Examining the Impact of Asthma and COPD on the Health-Related Quality of Life Among Older Adults in Florida, 2011-13

BACKGROUND:   Asthma and chronic obstructive pulmonary disease (COPD) are separate chronic respiratory conditions that often occur simultaneously.  Among older adults with obstructive respiratory disease, at least half may have overlapping diagnoses of asthma and COPD, and these persons are more likely to have low quality of life compared to those with either condition alone.  In Florida, minority populations often experience poor asthma-related outcomes compared to their white counterparts.  The current analysis explores differences in self-reported health-related quality of life (HRQoL) in persons with asthma and COPD, and evaluates racial and ethnic disparities among people living in Florida.

METHODS:   A cross-sectional analysis was done using data from the Florida Behavioral Risk Factor Surveillance System covering the period 2011 to 2013 (N=54,209).  The study population was limited to adults ages 40 to 75 who reported an asthma or COPD diagnosis.  Statistical analyses were performed using SAS 9.4.  Differences in self-reported HRQoL indicators among Floridians were examined using prevalence estimates, mean counts of poor health days, and odds ratios.

RESULTS:   From 2011 to 2013, 12.3% of Florida residents ages 40 to 75 reported lifetime asthma and 30.9% of these individuals reported current asthma at the time of interview.  Among residents with lifetime asthma, 39.4% reported that they had ever been told they had COPD, and 47.8% of those with current asthma also reported a COPD diagnosis.  Residents with comorbid COPD and asthma reported a higher average number of poor physical health days (15.5) than residents with current asthma alone (11.2) or COPD alone (12.9), and were more likely to report that their overall health was poor compared to those with lifetime asthma alone.  Hispanics with asthma, COPD and both conditions reported a higher average number of poor health days than non-Hispanic whites and blacks with the same conditions.

CONCLUSIONS:   In Florida, approximately 17% of residents ages 40 to 75 have asthma, COPD or both.  Adults in this age group comprise over 40% of the state population, representing a substantial number of older Floridians at risk for adverse health outcomes and impaired quality of life.  The results of this analysis can be used to inform public health interventions and policies to reduce the burden of respiratory disease in Florida.