Chronic Obstructive Pulmonary Disease or COPD may not roll easily off your tongue, but it is the third leading cause of death in the U.S. COPD affects some 24 million persons; of whom only half have been diagnosed. COPD progressively robs a person of their breath.
Although once thought of as an “old man’s disease,” women are disproportionately impacted by COPD. More than 7 million women are living with COPD, and millions more have symptoms but have yet to be diagnosed, according to the American Lung Association’s report, “Taking Her Breath Away: The Rise of COPD in Women.”
According to the Centers for Disease Control (CDC), women 45 to 64 are 51% more likely to have COPD than men of the same age. At age 65 and older, women are still 21% more likely than men to have COPD.
Not only do women have higher rates of COPD than men, women tend to be diagnosed at younger ages and are relatively sicker, using more healthcare resources than men of the same age.
Women also suffer more from co-occurring chronic conditions, including depression, and have an overall lower quality of life once diagnosed with COPD, according to a recent study in “Respiratory Medicine.”
Women with COPD have more frequent disease fl are-ups or exacerbations, which are a sudden worsening of COPD symptoms. These bouts of illness may require urgent or emergency care visits, and hospitalization. Each fl are-up accelerates the progressive loss of breathing ability, eventually leading to long-term disability and death.
According to the CDC, in 2009, nearly 70,000 women in the U.S. died from COPD. The number of COPD deaths among women has more than quadrupled since 1980, and since 2000, the disease has claimed the lives of more women than men in this country each year, accounting for 53% of deaths from COPD in 2009.
Tobacco use is by far the most common cause of COPD in women. However, research has indicated that women with COPD are 1.5 times more likely to have never smoked than men with COPD. This means that women are more susceptible to lung damage from other sources, such as secondhand smoke and outdoor air pollution.
For example, an analysis by the American Lung Association found that women who are exposed to similar levels of secondhand smoke have a greater risk for lung damage and disease than men. Meaning that our women casino and bar workers face serious occupational risk from workplace smoking. There is no safe level of exposure to secondhand smoke.
In a review by the Network for LGBT Health Equity at CenterLink of Behavioral Risk Factor Surveillance Survey (BRFSS) data from five states, it was found that LGBT people smoke at rates approximately 68% higher than straight people.
Smoking has historically been normalized in the LGBT community, because our socially safe gathering places were bars and clubs where smoking is still allowed under the Nevada Clean Indoor Air Act. So even non-smokers in the LGBT community are exposed to dangerous levels of secondhand smoke. Lesbian, bi and trans women, already at higher risk, have yet another burden of risk in their social settings.
Other studies have found that almost 15 percent of deaths from COPD can be attributed to occupational exposures to environmental toxins. Women with jobs in personal care services, agriculture, textiles, rubber and plastics and sales all had higher risk of developing COPD than men doing comparable work.
Because of women’s historically lower economic status than men, their lack of access to affordable health care coverage could be another factor in the under diagnosis of COPD in women. In general people with lower economic status also experience higher rates of smoking and greater environmental toxin exposure in the workplace.
A woman’s physiology—smaller air passageways and musculature—make women more susceptible to indoor and outdoor air pollutants. Estrogen has also been found to play a role in worsening the lung damage from smoking in women. Transgender women who take estrogen may be at greater risk.
COPD can only be diagnosed by a medical professional using spirometry, a breathing test. Treatment may include pulmonary rehabilitation and inhalant medications to treat symptoms and prevent exacerbations. Only oxygen therapy and quitting smoking have been demonstrated to effectively prolong life in someone living with COPD.
Women’s health advocates and women living with COPD must speak out about the toll that COPD is taking on their lives, and the importance of making it a health care priority. This means learning more about COPD and how it affects women; advocating for women’s healthcare; urging women to quit smoking now, and speaking up for the women in your life who are at risk from this disease that is taking their breath away.
Richard Davis is a health educator at Dignity Health – St. Rose Dominican Hospitals. Mr. Davis also writes special features and theatre reviews for Las Vegas Spectrum.