COPD, also known as emphysema or chronic bronchitis, is more than twice as common in rural areas. Air pollution from occupational exposures to dust, fumes, smoke, or chemicals from jobs like farming, mining, or manufacturing and higher rates of smoking in rural communities can increase the risk of developing COPD. According to the Centers for Disease Control and Prevention, the following states have the highest rates of COPD: West Virginia, Kentucky, Tennessee, Arkansas, Alabama, Mississippi, Louisiana, Ohio, Indiana, and Missouri.

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