Geographic Relationships Between Smoking and Chronic Lower Respiratory Disease in Delaware

OBJECTIVES: To determine geographical relationships between smoking prevalence, COPD prevalence, and lower respiratory disease mortality in Delaware by census tract and county. METHODS: Data about Delaware residents with COPD, who are smokers, and/or have chronic lower respiratory diseases, respectively, were analyzed from publically accessible datasets posted on PolicyMap and Delaware Open Data. Data was linked to shapefiles in order to map prevalence and mortality rates by Delaware census tract and county. Geo-based descriptive analysis was conducted via choropleth maps. RESULTS: COPD prevalence was higher in urban areas with high smoking prevalence. The highest proportion of census tracts with high COPD rates occurred in Sussex County and the lowest was in New Castle County. The highest crude and age-adjusted mortality rate due to chronic lower respiratory disease was in Sussex County and the lowest was in New Castle County. Chronic lower respiratory disease mortality was highest among white residents, increased as age increased, and occurred more frequently in females than in males. CONCLUSION: Sussex County had a high proportion of census tracts with high COPD rates and the highest mortality rate due to chronic lower respiratory disease. Urban census tracts displayed high rates of COPD prevalence and smoking prevalence. Identifying geographic focus areas can be used to direct future healthcare programs and public health initiatives. Future research should test statistical relationships between risk factors, geographic areas, and chronic lung disease outcomes.