characteristics
Smoking status
Current smoker	1462	22.0	(19.3–24.9)	9.5	(7.6–11.8)	25.4	(22.4–28.6)	17.6	(15.2–20.4)
Former smoker	2977	10.4	(8.9–12.1)	6.0	(4.9–7.2)	19.4	(17.4–21.5)	11.1	(9.5–12.9)
Never smoker	4999	6.4	(5.5–7.5)	3.0	(2.4–3.8)	12.9	(11.5–14.4)	4.6	(3.8–5.5)
Smoking duration (years)
Never smoked	4999	6.4	(5.5–7.5)	3.0	(2.4–3.8)	12.9	(11.5–14.4)	4.6	(3.8–5.5)
1–9	930	6.3	(4.3–9.2)	3.8	(2.2–6.3)	14.9	(11.7–18.8)	6.2	(4.3–8.9)
10–19	1090	9.5	(7.4–12.2)	5.3	(3.6–7.5)	15.5	(12.5–18.9)	8.0	(5.7–11.2)
20–29	1026	14.0	(11.4–17.0)	7.4	(5.5–9.9)	23.8	(20.2–27.8)	12.3	(9.8–15.3)
≥30	1393	26.0	(22.9–29.4)	11.5	(9.4–14.0)	29.9	(26.7–33.3)	24.6	(21.6–27.9)
Asthma history
None	8352	8.8	(8.0–9.8)	3.3	(2.8–3.9)	13.7	(12.7–14.8)	5.9	(5.2–6.7)
Former history only	309	12.1	(7.0–20.2)	–^f		20.1	(14.3–27.5)	14.9	(10.6–20.5)
Current asthma	777	27.8	(23.5–32.5)	23.1	(19.1–27.6)	51.9	(46.6–57.1)	38.6	(33.7–43.7)
COPD history
Yes	898	39.6	(35.0–44.3)	28.4	(24.4–32.9)	59.3	(54.3–64.0)	—
No	8540	7.7	(6.9–8.6)	2.9	(2.4–3.4)	13.1	(12.0–14.2)	—

^a Unweighted sample. Categories might not sum to survey total because of missing responses.

^b Defined as a response of either most days or every day to the question “During the past 30 days, how often do you cough up mucus or phlegm?”

^c Defined as a response of either most of the time or all of the time to the question “During the past 30 days, how often do you feel short of breath?”

^d Defined as a response of agree slightly or agree strongly to the question, “How much do you agree or disagree with the following statement? ‘In the past year, I am not as physically active as I once was because of my breathing problems.’”

^e Defined as a positive response to the questions, “Have you ever been told by a doctor or health professional that you have COPD, emphysema, or chronic bronchitis?”

^f Estimates not reliable. Relative standard error ≥ 0.3.

Table 2.  Age-adjusted^a prevalence and 95% confidence intervals (95% CI) of selected characteristics among South Carolina adults aged ≥35 years by COPD risk status^b-BRFSS, 2012

