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  5. Risk Factors and Patient Characteristics

COPD Trends Brief: Risk Factors and Patient Characteristics

COPD rates are not the same across demographic groups. This page describes COPD rates in different categories.

COPD Rates

Cigarette Smoking Status
  • Most COPD cases are caused by cigarette smoking. Compared to never smokers, COPD rates in 2022 were 7 times higher among current smokers and 4 times higher among former smokers.
Family Income
  • In 2022, COPD rates were lowest among those with a family income two times greater than the poverty threshold or more compared to those with lower family incomes.
Anxiety and Depression
  • Psychiatric comorbidities, such as depression and anxiety, are common among those with COPD. In 2022, 49.5% of those with COPD reported ever being diagnosed with anxiety or depression, compared to 22.7% among those without COPD.
Disabilities
  • COPD can severely limit one’s ability to work, get around, do chores, or manage personal care. In 2022, over a third (35.1%) of those with COPD reported having at least one disability, compared to only 8.0% among those without COPD.

Vaccinations

Influenza
  • Those with COPD are at increased risk for complications from influenza and are recommended to receive annual vaccination against the seasonal flu. In 2022, over half (57.3%) of those with COPD reported receiving a flu vaccination in the last year, compared to 46.7% among those without COPD.
Pneumonia
  • Those with COPD are at increased risk for pneumococcal pneumonia infection and are recommended to be vaccinated against it. In 2022, 58.6% of those with COPD had received a shot for pneumococcal pneumonia, compared to 22.2% among those without COPD.

COPD by State

  • In 2021, COPD rates among adults ranged from 3.5% in Hawaii to 13.1% in West Virginia.

COPD Prevalence, 2021
Percent of adults ever diagnosed with COPD

American Lung Association Research Team analysis of CDC data: BRFSS 2021

COPD Prevalence Rates and Counts by State and Gender, 2021
  Male Female Total
State Percent Count Percent Count Percent Count
Alabama 8.6 161,900 10.1 207,500 9.4 369,400
Alaska 5.3 15,300 6.1 16,100 5.7 31,400
Arizona 5.0 137,800 6.4 180,700 5.7 318,500
Arkansas 8.6 97,600 10.5 125,600 9.6 223,200
California 4.5 680,600 4.7 733,100 4.6 1,413,800
Colorado 4.3 98,900 5.9 135,100 5.1 233,900
Connecticut 4.7 65,400 5.9 87,200 5.3 152,500
Delaware 5.9 22,400 6.6 27,300 6.2 49,700
District of Columbia 4.1 10,600 5.1 15,100 4.6 25,700
Florida (2020) 6.8 574,600 8.2 745,500 7.5 1,320,100
Georgia 5.3 211,000 7.9 341,100 6.6 552,100
Hawaii 3.4 19,300 3.6 20,800 3.5 40,200
Idaho 5.0 35,400 6.4 45,800 5.7 81,200
Illinois 5.4 260,600 5.6 287,300 5.5 547,900
Indiana 7.4 188,300 9.5 256,200 8.5 444,400
Iowa 6.0 72,500 7.1 89,000 6.6 161,600
Kansas 5.9 64,400 7.0 79,300 6.4 143,700
Kentucky 9.8 166,800 12.0 214,900 10.9 381,700
Louisiana 8.5 144,500 8.9 163,700 8.7 308,200
Maine 8.1 43,600 9.8 56,200 9.0 99,900
Maryland 3.7 85,000 5.9 149,000 4.8 234,000
Massachusetts 5.0 136,300 6.7 196,200 5.9 332,500
Michigan 6.8 261,800 8.6 348,500 7.7 610,200
Minnesota 5.0 108,600 4.4 98,700 4.7 207,400
Mississippi 7.6 82,500 10.4 122,400 9.1 204,900
Missouri 6.6 153,500 10.4 255,600 8.5 409,000
Montana 5.2 22,800 6.6 28,400 5.9 51,200
Nebraska 5.2 38,300 6.1 45,600 5.6 83,900
Nevada 5.7 69,200 8.0 98,600 6.8 167,800
New Hampshire 4.7 165,200 6.3 235,000 5.5 400,100
New Jersey 6.3 35,100 8.1 46,400 7.2 81,400
New Mexico 4.5 36,100 6.7 55,900 5.6 91,900
New York 5.0 379,600 5.9 490,200 5.5 869,900
North Carolina 6.1 241,000 9.0 386,500 7.6 627,500
North Dakota 4.4 13,500 5.3 15,600 4.8 29,100
Ohio 7.6 340,300 9.5 452,900 8.6 793,200
Oklahoma 6.6 98,500 8.9 136,800 7.8 235,300
Oregon 5.1 85,200 7.0 120,300 6.1 205,500
Pennsylvania 6.9 344,000 6.8 361,300 6.8 705,300
Rhode Island 5.8 24,600 5.7 26,000 5.7 50,600
South Carolina 6.7 130,600 8.3 177,200 7.5 307,800
South Dakota 5.7 19,300 6.2 20,800 6.0 40,100
Tennessee 9.7 254,600 11.1 311,100 10.4 565,700
Texas 5.2 570,900 6.8 771,100 6.0 1,342,000
Utah 3.9 46,500 4.7 56,300 4.3 102,800
Vermont 5.8 15,000 7.3 19,700 6.6 34,700
Virginia 5.4 179,600 7.3 254,500 6.4 434,100
Washington 4.7 143,400 5.6 172,300 5.1 315,700
West Virginia 11.8 82,300 14.4 103,900 13.1 186,200
Wisconsin 5.5 126,400 5.7 132,800 5.6 259,200
Wyoming 6.2 14,100 6.9 15,100 6.5 29,200
United States 5.5 6,800,400 6.8 8,875,100 6.2 15,587,000

Source:
Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System 2021, raw data analysed by the American Lung Association Epidemiology and Statistics Unit.

COPD in Your State

Take action to reduce the burden of COPD in your state. Download your state’s COPD State Brief.
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