The breathtakingly beautiful scenery of rural America is so in part due to the vast openness afforded by the distancing of farms, communities and people. An estimated 60 million people—or one in five—live in areas defined as “far from an urban center.” Such wide-open spaces can make access to healthcare difficult, and specialized care more so. And for veterans at higher risk for lung conditions such as chronic obstructive pulmonary disease (COPD), it becomes even more important to know the early warning signs of lung disease and follow up on any new signs and symptoms. Case in point, approximately 25% of veterans are diagnosed with COPD and many veterans begin to show signs of COPD earlier than the general population.

A Higher Risk

Why are veterans more likely to have COPD than most of the civilian population? Veterans typically have higher rates of exposure to hazardous conditions such as oil well fires, sand and dust particles, open-air burn pits, extreme temperatures, and carbon monoxide, increasing their risk of developing lung diseases.

However, environmental pollutants are not the only factors that contribute to Veterans’ higher levels of COPD and other lung diseases. Smoking and vaping are also contributors to symptoms experienced by Veterans. The CDC reported in 2018 that close to 30% of veterans in the United States use some form of tobacco products, which was significantly higher than among nonveterans. If you currently use tobacco products, you can reduce your risk of developing COPD and other chronic diseases by taking steps to quit smoking, chewing and vaping by joining a Freedom From Smoking program or accessing other resources available through the American Lung Association.

COPD is a preventable and treatable disease. Knowing the early warning signs that should get checked out by your healthcare provider can lead to a quicker diagnosis and earlier treatment, resulting in better disease management. Early warning signs include:

  • A chronic cough
  • Shortness of breath
  • Chest tightness
  • Coughing up mucus
  • Wheezing or noisy breathing
  • Unexplained chest pain
  • Coughing up blood

Healthcare in Rural America

While all veterans are at an increased risk, those living in rural areas, which make up nearly a quarter of the veteran population, are not only at an even higher risk of developing COPD and other lung disease, but they are also more likely to die from COPD. Nearly 25% of people living in rural areas say that it is hard to find good doctors and hospitals in their community. In comparison, 18% of people living in cities said the same and only 9% of those living in suburbs reported having this problem. It also takes the average rural resident about twice as long as someone living in a city or a suburb to reach a healthcare facility.

In addition, it can be difficult for veterans or their caregivers to access necessary care. For instance, hospitals are more likely to close in rural areas due to financial instability. Delivery of medication and other medical supplies can be difficult to receive, or deliveries may take longer. The limit of broadband internet also restricts 26% of veterans living in rural areas from accessing the care they need.

To help these veterans living in rural communities, the VA has dedicated targeted resources and allocated 32% of its healthcare budget to care for rural veterans. For further information on veteran-specific care, find a VA location or visit the Veterans Health Library.

What You Can Do

Veterans have given so much to this country and one way to give back is to help them breathe a bit easier. If you are a veteran, or care for a veteran, who is experiencing symptoms such as chronic cough, shortness of breath or repeated respiratory infections, seek out your healthcare provider to receive an evaluation of these signs and symptoms.

The American Lung Association provides resources for individuals living with COPD, including our COPD Action Plan and Management Tool which can help manage symptoms. You can get your questions about COPD or lung health answered by calling our Lung HelpLine at 800-LUNG-USA or visit

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