PURPOSE: COPD is the only one of the six leading causes of death that is steadily increasing in the U.S. The purpose of the survey was to estimate the burden of COPD in Hawai’i.
METHODS: We used SAS(r) 9.1.3 to create variables for the analysis of 2008 BRFSS data. SUDAAN(r) 10.0 was used for statistical analysis.
RESULTS: The overall prevalence of COPD was 3.2% (20,800 people). It was highest among persons who reported being unable to work (RR 3.6; 95% CI = 2.6, 5.1; p < 0.0001), those with household incomes < $15,000/year (RR 4.4; 95% CI = 3.2, 6.0; p < 0.0001), and those with less than a high school education (RR 1.2; 95% CI = 0.74, 2.02; p = 0.44). Persons with COPD were 1.2 times (95% CI = 0.74, 2.1) more likely to be obese and 2.6 times (95% CI = 1.0 to 6.7) more likely to be underweight than those with no COPD. Persons with COPD were 10.3 times more likely to also report asthma (95% CI = 7.0, 15), 2.9 times more likely to have heart disease, (95% CI = 1.7, 4.9) and 1.7 times more likely to have diabetes, (95% CI = 1.1, 2.7) than those with no COPD. The total charges for COPD-related hospitalizations in Hawaii was over $30 million in 2008.
CONCLUSION: Data from this report underscore the need for integrated chronic disease planning that incorporates factors associated with social, economic, and health disparity. We recommend a spirometry-based survey of airway obstruction in adult smokers, since COPD self-reports are likely to under-estimate the true prevalence.
CLINICAL IMPLICATIONS: The report will inform future interventions and guide policy to address COPD in Hawai’i.
DISCLOSURE: Earl Bradbury, No Financial Disclosure Information; No Product/Research Disclosure Information