An understanding of the health inequities that surround the treatment and prevention of COPD is required to address the barriers that hinder improvement of care for underserved populations. This scoping review was conducted to identify the existing evidence of social factors that affect the health, health-care access, and health-care quality of patients with COPD within the United States, and to identify gaps in knowledge to help direct future research. We followed the guidelines from the Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta Analyses Extension for Scoping Reviews. In July 2022, a literature search by using Ovid (Embase) and MEDLINE (PubMed) databases was conducted to identify articles on COPD, published between 2016 and 2021, written in English, and that investigated at least one health inequity as defined by the National Institutes of Health. All studies were screened for inclusion criteria and were extracted in a masked, duplicate manner. Each health inequity was investigated, extracted, and summarized. Thirty articles were screened in full text, and 19 were found to meet inclusion criteria. Common social factors investigated in the COPD literature included race/ethnicity, income, and education. Since the implementation of the National Institutes of Health's sex and gender minority category in 2016, only one study within our sample examined LGBTQ+ (lesbian, gay, bisexual, transgender, queer [or sometimes questioning], and others) patients with COPD. The least commonly investigated social factors that affect patients with COPD were rural/under-resourced (geography), sex and gender, and LGBTQ+ affiliation. In addition, occupational status was not investigated by any included studies in our sample. Our scoping review underlines the lack of research with regard to inequities that affect patients with COPD. We propose researching hormone replacement therapy's impact on lung function in transgender and nonbinary patients with COPD. Implementation science studies are suggested to enhance intervention for COPD medication adherence among racial/ethnic minority groups, given the intersectionalities of social factors that disproportionately affect this population. We, also recommend developing telemedicine pulmonary rehabilitation technology for rurally located patients with COPD.

中文翻译：

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慢性阻塞性肺病健康不平等的现状。

需要了解慢性阻塞性肺病治疗和预防方面的健康不平等现象，以解决阻碍改善服务不足人群护理的障碍。此次范围界定审查的目的是确定影响美国慢性阻塞性肺病患者的健康、医疗保健获取和医疗保健质量的社会因素的现有证据，并确定知识差距以帮助指导未来的研究。我们遵循乔安娜·布里格斯研究所 (Joanna Briggs Institute) 的指南和系统评价的首选报告项目以及范围界定评价的荟萃分析扩展。2022 年 7 月，使用 Ovid (Embase) 和 MEDLINE (PubMed) 数据库进行了一项文献检索，以识别 2016 年至 2021 年期间发表的、用英文撰写的关于 COPD 的文章，这些文章调查了至少一项国家卫生健康委员会定义的健康不平等问题。卫生研究院。所有研究均根据纳入标准进行筛选，并以隐蔽、重复的方式提取。每项健康不平等都经过调查、提取和总结。全文筛选了 30 篇文章，发现 19 篇符合纳入标准。慢性阻塞性肺病文献中调查的常见社会因素包括种族/民族、收入和教育。自 2016 年美国国立卫生研究院实施性别和性别少数类别以来，我们的样本中只有一项研究检查了 LGBTQ+（女同性恋、男同性恋、双性恋、跨性别者、酷儿 [或有时质疑] 和其他）患有 COPD 的患者。影响 COPD 患者的最不常研究的社会因素是农村/资源不足（地理）、性和性别以及 LGBTQ+ 群体。此外，我们样本中的任何纳入研究均未调查职业状况。我们的范围审查强调了缺乏对影响慢性阻塞性肺病患者的不平等现象的研究。我们建议研究激素替代疗法对跨性别和非二元性别慢性阻塞性肺病患者肺功能的影响。鉴于不成比例地影响少数族裔群体的社会因素的交叉性，建议实施科学研究，以加强对少数种族/族裔群体中慢性阻塞性肺病药物依从性的干预。我们还建议为农村慢性阻塞性肺病患者开发远程医疗肺康复技术。