Comparing Urban and Rural Effects of Poverty on COPD (CURE COPD)

EPA Grant Number: R836150
Center: Comparing Urban and Rural Effects of Poverty on COPD
Center Director: Hansel, Nadia
Title: Comparing Urban and Rural Effects of Poverty on COPD (CURE COPD)
Investigators: Hansel, Nadia , Koehler, Kirsten , Matsui, Elizabeth C. , McCormack, Meredith , Rand, Cynthia
Current Investigators: Hansel, Nadia , Diette, Gregory B. , Hanson, Corrine K , Koehler, Kirsten , Maier, Kurt , Maisonet, Mildred , Matsui, Elizabeth C. , McCormack, Meredith , Paulin, Laura , Peng, Roger D. , Putcha, Nirupama , Rand, Cynthia , Scheuerman, Phillip
Institution: The Johns Hopkins University
Current Institution: The Johns Hopkins University , The Johns Hopkins Bloomberg School of Public Health , University of Nebraska Medical Center
EPA Project Officer: Breville, Maggie
Project Period: July 1, 2015 through June 30, 2020
Project Amount: $1,500,000
RFA: NIH/EPA Centers of Excellence on Environmental Health Disparities Research (2015) RFA Text |  Recipients Lists
Research Category: Health


Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States and morbidity is expected to rise. We have chosen to focus our studies on the role of indoor air pollution (particulate matter, PM and nitrogen dioxide, NO2) exposures on COPD morbidity in low income US communities, based on intriguing findings from our previous studies. It is known that COPD morbidity is higher in low income areas, and we have shown that COPD burden is highest in rural, poor areas. Despite the recognized increased burden of COPD in low income communities, few studies of COPD have focused on these high risk communities. In particular, almost no studies of COPD have focused on rural Appalachia, one of the poorest regions in the U.S. We have also found that indoor pollutant concentrations are higher in poor urban communities, such as inner city Baltimore, than in suburban homes or those of higher socioeconomic status. We have also found that homes in Appalachia have elevated PM and NO2, even exceeding concentrations typical of urban settings. This underscores the importance of understanding the role of indoor air pollution in contributing to the COPD health disparities identified in these low income settings. We will also have a specific focus on understanding the role of obesity and poor dietary intake (low anti-oxidant, pro-inflammatory diet) as factors that are common in low income communities and may increase susceptibility to indoor pollution exposure. Though there are many factors that coalesce in poor environments that may contribute to COPD morbidity or increase susceptibility to pollution exposure, we chose to focus on two factors (obesity and diet) that may increase the risk of indoor air pollution, for several reasons. These reasons include 1) our preliminary data strongly support the likely role of obesity and poor diet in contributing to both COPD outcomes and susceptibility to air pollution exposure, 2) both factors are not only more prevalent in low income settings but are quite common. Positive results will have high potential for significant public health impact, 3) at the individual level, indoor air, diet and obesity are modifiable, unlike many other factors such as outdoor air or access to healthcare, and 4) the hypotheses being tested in this application are highly novel. The aim of our Center, Comparing Urban and Rural Effects of poverty on COPD (CURE COPD) is to understand these interactive effects (high indoor air pollution, obesity and low anti-oxidant, pro-inflammatory diets) in both urban (Project 1) and rural (Project 2) low income communities, both of which suffer disproportionate prevalence and morbidity from COPD, obesity and poor diet. This Center brings together a multidisciplinary team of investigators with Projects that are highly complementary and supported by Administrative, Environmental, Data, and Community Engagement Cores. This Center also has strong institutional support from both the Johns Hopkins School of Medicine and the College of Public Health of East Tennessee State University. 

Progress and Final Reports:

2016 Progress Report

Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
R836150C001 Obesity and Adverse Dietary Patterns as Susceptibility Factors to Pollutant Exposure in Urban COPD
R836150C002 Environmental Health Disparities in Rural Appalachia: The impact of air pollution, obesity and diet on COPD morbidity