Chronic Obstructive Pulmonary Disease Prevalence, Puerto Rico 2016
José A. Bartolomei-Díaz, PhD
Chronic lower respiratory disease (COPD) refers to a group of diseases that cause airflow blockage and breathing-related problems. COPD, is the third leading cause of death in the US and affects more than 15 million Americans. While tobacco smoke is the primary cause, 1 in 4 people with COPD have never smoked. Air pollutants at home (secondhand smoke), at work (fumes), and genetics can also cause COPD. Symptoms include chronic or smoker’s cough, chronic phlegm production, shortness of breath, and wheezing. The most important aspect of treatment for COPD is avoiding tobacco smoke and other air pollutants. (https://www.cdc.gov/dotw/copd)
Objective
The objective of this post is to provide insight into the prevalence of chronic obstructive pulmonary disease in Puerto Rico. This type of information can be useful for institutional strategies and activities such as: allocating human or economic resources, developing scientific hypotheses for continued research into the disease’s etiology or risk factors or the development of marketing strategies.
Methods
In an effort to survey many types of social, demographic, disease and behavioral outcomes in the United States and its associated territories, the Centers for Disease Control and Prevention (CDC) runs numerous population-based surveys. The information used to estimate chronic obstructive pulmonary disease prevalence in this article came from the latest available data from a population-based survey regularly administered by the CDC known as the Behavioral Risk Factor Surveillance Survey (BRFSS). Chronic Obstructive Pulmonary Disease prevalence is surveyed by the BRFSS using the following question: Has a doctor, nurse, or other health professional ever told you that you have chronic obstructive pulmonary disease, emphysema or chronic bronchitis?
The complete methodology used to conduct the analyses shown in this post can be found here.
Statistical Remarks
The following statistical remarks highlight the most meaningful differences among a selected group of demographic variables based on a logistic regression model. We encourage you to refer to the graphs and tables below for a more in-depth look at the chronic obstructive pulmonary disease prevalence in Puerto Rico.
An estimated 137,210 (4.91%) adults in Puerto Rico had chronic obstructive pulmonary disease in 2016. When evaluating chronic obstructive pulmonary disease by age group, adults in the 25-34, 35-44, 45-54, 55-64, and 65+ group had a 5.56, 6, 10.5, 8.79, and 14.2 times more likely, respectively, to report chronic obstructive pulmonary disease than the 18-24 group. This differences were significant (p-value \(<\) 0.05). Among adults, females had a 68% higher likelihood of reporting having chronic obstructive pulmonary disease compared to males. This difference was significant (p-value \(<\) 0.05). In term of education level, the group some collage had a 35% lower likelihood of reporting having chronic obstructive pulmonary disease than the reference group (those who completed only some high school). This difference was not significant (p-value \(>\) 0.05). Those with an annual income of $25k-$<$35k had a 48% lower likelihood of reporting chronic obstructive pulmonary disease than those whose annual income was less than $14,999. This difference was not significant (p-value \(>\) 0.05). Those who were in the divorced group had a 41% higher likelihood of reporting having chronic obstructive pulmonary disease compared to those who reported being married. This difference was not significant (p-value \(>\) 0.05). Adults who were in the out of work \(<\) 1 year group had a 2.32 times more likelihood to report having chronic obstructive pulmonary disease compared to those who reported being employ for wages. This difference was not significant (p-value \(>\) 0.05).