									Contrast
	Diagnosed with COPD (N=898)		High-risk for COPD (N=700)		Low-risk for COPD (N=7840)		Diagnosed vs high-risk	Diagnosed vs low-risk	High-risk vs low-risk
Characteristic	%	(95% CI)	%	(95% CI)	%	(95% CI)	p-value	p-value	p-value
Sociodemographics
Sex
Men	42.3	(35.7–49.2)	58.2	(51.7–64.4)	45.8	(44.1–47.5)	<0.001	NS	<0.001
Women	57.7	(50.8–64.3)	41.8	(35.6–48.3)	54.2	(52.5–55.9)	<0.001	NS	<0.001
Age (years) - (Not age-adjusted)
35-44	13.8	(9.9–19.0)	12.3	(9.0–16.6)	26.0	(24.5–27.6)	NS	<0.001	<0.001
45–54	25.4	(21.3–29.9)	32.5	(27.3–38.2)	25.6	(24.2–27.2)	<0.05	NS	<0.05
55–64	29.2	(25.1–33.7)	26.8	(22.5–31.7)	22.8	(21.5–24.1)	NS	<0.01	NS
65–74	19.2	(16.1–22.8)	16.6	(13.4–20.4)	16.0	(15.0–17.0)	NS	NS	NS
75+	12.4	(10.1–15.1)	11.7	(9.3–14.6)	9.6	(8.9–10.4)	NS	<0.05	NS
Mean (SE)	57.9	(0.6)	58.7	(0.7)	55.3	(0.2)	NS	<0.001	<0.001
Race
White	78.6	(73.6–82.8)	71.0	(64.6–76.7)	71.4	(69.8–72.9)	NS	<0.01	NS
African American	18.7	(14.6–23.6)	27.0	(21.4–33.4)	24.1	(22.7–25.6)	<0.05	<0.05	NS
Other/multiracial	2.7	(1.6–4.6)	2.0	(1.1–3.4)	4.5	(3.7–5.6)	NS	<0.05	<0.001
Education
Less than high school diploma	30.7	(24.1–38.2)	29.0	(23.5–35.3)	12.5	(11.2–13.9)	NS	<0.001	<0.001
High school graduate or GED	31.5	(26.6–36.9)	34.1	(28.6–40.1)	29.2	(27.7–30.7)	NS	NS	NS
At least some college	37.8	(31.6–44.4)	36.9	(31.0–43.2)	58.4	(56.7–60.0)	NS	<0.001	<0.001
Risk factors
Smoking status
Current smoker	40.5	(34.0–47.4)	59.2	(53.4–64.7)	14.0	(12.8–15.3)	<0.001	<0.001	<0.001
Former smoker	33.1	(26.4–40.4)	40.8	(35.3–46.6)	27.6	(26.1–29.1)	NS	NS	<0.001
Never smoker	26.4	(20.9–32.8)	0.0		58.4	(56.7–60.1)	<0.001	<0.001	<0.001
Smoking duration (years)
Never smoked	26.4	(20.9–32.8)	–		58.4	(56.7–60.1)	<0.001	<0.001	<0.001
1–9	7.8	(4.6–13.0)	–		11.6	(10.6–12.8)	<0.001	NS	<0.001
10–19	12.2	(7.2–19.8)	28.9	(23.2–35.4)	11.5	(10.4–12.7)	<0.001	NS	<0.001
20–29	20.8	(15.7–27.0)	37.4	(31.3–44.0)	9.9	(8.9–11.0)	<0.001	<0.001	<0.001
≥30	32.8	(28.7–37.2)	33.7	(29.6–38.0)	8.5	(7.7–9.4)	NS	<0.001	<0.001

^a Age-adjusted to the projected 2000 U.S. population aged ≥35 years.

^b Diagnosed-Self-reported physician diagnosis of COPD. High-risk-No COPD diagnosis, ≥10 more years of cigarette/tobacco use, and at least one respiratory symptom (frequent productive cough, frequent shortness of breath (SOB), or breathing problems limited physical activity in past year.) Low-risk-Neither diagnosed nor high-risk.

^c Estimates not reliable. Relative standard error ≥ 0.3.

Table 3.  Age-adjusted^a prevalence and 95% confidence intervals (95% CI) of health characteristics and respiratory symptoms among South Carolina adults aged ≥35 years by COPD risk status^b-BRFSS, 2012

