Demographic and Health Determinants of COPD Across Texas: An Epidemiologic Perspective

Introduction: COPD represents a major public health challenge, with uneven distribution across populations and regions. This study examines county-level COPD prevalence variations in Texas and identifies associated demographic, socioeconomic, and health factors. Our goal is to provide evidence for targeted interventions in high-risk communities.


Methods: Data were obtained from the County Health Rankings & Roadmaps 2021 and the CDC. We conducted a cross-sectional ecological study analyzing all 254 Texas counties. COPD prevalence was examined in relation to multiple predictors: demographic indicators (rurality, ethnicity, age distribution, gender ratio), socioeconomic factors (median household income, homeownership rates, housing cost burden), and health metrics (frequent mental/physical distress prevalence). Statistical analyses included Pearson correlation coefficients to assess bivariate relationships, hierarchical multivariate regression models to identify independent predictors while controlling for confounders, and one-way ANOVA with post-hoc Tukey tests to examine differences across COPD prevalence quartiles. All analyses were performed using R statistical software (version 4.1.2), with statistical significance set at p< 0.05.05.


Results: Mental distress emerged as strongest predictor of COPD prevalence (r = 0.70, p < 0.001), followed by physical distress (r = 0.53, p < 0.001). ANOVA revealed significant differences across COPD quartiles for both mental distress (F = 64.30, p < 0.001) and physical distress (F = 28.45, p < 0.001). Rurality was positively associated with COPD rates (p = 0.017), while ethnicity showed significant variations with Hispanic (p = 0.006) and Non-Hispanic White populations (p = 0.015). Gender and English proficiency showed no significant associations.


Conclusions: Mental and physical health distress are the most robust predictors of COPD prevalence across Texas counties. Socio-demographic factors such as ethnicity and rurality also influence COPD distribution, underscoring the need for targeted interventions in high-risk communities. These findings can inform resource allocation and public health strategies for COPD prevention and management.