Equality has come hard to women—but unfortunately when it comes to lung diseases like chronic obstructive pulmonary disease (COPD), women appear to be surpassing men as its victim.
According to the Centers for Disease Control and Prevention (CDC), between 1998 and 2009, more women than men have been diagnosed with COPD—an umbrella term for emphysema and chronic bronchitis—and death rates have slowed only for men.
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A 2013 report by the American Lung Association says that women are 37 percent more likely to have COPD than men, and now make up more than half the deaths from COPD. At least seven million women in the United States now have the disease.
Sold on Smoking
Why the upswing? “In general, the increase likely reflects women’s increased smoking,” says Dr. MeiLan Han, chairperson of the COPD Foundation’s Educational Review Working Group and an associate professor of medicine at the University of Michigan in Ann Arbor.
Before World War II, few women smoked. But marketing directed toward women worked, and from the 1940s on, women increasingly took up the habit, says respiratory therapist Jane M. Martin, associate director of education at the COPD Foundation in Washington, D.C. “Those women are now in their older years,” she says.
“It could also be that men are dying at an earlier age from other causes, and women are living long enough to die of COPD at 70 or 80,” says Han.
A Body of Difference
But the COPD upswing in women may also have to do with physical differences between genders, says Martin. “Women have smaller lungs than men,” she says. “So, if smoking causes damage equally, women are going to have greater relative damage than men.”
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Women are more likely to experience anxiety and depression from the disease as well, says Han. Plus, more women experience “exacerbations,” sudden increases in COPD symptoms and severity. “They also report more shortness of breath than men with a similar smoking history.” The reasons for such differences are unclear.
No Longer a Man’s Disease
“COPD is still considered a man’s disease,” says Martin. “Women may not be seeking optimal treatment because they’re not considering that they may have it—and some physicians are probably doing the same.” Women are more likely to be misdiagnosed than men, she says.
So, what can be done to reverse the trend? Below are ways both individuals and policy makers can help women and lung-related conditions like COPD and emphysema.
Kick the habit. “Smoking cessation is the most important factor for preventing COPD,” says Han. Ask your doctor about a smoking cessation program. The CDC offers information about cessation programs including a guide to telephone quit lines. Or sign up for the American Lung Association (ALA) Freedom from Smoking program, available as a group clinic, online program, or self-help book. The ALA also offers direct access to cessation counseling at its free Lung Helpline (1-800-586-4872).
Know the air you breathe. “Be aware of airborne hazards in your workplace, and make sure to wear whatever protective gear your employer recommends,” says Martin. If your workplace doesn’t offer protection, let management know your concerns, she says.
Get a breathing test. A diagnostic test for COPD called spirometry, done in a physician’s office, measures how much you inhale and exhale. If you have ever smoked, ask your doctor for a breathing test, says Martin: “If you are a woman over 40 with a history of smoking, and you have a cough, and you’re not getting [a breathing test], that’s like not getting a mammogram.” Online assessment tools can also help you understand your risk, says Han. “Don’t attribute a cough or shortness of breath simply to smoking or aging,” she says. The drug company GlaxoSmithKline offers an easy, quick assessment test you can print out to take to your doctor. The COPD Foundation also has a toll-free COPD information line, 866 316 COPD.
Raise awareness. Understanding that the risks of COPD, emphysema and chronic bronchitis exist for smokers and non-smokers is key to getting more people diagnosed and treated, says Martin. “The COPD Foundation, for instance, is now working with employers to optimize awareness and care for employees,” she says.
Understanding how diseases affect women is key as well, says Han. While women were once excluded from research studies largely due to concerns surrounding around pregnancy, that’s now changed, Han notes: The U.S. Food and Drug Administration, for instance, has established the Office of Women’s Health advocating for the participation of women in clinical trials and the analyses of data by sex.