									Contrast
	Diagnosed with COPD (N=898)		High-risk for COPD (N=700)		Low-risk for COPD (N=7840)		Diagnosed vs high-risk	Diagnosed vs low-risk	High-risk vs low-risk
Characteristic	%	(95% CI)	%	(95% CI)	%	(95% CI)	p-value	p-value	p-value
Healthcare access^c
Healthcare coverage	79.4	(73.0–84.6)	71.5	(65.1–77.2)	84.0	(82.6–85.3)	NS	NS	<0.001
Healthcare provider	85.7	(79.9–90.0)	78.4	(71.9–83.8)	85.2	(83.9–86.4)	NS	NS	<0.05
Cost prevented seeking care	32.5	(26.2–39.5)	32.1	(26.4–38.5)	15.7	(14.5–17.0)	NS	<0.001	<0.001
Routine checkup in previous 12 months	67.0	(60.0–73.3)	62.6	(56.1–68.7)	69.1	(67.5–70.7)	NS	NS	<0.05
Chronic conditions
Current asthma	39.0	(32.5–45.9)	12.9	(9.2–17.8)	5.4	(4.6–6.3)	<0.001	<0.001	<0.001
Coronary heart disease	17.1	(13.7–21.1)	12.3	(9.0–16.6)	4.6	(4.0–5.2)	NS	<0.001	<0.001
Diabetes	20.4	(16.9–24.5)	18.6	(14.8–23.0)	12.9	(11.9–13.9)	NS	<0.001	<0.01
Arthritis	63.4	(56.5–69.9)	52.2	(45.6–58.6)	32.1	(30.7–33.5)	<0.05	<0.001	<0.001
Cancer (excluding skin)	14.1	(11.4–17.3)	8.8	(6.7–11.4)	7.7	(7.0–8.5)	<0.01	<0.001	NS
Depression	49.2	(42.8–55.7)	29.9	(24.8–35.6)	15.5	(14.3–16.7)	<0.001	<0.001	<0.001
Stroke	10.3	(7.2–14.4)	7.6	(5.4–10.4)	3.6	(3.1–4.2)	NS	<0.001	<0.01
Kidney disease	5.5	(4.0–7.4)	4.3	(2.6–7.0)	2.5	(2.1–3.1)	NS	<0.01	NS
Health Impairment
Fair/poor health	57.2	(50.3–63.7)	43.6	(37.8–49.6)	16.1	(15.0–17.4)	<0.01	<0.001	<0.001
Frequent mental distress^f	36.6	(29.9–44.2)	26.6	(21.2–33.2)	9.4	(8.5–10.2)	<0.05	<0.001	<0.001
Frequent physical distress^g	47.8	(41.0–54.7)	30.8	(25.4–36.9)	10.7	(9.7–11.7)	<0.001	<0.001	<0.001
Respiratory symptoms
Frequent shortness of breath	25.7	(21.2–30.6)	15.2	(11.1–20.5)	1.6	(1.2–2.2)	<0.01	<0.001	<0.001
Frequent productive cough	37.2	(32.0–42.8)	48.1	(41.7–54.5)	3.9	(3.3–4.7)	<0.05	<0.001	<0.001
Breathing problems limited activity	55.1	(48.4–61.6)	67.8	(61.8–73.3)	7.8	(7.0–8.8)	<0.01	<0.001	<0.001

^a Age-adjusted to the projected 2000 U.S. population aged ≥35 years

^b Diagnosed-Self-reported physician diagnosis of COPD. High-risk-No COPD diagnosis, ≥10 more years of cigarette/tobacco use, and at least one respiratory symptom (frequent productive cough, frequent shortness of breath (SOB), or breathing problems limited physical activity in past year.) Low-risk-Neither diagnosed nor high-risk.

^c Health care coverage based on response to “Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare, or Indian Health Service?” Health care provider based on response to “Do you have one person you think of as your personal doctor or health care provider?” Cost prevented seeking care based on response to “Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?” Routine checkup in previous 12 months based on response to “About how long has it been since you last visited a doctor for a routine checkup?”

^d Number of chronic illnesses included current asthma, coronary heart disease, diabetes, arthritis, cancer (excluding skin), depression, stroke, and kidney disease. COPD was not included in count of chronic illnesses.

^e Estimates not reliable. Relative standard error ≥ 0.3.

^f Frequent mental distress: a response of ≥ 14 days to the question, “Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good.”

^g Frequent physical distress: a response of ≥ 14 days to the question, “Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good.”

Figure 1.  Age-adjusted^a prevalence of respiratory symptoms among South Carolina adults aged ≥ 35 years diagnosed with or at high-risk for COPD-BRFSS, 2012