Neighborhood poverty, uninsured status linked to COPD hospitalizations

Certain neighborhood characteristics, including higher poverty, more uninsured residents, and lower educational attainment, may lead to an increase in COPD-related emergency department visits and hospitalizations, according to a new study in the January 2026 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, a peer-reviewed, open access journal.

COPD, which includes emphysema and chronic bronchitis, affects more than 30 million Americans and is the fourth leading cause of death worldwide. It can be caused by genetics and irritants like smoke or pollution.

Acute exacerbations, or flare-ups, are a sudden worsening of symptoms. People experiencing an acute exacerbation often require an emergency department visit or hospitalization, which can impact quality of life and health care costs.

This observational, ecological study analyzed nearly 10,000 COPD-related emergency department visits, hospitalizations, and 30-day readmissions in census tracts in Travis County, Texas from 2016 through 2020. Census tracts are small, relatively permanent subdivisions of a county, averaging approximately 4,000 people. Population characteristics, economic status, and living conditions are consistent among each census tract.

The results showed geographic patterns across neighborhoods when examining specific neighborhood characteristics for emergency department visits and hospitalizations related to a COPD exacerbation. Hospital readmission rates did not show the same geographic patterning.

Our findings suggest that addressing the risk of COPD exacerbations requires not just prioritizing individual medical care but also implementing community-level interventions that target neighborhood risk factors. By combining population-based data with studies focusing on an individual's exacerbation risk profile, we can inform appropriate policies to help improve people's quality of life and reduce acute care use."

Trisha M. Parekh, D.O., MSPH, of the Division of Pulmonary and Critical Care at Dell Medical School at The University of Texas at Austin and lead author of the study