Significant Variation in COPD Prevalence and Burden Across U.S. States

A recent study published in the March 2025 issue of *Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation* reveals notable disparities in the prevalence and burden of chronic obstructive pulmonary disease (COPD) across different states in the United States. This research, which utilized Medicare fee-for-service, Medicaid, and commercial health insurance claims data, is crucial for addressing public health gaps and improving health care responses for individuals affected by COPD.

COPD, a chronic inflammatory lung disease characterized by obstructed airflow, comprises conditions such as chronic bronchitis and emphysema. According to the COPD Foundation, this condition affects over 30 million Americans, rendering it the fourth leading cause of death globally, as reported by the World Health Organization (WHO) (WHO, 2023). The recent study highlights a wide range in diagnosed COPD prevalence, with West Virginia reporting the highest rate at 143 per 1,000 insured individuals, while Utah recorded the lowest at 44 per 1,000 insured individuals (Bazell et al., 2025).

The study's lead author, Dr. Carol Bazell, M.D., MPH, a Principal at Milliman, Inc., emphasized the importance of understanding these variations. "Information about people with COPD and their health care utilization is lacking, particularly when examining state level and insurance type data," Bazell stated. The study found that, in 2021 alone, approximately 11.7 million insured individuals were diagnosed with COPD, resulting in 1.8 million acute inpatient hospitalizations and 1.4 million emergency department visits related to the disease (Bazell et al., 2025).

Further analysis indicated that certain states, including West Virginia, Kentucky, and Mississippi, exhibited higher than average all-cause mortality rates among Medicare-insured individuals diagnosed with COPD, despite being younger on average (Bazell et al., 2025). This finding underscores the critical need for tailored public health strategies to mitigate the burden of COPD on patients and the health care system.

The study’s implications extend beyond individual states, highlighting a national public health concern. For instance, disparities in COPD prevalence correspond with socioeconomic factors, including income and access to health care resources. According to Dr. Jennifer Smith, a public health expert at the Johns Hopkins Bloomberg School of Public Health, "These variations in COPD rates can reflect broader social determinants of health that impact disease management and outcomes."

In light of these findings, experts recommend targeted interventions in states with higher COPD burdens to enhance health care access and improve management strategies for the disease. Dr. Mark Thompson, an epidemiologist at the American Lung Association, noted, "Addressing the gaps in COPD care requires not only awareness but also actionable policies that prioritize resources for the most affected regions."

As the health care system continues to navigate the complexities of chronic diseases, this study serves as a reminder of the essential role of data in formulating effective public health strategies. Future research is needed to further explore the underlying causes of these variations and to develop comprehensive measures that can alleviate the burden of COPD across the nation.

In conclusion, understanding the critical state-by-state differences in COPD prevalence and burden can significantly enhance public health responses and improve the quality of life for millions of Americans living with this debilitating condition. By focusing on these disparities, health care providers and policymakers can better allocate resources, ensuring that those in the most affected areas receive the necessary support to manage their health effectively.

### References 1. Bazell, C., et al. (2025). Variation in Prevalence and Burden of Chronic Obstructive Pulmonary Disease by State and Insurance Type in the United States. *Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation*. DOI: 10.15326/jcopdf.2024.0560 2. World Health Organization. (2023). Chronic Obstructive Pulmonary Disease (COPD) Fact Sheet. Retrieved from [WHO](https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd))