36: Spatiotemporal Trends in County- Level Prevalence of Chronic Obstructive Pulmonary Disease among U.S

Music City Center 

Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the U.S. While overall COPD prevalence remained stable nationally during 2011–2021, data to assess local level trends are lacking. By applying CDC's PLACES methodology, we estimated county level COPD prevalence and variance (σ2) among adults ≥18 years during 2011–2021 using annual Behavioral Risk Factor Surveillance System data, census county-level population estimates and 5-year American Community survey data. A Bayesian hierarchical regression model was constructed for county-level COPD prevalence over time. It was assumed to follow a normal distribution, with mean modeled as a linear function of the year for overall trend, county-level random slopes by years to capture the temporal trend for each county, and variance assumed to be σ2. A conditional autoregressive model was incorporated to account for the spatial dependency among counties. Results showed that 53 counties exhibited significant increasing trends in COPD estimates, 87 counties had decreasing trends, and the rest remained stable. Findings suggest the importance of monitoring trends in areas where public health interventions are needed.

Behavioral Risk Factor Surveillance System

Bayesian hierarchical regression

Chronic obstructive pulmonary disease

CDC’s PLACES

conditional autoregressive model 

Section on Statistics in Epidemiology