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COPD Burden in Rural America

COPD Burden Higher In Rural America.

In 2015, according to data released in CDC’s Morbidity and Mortality Weekly Report (MMWR)1, rural US residents experienced higher rates of COPD prevalence, COPD-related Medicare-covered hospitalizations, and deaths than residents living in more urban counties (those with populations of at least 10,000 people): The percentage of adults in rural areas diagnosed with COPD has nearly double the percentage in large metropolitan areas.

  • Percentage with diagnosed COPD was greater among adults living in rural areas (about 8%) than among adults living in large metropolitan centers (about 5%).
  • Hospitalizations among Medicare enrollees for COPD were about 14 per 1000 enrollees in rural areas compared with about 11 per 1000 enrollees in large metropolitan centers.
  • Death rates from COPD were also greater among people living in rural areas (about 55 per 100,000 people) compared with people living in large metropolitan centers (32 per 100,000 people).

Seven states (Alabama, Arkansas, Indiana, Kentucky, Mississippi, Tennessee, and West Virginia) were in the highest quartiles for all three measures in 2015. Of these, four states (Arkansas, Kentucky, Mississippi, and West Virginia) were also in the highest quartile (≥18%) for percentage of rural residents.


  1. Croft JB, Wheaton AG, Liu Y, et al. Urban-Rural County and State Differences in Chronic Obstructive Pulmonary Disease — United States, 2015. MMWR Morb Mortal Wkly Rep 2018;67:205–211. DOI:
Page last reviewed: August 28, 2018