Page 17 - Delaware Medical Journal - September 2017
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SCIENTIFIC ARTICLE
Data from 441,456 U.S. adults using the year 2015 were analyzed. The median BRFSS survey response rate for all states was 47.2 percent and ranged from 33.9 to 61.1 percent. Cooperation rates ranged from 51.1 to 78.3 percent (median: 63.8 percent).
“Has a doctor, nurse, or other health professional ever told you that you
have chronic obstructive pulmonary disease or COPD, emphysema or chronic bronchitis?” Current asthma was “Has a doctor, nurse, or other health professional ever told you that you have asthma?” and “Do you still have asthma?” Persons who reported “don’t know/not sure” as a response to either COPD or diagnosed with that condition. ACOS was assessed by a yes response to both COPD and current asthma questions.
For obesity, data on self-reported weight and height was used to calculate body mass index (BMI). Participants were status was assessed by categorizing responses to the question “Do you now smoke cigarettes every day, some days, or not at all?” Based on the responses, smokers, former smokers, and never smokers. To identify a person with
a disability, two survey questions
are asked as part of the BRFSS. The
that affect participation in daily life.
The second question addresses use of special equipment. All respondents are asked these two disability questions. Participants who responded “yes” to a disability.
Statistical Analyses
SAS software 9.3 (RTI International, Research Triangle Park, NC) was used to account for the complex sample design of BRFSS when generating estimates estimates were calculated for subgroups health insurance coverage. Two-tailed
for differences in prevalence between population subgroups (P < .05). Three standard BRFSS data suppression guidelines were followed for the reporting of results namely: numerator less than 5; interval more than 20 points wide. If
any of these guidelines are not met for a given cell, the results for that cell were suppressed.
RESULTS
Prevalence of ACOS by select sociodemographic groups
Overall, 2.2 percent of U.S. adults (an estimated 5.4 million people) have ACOS (Table 1). COPD and asthma prevalence is also provided for quick comparison (Table 1). Prevalence of ACOS increased, from 0.7 percent among those aged 18-44 years to 3.6 percent among those aged report ACOS than non-Hispanic whites and blacks (1.1 percent compared with
2.5 percent and 2.3 percent, respectively). Women were more likely to report
ACOS than men (2.8 percent compared with 1.5 percent). Respondents with
less than college education reported a higher prevalence of ACOS (2.6 percent) than those with a college degree and above (0.9 percent). ACOS prevalence decreased with increasing household income, from 4.3 percent among those reporting a household income <$25,000 annually to 1 percent among those
Smoking tobacco and obesity were
(p<.0001). More current smokers reported having ACOS (4.7 percent) than former smokers (3.4 percent) or never smokers
(1 percent). ACOS prevalence was high among both obese (3.5 percent) and underweight (3.2 percent) respondents.
correlated with ACOS (p<.0001). Respondents with ACOS also were more likely to report disability (7 percent).
The prevalence of ACOS varied considerably by state, from 1.3 percent in Colorado to 5.0 percent in Kentucky and West Virginia. The median prevalence by state was 2.1 percent. (Table 2).
DISCUSSION
prevalence of ACOS among adults in all 50 states, DC, and Puerto Rico. State level data on prevalence of COPD and asthma is also provided for quick comparison.
Additionally, this report provides data on the prevalence of ACOS by select sociodemographic groups. Nationally, 2.2 percent of adults were estimated to have ACOS. Few studies have attempted to quantify the national prevalence of ACOS. A previous study estimated
the national prevalence of ACOS as
3.2 percent.6 The higher prevalence
may be attributed to the analyses
being restricted to adults 35 and older. State prevalences varied considerably, ranging from as low as 1.3 percent in Colorado to as high as 5.0 percent in Kentucky and West Virginia (Table 2). The southern states accounted for the highest prevalences of ACOS, similar
to geographic patterns previously reported for COPD.8 Additional research is needed to determine the underlying
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