Page 18 - Delaware Medical Journal - September 2017
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SCIENTIFIC ARTICLE
causes of geographic variations, which might be related to factors such as cigarette smoking, access to health care, and occupational and environmental exposures.
The ACOS patterns observed with respect to sex, age, race/ethnicity, income, and education are similar to those noted for COPD prevalence in earlier reports,8 and in the analyses on patterns for COPD and current asthma presented in this report (Table 1). Consistent with the literature, histories of correlated with ACOS.7,9 Smoking cessation is important in prevention
and management of ACOS, given that smoking cessation is the only proven way of modifying the decline in lung function associated with COPD.
Obesity and underweight were both
with ACOS similar to COPD and asthma.
previous research on the relationship of Body Mass Index (BMI) and obstructive lung diseases.10 The association of obesity with COPD is consistent to the results in previous studies.6,7,10 However, the relationship of underweight is a relatively less understood phenotype. Several pathways that can result in obstructive lung disease patients having low body weight include having baseline low body weight prior to developing disease; developing low body weight due to disease complications; and a tendency for higher rates of current smoking among persons who are underweight and/ or have obstructive lung disease.10
Previous research has reported more health burden and activity limitations
with ACOS.7,9 Respondents with ACOS disability.
We understand this study has limitations. BRFSS is a telephone survey that excludes persons living in institutions, nursing homes, long-term care facilities, and correctional institutions, and
results might not be applicable to these populations. Second, BRFSS data are self- reported and subject to recall and social desirability bias (e.g., underreporting of actual weight). Also, BRFSS captures
by a doctor or health professional, potentially leading to the underreporting of conditions that remain undiagnosed or were not recalled by the respondent during the BRFSS interview.
CONCLUSION
The overall prevalence of ACOS and reported worse clinical outcomes make it a serious public health burden that needs to be addressed, especially in areas with a higher prevalence. This analysis provides an important starting point for states to quantify the burden of ACOS locally and target their resources.
ACKNOWLEDGEMENT
The authors would like to thank the Centers for Disease Control and Prevention’s Behavior Risk Factor Surveillance System for making available the data for this research.
CONTRIBUTING AUTHORS
■ SANGEETA GUPTA, MD, MPH is an Associate Professor in the Department of Public and Allied Health Sciences at Delaware State University in Dover, Del.
■ RAYMOND TUTU, PhD is an Associate Professor of Global Societies in the Department of History, Political Science, and Philosophy at Delaware State University in Dover, Del.
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