Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. It’s an ongoing condition that blocks airflow from your lungs and can raise your risk for other severe health issues like heart disease and lung cancer.
But this condition is often underdiagnosed in Black people. Once you do learn that you have it, you may put off the care you need to prevent your symptoms from getting worse.
Here are some of the reasons why that’s common and how important it is to get the care you need from a doctor you trust.
COPD in Black Communities
About 11 million people have been diagnosed with COPD, but many others may not know that they have it.
Black Americans are at higher risk of COPD. The reasons include:
Environmental toxins. Because of racial disparities, Black people are more exposed to toxins like outdoor and indoor air pollution that have been linked to COPD.
Tobacco smoke. On average, studies show that Black people smoke less and start smoking at a later age than non-Hispanic white people. But Black children and adults are more exposed to secondhand smoke than any other racial or ethnic group.
Asthma. If you’re Black and assigned female at birth (AFAB), you’re more likely to have asthma, a chronic condition with a link to COPD.
A lack of research. Some studies have shown that certain genes passed down through families can make you more likely to get COPD. But little research has been done to explore genes that may put Black people at risk.
Racism. Studies have found that people in the U.S. who experience racism have worse health in general than people who don’t. This is especially true for Black Americans: Studies have found this group scores higher on indicators for poor health such as blood pressure, heart disease, and inflammation. This is true even when adjusting for other factors like income, age, gender, and health behaviors such as smoking, lack of physical activity, and poor diet.
Challenges to Care
Getting the care you need to manage COPD symptoms can feel like a challenge for many reasons, like:
Structural racism. Compared with other racial or ethnic groups in the U.S., Black people tend to receive lower quality health care services for a range of conditions. For instance, research shows that when you’re Black and live with COPD, you’re less likely to get care like oxygen therapy, help to quit smoking, or even regular flu shots.
Financial hardships. In the U.S., Black people are twice as likely as non-Hispanic white people to live in poverty. That can make it much harder to afford medical costs like doctor co-pays and medication. At least 10% of Black Americans are also uninsured.
Race-based equations. Because of biased medical guidelines, “severe” lung disease in Black people is often mistaken by doctors as “moderate.” Researchers who have studied these guidelines found that they were based on faulty beliefs that Black slaves had less lung function than white slaveholders.
Bias at the doctor’s office. One study found that nearly 1 in 3 Black Californians has been treated unfairly at a doctor’s office because of their race or ethnicity. And nearly 1 in 4 avoid seeking care because they feel they’ll be treated with disrespect.
What You Can Do
Because COPD is a chronic, or ongoing condition, it’s important to learn how to manage your symptoms. Here’s what will help.
Find a doctor you trust. A good relationship with your doctor is key to keeping COPD symptoms in check. Studies show that Black people have better health outcomes when they see a Black doctor. You may find it easier to connect to them and trust the advice they give you.
To find a doctor who may be a good fit for you, try the following:
- Asking family and friends for suggestions
- Using an app that posts patient reviews of doctors of color
- Finding a doctor near you through a professional group like the Association of Black Women Physicians
Be proactive. When you do find a doctor, think about bringing a loved one to your appointment. Doing so can help you and your doctor connect and increase how involved you both are in your care. Your friend or family member can also help you speak up for what you need, whether that’s a language interpreter, a chaperone during a medical exam, or written notes from your visit.
Stay on top of your treatment. Talk to your doctor about making an action plan. It can include what you’ll do to manage your symptoms on a daily basis and the steps you can take if they begin to worsen.
Talk to your doctor about pulmonary rehab (PR). Black people are less likely to sign up for pulmonary rehab, even though it can help manage COPD symptoms. When you sign up for one of these group classes, you exercise your muscles as well as your lungs. Most programs also include tips on meal planning, emotional support, and a chance to connect with other people living with COPD.
If you smoke, quit. Giving up all forms of tobacco is key to COPD treatment, but some research shows that Black patients are less likely to do so. If you need help, talk to your doctor.
Know what makes your symptoms worse. Everyone’s different, but some common triggers of COPD symptoms include pollen, wind, pollution, and strong perfumes found in products like cleaning supplies and candles. When you know what can bring on a flare-up, you can do your best to avoid it.
Keep on top of other health issues. Ongoing health issues like arthritis, gastric reflux, heart disease, osteoporosis, and metabolic disorders have been linked to worse COPD outcomes in Black patients.
Show Sources
Photo Credit: DigitalVision/Getty Images
SOURCES:
Mayo Clinic: “COPD.”
American Journal of Respiratory and Critical Care Medicine: “Chronic Obstructive Pulmonary Disease in America's Black Population.”
Chronic Obstructive Pulmonary Disease: “Race and Gender Disparities are Evident in COPD Underdiagnoses Across all Severities of Measured Airflow Obstruction.”
UCSF Medical Center: “Race-Based Equations May Lead to Under-Treatment of Lung Disease in Black Patients.”
European Respiratory Review: “Never-smoker African–American women suffer more from COPD compared with never-smoker Caucasian women.”
International journal of environmental research and public health: “Racial Disparities in Health Risk Indicators Reported by Alabamians Diagnosed with COPD.”
Du Bois review: social science research on race: “Structural Racism and Health Inequities: Old Issues, New Directions.”
California Health Care Foundation: “Listening to Black Californians: How the Health Care System Undermines Their Pursuit of Good Health.”
Association of American Medical Colleges: “Do Black patients fare better with Black doctors?”
University of Michigan Medicine: “Minority Patients Benefit From Having Minority Doctors But That’s a Hard Match to Make.”
Florida International University: “Reducing COPD Exacerbations Among African Americans Affected with COPD in a South Florida Clinic. A Quality Improvement Project.”
American Lung Association: “My COPD Action Plan,” “Pulmonary Rehabilitation,” “How Pulmonary Rehab Helps You Breathe,” “Prevent COPD Exacerbations or Flare-Ups.”
AJMC: “African American COPD Patients Underutilize Pulmonary Rehabilitation.”
Chest: “Burden of COPD, Asthma, and Concomitant COPD and Asthma Among Adults: Racial Disparities in a Medicaid Population.”
Journal of Behavioral Medicine: “Discrimination and racial disparities in health: evidence and needed research.”
