Navigating COPD in Rural America

1 in 5 Americans live in a rural area.

Rural Americans face more health challenges than people living in cities and difficulties getting healthcare because of:

• Clinician shortages
• Hospital closings
• Long distances to get to hospitals, specialists and pharmacies
• Lack of public transportation

These factors make it harder to live with COPD.

What Is COPD?

COPD, or chronic obstructive pulmonary disease, is a progressive lung condition that causes inflammation of the airways, making it hard to breathe.

COPD is the 5th leading cause of death in the U.S.

COPD in Rural Areas

1 in 12 of people in rural areas have COPD compared to 1 in 20 in urban areas.

Compared to people who live in cities, people in rural areas are:

• 2x as likely to have COPD
• More likely to go to the hospital for COPD
• More likely to die from COPD

Why COPD Is Worse in Rural Areas

People in rural areas:

• Are more likely to smoke
• Have fewer stop-smoking programs
• Are more likely to work in industries that expose them to pollutants
• Live with more indoor pollution from burning wood or coal for heating or cooking
• Have more medical problems that can make COPD worse
• Have less money to afford medications to treat COPD
• Are more likely to not have health insurance
• Have less access to healthcare, including specialists who treat COPD
• May have more trouble getting diagnosed and treated for COPD

How to Manage COPD in Rural America

• Track disease progression and symptoms to know if they’re getting worse
• Use that information as an early warning and get to care

• Use telehealth for:
• Remote monitoring to track symptoms, trends and triggers
• Digital pulmonary rehab to learn strategies
• Routine and time-sensitive care

• Line up transportation in advance
• Insurance may cover transportation or local nonprofits may help
• Medicaid is required to pay for non-emergency medical transportation

• Make a COPD Action Plan with:
• Your medicines
• How to know it’s time to seek care
• How to reach your clinician
• Transportation options

• Make lifestyle choices that keep COPD from getting worse
• Quit smoking
• Exercise for strength and stamina
• Eat nutritious foods
• Avoid irritants like dust and pollen
• Get good sleep
• Get vaccinated to prevent infections that make COPD worse

• Advocate for yourself
• You may have to look harder or travel farther for a lung specialist.
• Most health insurance (including the VA and Medicaid) have to offer specialists within a certain travel time or distance. If they don’t, you can get an exception to see someone out of the insurance network (but you have to request it).
• Find free or lower-cost care from rural and federally qualified health centers.

Remember: You ALWAYS have the right to emergency care.

Resources

American Lung Association – My COPD Action Plan

COPD Action Alliance – Veterans and COPD

COPD Foundation – My COPD Action Plan

This educational resource was created with support from Chiesi, Sanofi and Regeneron.