COPD: a social justice issue

A summary of research published in American Journal of Respiratory and Critical Care Medicine

A recent paper has explored a new way of viewing Chronic Obstructive Pulmonary Disease (COPD); as a social justice issue. The authors believe that looking at COPD and other lung conditions in this way can bring more attention to the unmet needs of patients.

What did this study look at?

In this paper, the authors focused on COPD, which is one of the leading causes of disability and early deaths. COPD has more of an impact on people who receive a lower income and those with lower levels of education. They argue that it can be useful to think of COPD, and health conditions in general, not as something people “have” but something that has been “done to” people.

This view means that the causes of COPD driven by inequality are more obvious. The authors use the term “structural violence” to describe the factors that can cause or worsen COPD. In their research, they wanted to understand more about the different ways that this structural violence appears.

What do the results show?

The authors of this paper consulted lung health experts and people with lung conditions to develop an outline, or framework, of the different factors. They found that there were five main areas of concern for people with COPD:

  1. Avoidable lung harm. Many factors can contribute to the development of COPD including tobacco use, low air quality and a poor diet.
  2. Delays in diagnosis. Many cases of COPD are not diagnosed until the condition has worsened and there has already been significant lung damage.
  3. Poor-quality care. Lots of people are denied effective treatment for their condition.
  4. Lack of focus on COPD. COPD receives proportionally little attention and funding for the huge impact it has on the population.
  5. Lack of support. COPD can make accessing support more difficult and can isolate people from support networks.

Why is this important?

By creating a clear framework of how COPD is a result of issues in society, we can see more clearly what can be done to fix them. The authors also argue that if we think of COPD as something that is “done to” people, then we feel that we have more responsibility to do something about it.

This perspective is useful for policymakers and healthcare professionals as it highlights the many needs of COPD patients and the general population that are not being met. It is also relevant for the public as it can encourage advocacy and activism for public health.


The European Lung Foundation believes that everybody should be advocates for lung health. Read our Healthy Lungs for Life Advocacy Pack to find out more. We also run a free online European Patient Ambassador Programme to help patients and carers represent themselves successfully.

Read the original research paper:

Lung Disease and Social Justice: Chronic Obstructive Pulmonary Disease as a Manifestation of Structural Violence