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Identifying risk factors for adverse lung health outcomes among rural Appalachian women
Journal article   Open access   Peer reviewed

Identifying risk factors for adverse lung health outcomes among rural Appalachian women

Jessica R Thompson, Courtney J Walker, John C Flunker, W Jay Christian, Wayne T Sanderson, Nancy E Schoenberg and Steven R Browning
The Journal of rural health, Vol.41(2), e70035
03/2025
DOI: 10.1111/jrh.70035
PMCID: PMC12075779
PMID: 40361270
url
https://doi.org/10.1111/jrh.70035View
Published (Version of record) Open Access

Abstract

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.
 Adult Aged Appalachian Region - epidemiology Cross-Sectional Studies Female Humans Kentucky - epidemiology Lung Diseases - epidemiology Middle Aged Prevalence Respiratory Function Tests - methods Respiratory Function Tests - statistics & numerical data Risk Factors Rural Population - statistics & numerical data

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