Thompson Jessica R, Walker Courtney J, Flunker John C, Christian W Jay, Sanderson Wayne T, Schoenberg Nancy E, Browning Steven R
Community Impact Office, Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA.
Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, USA.
J Rural Health. 2025 Mar;41(2):e70035. doi: 10.1111/jrh.70035.
Despite high rates of lung disease and lung cancer among women, few studies have focused on adverse lung health risk factors among rural Appalachian women. We aim to describe the prevalence of demographic, behavioral, and economic characteristics among a cohort of rural Appalachian women and ascertain the association between these risk factors and lung function.
Through a cross-sectional study in two rural Appalachian Kentucky counties (2015-2017), we collected demographics, health history/behaviors, and lung function via pulmonary function tests. Restricting to female participants with interpretable pulmonary function tests (N = 456), we estimated prevalence ratios of the association between individual-level characteristics and lung function using log binomial regression.
Reduced lung function was high among this sample, including 20.8% with restrictive function and 18.4% with obstructive function. After adjustment, those age 65+ had 7× the prevalence of obstructive function compared to those <45 years, and current smokers had 6× the prevalence of never-smokers. Conversely, those age 45-64 had over 5× the prevalence of restrictive function compared to those <45 years, and participants with an obese-classified BMI or 2+ co-morbidities had nearly 4× the prevalence of restrictive function compared to those with normal BMI or without a comorbid condition, respectively.
This study highlights the high levels of reduced lung function among rural Appalachian women, including varying risk factors between those with restrictive and obstructive function. The high prevalence of restrictive function among middle-aged women with high BMI, poor cardiovascular health, and multiple comorbidities suggests the need for culturally tailored health behavior interventions.
尽管女性肺部疾病和肺癌的发病率很高，但很少有研究关注阿巴拉契亚农村地区女性的不良肺部健康风险因素。我们旨在描述一组阿巴拉契亚农村女性的人口统计学、行为和经济特征的患病率，并确定这些风险因素与肺功能之间的关联。
通过对肯塔基州两个阿巴拉契亚农村县进行的横断面研究（2015 - 2017年），我们通过肺功能测试收集了人口统计学、健康史/行为和肺功能数据。限于肺功能测试结果可解释的女性参与者（N = 456），我们使用对数二项回归估计个体水平特征与肺功能之间关联的患病率比。
该样本中肺功能降低的比例很高，其中限制性肺功能障碍者占20.8%，阻塞性肺功能障碍者占18.4%。调整后，65岁及以上人群的阻塞性肺功能患病率是45岁以下人群的7倍，当前吸烟者的患病率是从不吸烟者的6倍。相反，45 - 64岁人群的限制性肺功能患病率是45岁以下人群的5倍多，肥胖等级BMI或有2种及以上合并症的参与者的限制性肺功能患病率分别是BMI正常或无合并症参与者的近4倍。
本研究强调了阿巴拉契亚农村女性中肺功能降低的高水平，包括限制性和阻塞性肺功能障碍患者的不同风险因素。BMI高、心血管健康差和多种合并症的中年女性中限制性肺功能障碍的高患病率表明需要进行针对文化特点的健康行为干预。
