Chronic Obstructive Pulmonary Disease (COPD) is a significant health burden, affecting approximately 1.1 million or 4% of California adults. Among them, more than half (550,000) live in Southern California (Los Angeles, Orange, Ventura, San Bernardino, Riverside, San Diego and Imperial Counties), and nearly one-fifth of California adults with COPD, or approximately 197,000 people, reside in Los Angeles County. Key findings of this policy note include: California's COPD profile is complex. (1) While a third of adults with COPD in California are age 65 and older, one quarter of adults with COPD in California (25.4%) are under the age of 45. (2) Three-fifths of Californians with COPD (59.1%) are women, and more than two-fifths (43.7%) belong to minority populations. (3) More than one-third of Californians with COPD (35.7%) live below 130% of the federal poverty level (FPL). Another 20.5% live between 131-249% of the FPL. (4) More than one-third of adults with COPD (37.4%) never smoked. Many Californians with COPD need better access to care: (1) Around two-fifths, or 42.9%, have seen a doctor for symptoms related to COPD, and 17.5% have visited an emergency room or been admitted to the hospital due to COPD in the past 12 months. (2) Approximately one-third of California adults with COPD (30.4%) reported never having received a breathing test (i.e. spirometry), the only approved method for diagnosing COPD. (3) Compared to Californians without COPD, twice as many Californians with COPD reported that the cost of health care was an obstacle to receiving medical care (27.7% vs. 14.7%). (4) Among Californians with COPD, 19.4% do not have a personal health care provider. Californians with COPD fare less well than their counterparts without COPD: (1) Although smoking is the most well-known risk factor for developing and worsening COPD, a third of adults with COPD are current smokers (33.7%) compared to one in ten adults without COPD who are current smokers (10.8%). A quarter of adults with COPD are exposed to household smoking, which is double that of respondents without COPD (25.2% vs. 12.5%). (2) Approximately two-fifths of respondents with COPD (42.8%) report poor/fair health status, compared to 17.4% among those without COPD. (3) Nearly a third of respondents with COPD (29%) report poor mental health, compared to 10.5% among those without COPD. Chronic Obstructive Pulmonary Disease (COPD), referring to chronic bronchitis and emphysema, is characterized by obstruction to airflow that makes emptying air from the lungs progressively difficult. Chronic lower respiratory disease, primarily COPD, is a major cause of disability and death; it was the third leading cause of death in the United States, and the fourth leading cause of death in California and Los Angeles County in 2009. Currently, approximately 14.8 million people in the U.S. are diagnosed with COPD, and there may be just as many who have the disease and do not know it. Major symptoms of COPD include coughing, mucus production, wheezing and shortness of breath. COPD is largely preventable, but not curable. The most well-known associated risk factor for developing COPD is cigarette smoking, but COPD has also been linked to air pollution exposure, recurrent infection, diet and genetic factors. Treatment can control symptoms and slow disease progression. This policy note represents the first time that data has been made available to characterize adults with COPD in the state of California, as well as the regions of Southern California and Los Angeles County. The policy note uses California Behavioral Risk Factor Surveillance System (BRFSS) data to detail COPD prevalence, COPD health care utilization and outcomes, and characteristics of Californians with COPD. It provides the estimation of overall prevalence of COPD for California as a whole, as well as by region (Southern California and Los Angeles County), and also provides descriptive statistics for COPD-related care and quality of life. Demographic, social and behavioral characteristics are compared among those with COPD versus those without.
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