abstract: 'Objectives Educational attainment, income, and race play significant

  roles in managing and treating patients with chronic obstructive

  pulmonary disease (COPD). The purpose of this study was to evaluate the

  impact of these socioeconomic factors and others on the physical and

  mental distress reported by patients with COPD living in Alabama.

  Methods A cross-sectional analysis was completed of Alabama Behavioral

  Risk Factor Surveillance System 2015-2019 data collected from 4123

  respondents who reported that a health professional told them they had

  COPD, chronic bronchitis, or emphysema. Univariate analyses examined

  descriptive differences in physical and mental distress among racial

  groups. Multivariable logistic regression models were used to assess

  physical and mental distress as a function of race and demographic

  variables (age, sex, employment status, household income, education

  level), controlling for dichotomous healthcare access variables

  (enrollment in a health insurance plan, having a usual source of care,

  routine check-up in the past 2 years). Results Most Alabama adults with

  COPD from 2015 to 2019 were female (64\%) and older than 45 years

  (88\%). Annual incomes were low, with >40\% of respondents (43.84\%)

  earning <\$20,000/year; adults making between \$35,000 and \$49,999 were

  less likely (odds ratio 0.60, 95\% confidence interval 0.38-0.96) to

  experience mental distress. Younger Alabama adults with COPD (25-64

  years) were approximately two times more likely than respondents ages 65

  and older to report mental distress. African Americans were less likely

  to report physical distress as compared with Whites (odds ratio 0.61,

  95\% confidence interval 0.44-0.83). Alabama adults who could not work

  were more likely than those with COPD who were employed/self-employed,

  out of work, retired, or identified as homemakers to report physical

  distress. Conclusions Public health and healthcare practitioners across

  Alabama should use these analyses to direct more targeted, high-yield

  interventions that will address existing health disparities among state

  residents living with COPD.'
affiliation: 'Stellefson, M (Corresponding Author), Univ Alabama, Dept Hlth Sci, 103
  Russell Hall,Box 870313, Tuscaloosa, AL 35487 USA.

  Univ Alabama, Dept Hlth Sci, Capstone Coll Nursing, Coll Arts \& Sci, Tuscaloosa,
  AL USA.

  Univ Alabama, Coll Educ, Tuscaloosa, AL USA.

  Univ Maryland, Dept Behav \& Community Hlth, College Pk, MD 20742 USA.'
author: Stellefson, Michael and Ford, Cassandra D. and Wang, Min Qi and Cline, Isabella
  and Kinder, Caitlin
author-email: 'stell001@ches.ua.edu

  ford039@ua.edu

  mqw@umd.edu

  ircline@crimson.ua.edu

  cmkinder@crimson.ua.edu'
author_list:
- family: Stellefson
  given: Michael
- family: Ford
  given: Cassandra D.
- family: Wang
  given: Min Qi
- family: Cline
  given: Isabella
- family: Kinder
  given: Caitlin
da: '2023-09-28'
doi: 10.14423/SMJ.0000000000001407
eissn: 1541-8243
files: []
issn: 0038-4348
journal: SOUTHERN MEDICAL JOURNAL
keywords: COPD; income; mental distress; physical distress; race
keywords-plus: 'OBSTRUCTIVE PULMONARY-DISEASE; QUALITY-OF-LIFE; RISK-FACTORS;

  DISPARITIES; PEOPLE'
language: English
month: JUN
number: '6'
number-of-cited-references: '27'
pages: 374-380
papis_id: 587efb01ea64d0b2e3f7bcffbe44b4bc
ref: Stellefson2022rolesocioeconomic
researcherid-numbers: Stellefson, Michael/ACE-4522-2022
times-cited: '0'
title: Role of Socioeconomic Factors on Physical and Mental Distress Reported by Alabama
  Adults with COPD
type: article
unique-id: WOS:000797125300007
usage-count-last-180-days: '0'
usage-count-since-2013: '1'
volume: '115'
web-of-science-categories: Medicine, General \& Internal
year: '2022'