The challenge rural areas face with Chronic Respiratory Diseases

JONESBORO, Ark. (KAIT) - Chronic Respiratory Diseases are the fourth leading cause of death in the state of Arkansas, and healthcare officials say many of those deaths could be prevented.

Dr. Manuel Ramos is a pulmonologist at NEA Baptist Memorial Hospital.

A lot of his day consists of treating Chronic Respiratory Diseases.

“So a Chronic Respiratory Disease essentially is an umbrella term that we use for chronic, noncommunicable pulmonary diseases.”

In Arkansas, the most prominent are asthma, pneumoconiosis, silicosis, and Chronic Obstructive Pulmonary Disease, or COPD.

While some of these diseases are not preventable, Ramos said most cases are.

A challenge we all face in reducing the risk is proper education.

“I’d say a good part just don’t know, are not aware, that long term tobacco use can cause COPD. Some of them are. A lot of them never knew that COPD can also lead to cancer, which is why there’s such a high mortality rate in the state.”

According to a 2019 study, Arkansas ranked 4th in the country for most CRDs, with more than 2,000 deaths that year.

“What is concerning in Arkansas, in particular, is the death because of COPD and the prevalence of COPD. So a lot of people getting continuously diagnosed, COPD exacerbations and flare-ups, and I think we need to do a better job in the state for that.”

According to 2013 data from the Arkansas Center for Health Improvement, the average rate of COPD in the Natural State was 11.6%, compared to the national average of 11.2%.

Counties in the Northeast and Southwest parts of the state also saw a higher case average, ranging from 14 to 19%.

“Craighead County has COPD, just slightly above the U.S. average. However, we notice in Poinsett, Greene, Jackson, Mississippi, Woodruff County. All these counties have a much higher prevalence of COPD than the averages in the United States,” said Ramos.

Ramos said that gap in prevalence could be due to more education and awareness in more urban areas like Jonesboro, the largest city in Northeast Arkansas.

“Also, there’s that cultural influence right. You know, mom smokes, therefore I smoke, and my daughter smokes, and so on and so forth,” said Ramos.

Some occupations can also impact the rate of respiratory cases.

“Obviously, we have lots of areas that have lots of welding, and exposures to noxious gases,” said Ramos. “Same as we live in a very, strong agricultural society. So, crop dusting, crop burning, can predispose you to COPD exacerbations.”

While tobacco use is the number one cause of these diseases in the U.S., there are studies that show a higher rate of respiratory diseases in farming communities.

With more than 42,000 farms in Arkansas, it’s no surprise more rural counties have higher numbers.

“It is challenging. Right now, we’re trying to do more community outreach. I know NEA Baptist has been doing something called MAPS, so Medication Assistance Programs, to try and get these patients with lower resources the medications they need to thrive and function.”

Proper access to preventative measures could play a role in these numbers as well.

“I think the challenge is there are several barriers that these patients will have. Among them being obviously lack of access to gyms and natural groceries and stuff like that.”

A healthy lifestyle, with exercise and healthy food options, plays a key role in reducing the risk of developing a chronic respiratory disease.

While not everyone will have immediate access to these, Ramos said there are things patients can do at home to help reduce the risk.

“You know not smoking being the top- being part. Taking a walk, you know a lot of my patients who are from rural areas I encourage them to four days a week, 30 minutes, you know just try to take a walk as much as you can. And it goes a long way,” said Ramos.

There is no cure for Chronic Respiratory Diseases, and while there are treatments available, they can be costly.

“A lot of these medications are still not in the generic scene. So it can definitely ramp up costs not only to the patient but to healthcare in general. COPD is very expensive to take care of whenever you have exacerbations,” said Ramos.

When it comes to reducing the risk in Arkansas, Ramos said there are a lot of areas professionals can work to improve.

“Us as specialists, we need to do more outreach, especially to help the primary care provider. Letting them know that there’s help out there out there to adequately treat their patients,” said Ramos. “Having more engagement with primary care providers and outreach clinics I think would go a long way in helping the community as a whole.”

Connecting patients with Primary Care Physicians, teaching healthier lifestyle habits, and educating patients about the causes and consequences of respiratory diseases will all play a role in bridging the health divide with these diseases.

“I think we owe it to our family and communities to be at the best health we can be to participate in society,” said Ramos.