Social Determinants
Education, as a social determinant, impacts the health outcome of individuals. In India, the level of education is low, and therefore few are informed of risk factors to COPD. It is not only evident on the non-healthcare providers but also the healthcare providers who are unable to make proper diagnosis due to ignorance and lack of spirometers ( Grigsby et al., 2016 ). Besides, culture has been among the top social determinants that have led to an increased prevalence of the DALY. It is principally perceived that the condition only occurs in men. This notion has led to suffering from the condition leading to a rise in the incidences. Lastly, considering the socio-economic conditions in India, most citizens live in poverty. The majority are using biomass fuels such as animal dung to warm their houses which are poorly ventilated. This has increased exposure to the high level of indoor air pollution; this has substantially enhanced the risk of COPD. In the U.S.A., particularly rural areas where biomass fuels are still used record high incidence rate of COPD due to exposure to the carbon dioxide from fuels, this is due low socioeconomic ability of most people in rural areas. The culture of smoking has also increased the prevalence of the disease the COPD in the U.S.A. Besides, education and awareness levels tend to be higher in the U.S. compared to India. Generally, the social determinants in the U.S.A. and India may be the same despite the difference in the economy. India is greatly affected due to a low economy, unlike the U.S.A.
Intervention
The use of public smoking zones in India has been put by the public health department to curb the spread of the COPD. In the U.S.A., a similar approach is applied so that non-smokers can be protected from the risk ( Shah et al., 2016 ). Both governments encourage the use of carbon-free fuels to reduce the risks of infection. The U.S.A. particularly has enhanced access to spirometers devices that have aided in a proper diagnosis of the COPD. At the same time, India has also improved access to healthcare and reduced the cost of drugs for treating the COPD.
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References
Grigsby, M., Siddharthan, T., Chowdhury, M. A., Siddiquee, A., Rubinstein, A., Sobrino, E., ... & Checkley, W. (2016). Socioeconomic status and COPD among low-and middle-income countries. International journal of chronic obstructive pulmonary disease , 11 , 2497.
Shah, T., Press, V. G., Huisingh-Scheetz, M., & White, S. R. (2016). COPD readmissions: addressing COPD in the era of value-based health care. Chest , 150 (4), 916-926.
