COPD MORTALITY AND ECONOMIC DEPRIVATION: A GLOBAL ANALYSIS OF LUNG FUNCTION ABNORMALITIES

Abstract

Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality worldwide, often attributed to smoking. However, COPD-related deaths are disproportionately high in low-income countries despite their lower smoking prevalence. Recent research suggests that spirometric restriction, rather than airflow obstruction, may be a stronger predictor of COPD mortality. This study examines the relationship between COPD mortality, lung function impairment, smoking habits, and gross national income (GNI) per capita. Using data from 125 patients collected between December 2020 and December 2024, this study assessed the prevalence of airflow obstruction (FEV1/FVC < LLN) and spirometric restriction (FVC < LLN) and their correlation with national COPD mortality rates. We analyzed associations between lung function, smoking history (pack years), and economic indicators, applying Spearman rank correlation and regression models. Results demonstrated a stronger correlation between COPD mortality and spirometric restriction than with airflow obstruction in both younger (<60 years) and older (≥60 years) age groups. Spirometric restriction was not linked to smoking but was significantly higher in lower-income populations. These findings suggest that while smoking remains the dominant cause of airflow obstruction, spirometric restriction—likely driven by socioeconomic factors such as poor early-life nutrition, environmental pollution, and inadequate healthcare—plays a crucial role in high COPD mortality in disadvantaged regions. Addressing these underlying determinants through improved healthcare access, environmental interventions, and early-life nutritional programs could significantly reduce the global COPD burden. Expanding the focus beyond tobacco control to broader socioeconomic and environmental risk factors is essential for effective COPD prevention and management, particularly in resource-limited settings.