The Current State of Health Inequities in Chronic Obstructive Pulmonary Disease: A Scoping Review

As of 2019, chronic obstructive pulmonary disease (COPD) was the third leading cause of death worldwide. An understanding of the health inequities surrounding treatment and prevention of COPD is required to address the barriers in order to improve care for underserved populations. This scoping review was conducted to identify the existing evidence of health inequity in COPD and identify the gaps in knowledge to help direct future research. We followed the guidelines from the Joanna Briggs Institute and PRISMA-ScR extension for this scoping review. In July 2022, a literature search using Ovid (Embase) and MEDLINE (PubMed) databases was conducted to identify articles on COPD, published between 2016-2021, written in English, and investigating at least one health inequity as defined by the NIH. All studies were screened for inclusion criteria and extracted in a masked, duplicate manner. Each health inequity was investigated, extracted, and summarized. Thirty articles were screened in full-text and 19 were found to meet inclusion criteria. The most commonly investigated COPD patient inequities were race/ethnicity, income status, education. Since the implementation of the NIH’s sex and gender minority category in 2016, only one study within our sample examined the LGBTQ+ patients with COPD. The least commonly investigated inequities rural/under-resourced, sex/gender, LGBTQ+ affiliation. Occupational status was not investigated by any included studies in our sample. Our scoping review underlines the lack of research regarding inequities affecting COPD patients, especially in certain areas such as sex/gender and LGBTQ+. We recommend further research regarding LGBTQ+ spirometry findings, race/ethnicity associations with medication adherence, and more diverse race/ethnicity investigations.