Data Source: Behavioral Risk Factor Surveillance Survey
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Graphs and Tables
Overall Prevalence
- The prevalence of chronic obstructive pulmonary disease among adults for the year 2016 in Puerto Rico was 4.91 (4.15-5.67) percent.
| Table 1: Chronic Obstructive Pulmonary Disease prevalence among adults in Puerto Rico, 2016 | |||
| Prevalence | Cases | Sample Size | |
|---|---|---|---|
| Adults | 4.91 (4.16-5.67) | 137,210 | 5,794 |
Socio-demographics
Age group
Figure 1: Chronic Obstructive Pulmonary Disease prevalence among adults by age group, 2016
- Figure 1 shows that the chronic obstructive pulmonary disease prevalence for the 65+ age group was higher than the other age groups.
| Table 2: Chronic Obstructive Pulmonary Disease prevalence among adults by age group, 2016 | |||||
| Prevalence | Cases (N) | OR | OR(SE) | p-value | |
|---|---|---|---|---|---|
| Age group | |||||
| 18-24 | 0.57 (0.00-1.19) | 2,133 | 1.00 | 0.00 | 1.00 |
| 25-34 | 4.00 (1.40-6.60) | 18,752 | 5.56 | 0.83 | 0.03 |
| 35-44 | 3.68 (2.07-5.29) | 17,104 | 6.00 | 0.83 | 0.03 |
| 45-54 | 6.05 (4.10-7.99) | 28,771 | 10.5 | 0.82 | 0.00 |
| 55-64 | 5.64 (4.05-7.22) | 24,606 | 8.79 | 0.82 | 0.00 |
| 65+ | 7.94 (6.20-9.68) | 45,845 | 14.2 | 0.83 | 0.00 |
- Adults in the age group of 25-34, 35-44, 45-54, 55-64, and 65+ group had a 5.56, 6, 10.5, 8.79, and 14.2 times more likely, respectively, to report chronic obstructive pulmonary disease than the 18-24 group. This differences were significant (p-value \(<\) 0.05)
Sex
- Figure 2 shows that males had a lower chronic obstructive pulmonary disease prevalence than females.
Figure 2: Chronic Obstructive Pulmonary Disease prevalence among adults by sex group, 2016
- Among adults, females had a 68% higher likelihood of reporting having chronic obstructive pulmonary disease compared to males. This difference was significant (p-value \(<\) 0.05)
| Table 3: Chronic Obstructive Pulmonary Disease prevalence among adults by sex group, 2016 | |||||
| Prevalence | Cases (N) | OR | OR(SE) | p-value | |
|---|---|---|---|---|---|
| Sex | |||||
| Males | 3.95 (2.72-5.17) | 51,563 | 1.00 | 0.00 | 1.00 |
| Females | 5.75 (4.82-6.69) | 85,647 | 1.68 | 0.20 | 0.01 |
Education level
- When comparing education level, those who reported having finished some high school had the highest prevalence of chronic obstructive pulmonary disease, reported to be, 6.4%. (Figure 3).
Figure 3: Chronic Obstructive Pulmonary Disease prevalence among adults by education level, 2016
Using the adjusted odds ratio, the group some collage had a 35% lower likelihood of reporting having chronic obstructive pulmonary disease than the reference group (some high school).
This difference was not significant (p-value \(>\) 0.05)
| Table 4: Chronic Obstructive Pulmonary Disease prevalence among adults by education level, 2016 | |||||
| Prevalence | Cases (N) | OR | OR(SE) | p-value | |
|---|---|---|---|---|---|
| Education group | |||||
| Some High School | 6.39 (4.73-8.05) | 46,203 | 1.00 | 0.00 | 1.00 |
| High School Graduate | 5.01 (3.15-6.88) | 37,731 | 0.96 | 0.25 | 0.89 |
| Some Collage | 2.73 (1.80-3.66) | 19,474 | 0.65 | 0.28 | 0.14 |
| College Graduate | 5.51 (4.20-6.82) | 32,769 | 1.22 | 0.27 | 0.46 |
Income level
- Figure 4 shows that adults whose annual household income was $<15k, had a higher chronic obstructive pulmonary disease prevalence than those in other income groups.
