Exploring the Link Between Social and Economic Instability and COPD: A Cross-Sectional Analysis of the 2022 BRFSS

Michael Stellefson (), Min-Qi Wang, Yuhui Yao, Olivia Campbell and Rakshan Sivalingam
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Michael Stellefson: Department of Health Science, The University of Alabama, Tuscaloosa, AL 35487, USA
Min-Qi Wang: School of Public Health, University of Maryland, College Park, MD 20742, USA
Yuhui Yao: Department of Community Medicine and Population Health, The University of Alabama, Tuscaloosa, AL 35487, USA
Olivia Campbell: Department of Health Science, The University of Alabama, Tuscaloosa, AL 35487, USA
Rakshan Sivalingam: Department of Health Science, The University of Alabama, Tuscaloosa, AL 35487, USA

IJERPH, 2025, vol. 22, issue 8, 1-14

Abstract: Despite growing recognition of the role that social determinants of health (SDOHs) and health-related social needs (HRSNs) play in chronic disease, limited research has examined their associations with Chronic Obstructive Pulmonary Disease (COPD) in population-based studies. This cross-sectional study analyzed 2022 Behavioral Risk Factor Surveillance System (BRFSS) data from 37 U.S. states and territories to determine how financial hardship, food insecurity, employment loss, healthcare access barriers, and psychosocial stressors influence the prevalence of COPD. Weighted logistic regression models were used to assess the associations between COPD and specific SDOHs and HRSNs. Several individual SDOH and HRSN factors were significantly associated with COPD prevalence, with financial strain emerging as a particularly strong predictor. In models examining specific SDOH factors, economic hardships like inability to afford medical care were strongly linked to higher COPD odds. Psychosocial HRSN risks, such as experiencing mental stress, also showed moderate associations with increased COPD prevalence. These findings suggest that addressing both structural and individual-level social risks may be critical for reducing the prevalence of COPD in populations experiencing financial challenges.

Keywords: COPD; social determinants of health; health-related social needs (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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