Figure 4: Chronic Obstructive Pulmonary Disease prevalence among adults by household income level, 2016
- Those with annual income of $25k-$<$35k had a 48% lower likelihood of reporting chronic obstructive pulmonary disease than those whose annual income was less than $14,999. This difference was not significant (p-value \(>\) 0.05)
| Table 5: Chronic Obstructive Pulmonary Disease prevalence among adults by income level, 2016 | |||||
| Prevalence | Cases (N) | OR | OR(SE) | p-value | |
|---|---|---|---|---|---|
| Income group | |||||
| <15k | 5.61 (4.35-6.86) | 60,694 | 1.00 | 0.00 | 1.00 |
| 15k-<25k | 4.30 (3.05-5.55) | 29,370 | 0.80 | 0.23 | 0.35 |
| 25k-<35k | 2.68 (1.09-4.28) | 5,356 | 0.52 | 0.35 | 0.07 |
| 35k-<50k | 4.93 (2.21-7.66) | 6,284 | 0.94 | 0.37 | 0.86 |
| 50+k | 3.43 (1.33-5.52) | 4,447 | 0.59 | 0.41 | 0.20 |
Marital Status
- Adults who reported being divorced at the time of the interview had the highest chronic obstructive pulmonary disease prevalence among all marital status groups. Refer to figure 5.
Figure 5: Chronic Obstructive Pulmonary Disease prevalence among adults by marital status , 2016
- Those who were divorced group had a 41% higher likelihood of reporting having chronic obstructive pulmonary disease compared to those who reported being married. This difference was not significant (p-value \(>\) 0.05)
| Table 6: Chronic Obstructive Pulmonary Disease prevalence among adults by marital status, 2016 | |||||
| Prevalence | Number | OR | OR(SE) | p-value | |
|---|---|---|---|---|---|
| Marital group | |||||
| Married | 5.22 (4.08-6.35) | 55,145 | 1.00 | 0.00 | 1.00 |
| Divorced | 7.19 (4.64-9.75) | 21,831 | 1.41 | 0.25 | 0.17 |
| Widowed | 5.70 (3.51-7.90) | 12,567 | 0.67 | 0.29 | 0.18 |
| Separated | 5.13 (1.91-8.35) | 6,858 | 1.27 | 0.38 | 0.53 |
| Never married | 3.52 (1.88-5.16) | 26,121 | 1.07 | 0.26 | 0.77 |
| Unmarried couple | 4.40 (2.14-6.66) | 14,244 | 1.48 | 0.29 | 0.18 |
Employment Status
- Adults who reported being out of work > 1 year at the time of the interview had the highest chronic obstructive pulmonary disease prevalence (Figure 6).
Figure 6: Chronic Obstructive Pulmonary Disease prevalence among adults by employment status, 2016
- Adults who were out of work \(<\) 1 year group had a 2.32 times more likelihood to report having chronic obstructive pulmonary disease compared to those who reported being employ for wages. This difference was not significant (p-value \(>\) 0.05).
| Table 7: Chronic Obstructive Pulmonary Disease prevalence among adults by employment status, 2016 | |||||
| Prevalence | Cases (N) | OR | OR(SE) | p-value | |
|---|---|---|---|---|---|
| Employment status | |||||
| Employ for Wages | 3.27 (2.29-4.26) | 25,453 | 1.00 | 0.00 | 1.00 |
| Self-employed | 3.08 (0.70-5.46) | 8,510 | 1.04 | 0.43 | 0.92 |
| Out of work > 1 year | 6.27 (1.47-11.0) | 14,172 | 1.11 | 0.40 | 0.79 |
| Out of work < 1 Year | 5.92 (1.35-10.4) | 4,849 | 2.32 | 0.47 | 0.07 |
| A homemaker | 5.37 (3.88-6.86) | 28,838 | 0.91 | 0.28 | 0.76 |
| A student | 1.14 (0.00-2.62) | 2,094 | 1.07 | 1.07 | 0.94 |
| Retired | 7.50 (5.53-9.46) | 36,509 | 1.40 | 0.33 | 0.31 |
| Unable to work | 7.30 (4.21-10.3) | 15,420 | 1.01 | 0.35 | 0.96 |
Data Source: Behavioral Risk Factor Surveillance Survey
Note: Estimates were calculated by Outcome Project, LLC