Abstract Background Pulmonary health disparities persist across North Carolina, where rural, socioeconomic vulnerability, and uneven distribution of healthcare resources contribute to disproportionate respiratory disease outcomes. Interstitial lung disease and related fibrotic lung disorders represent high mortality conditions that may be further impacted by access to pulmonology care, pulmonary rehabilitation, and digital connectivity. Methods We analyzed county-level mortality data from the NC department of health and human services (2018-2023) for residents whose primary cause of death was “other interstitial pulmonary diseases with fibrosis” (ICD-10 J84). Data were linked with pulmonologist distribution (UNC Sheps Center for Health Services Research), pulmonary rehabilitation center availability, and social vulnerability indices including Lung Health Deprivation Index (LHDI). Spatial cluster analysis was performed using a SaTScan to identify statistically significant ILD mortality “hotspots.” Mapping and smoothing analyses were conducted in ArcGIS Pro with Empirical Bayes Kriging techniques. Results Distinct regional clusters of elevated ID mortality were identified in eastern and rural NC counties (figure 1), corresponding with limited pulmonologist density, lower broadband access, and higher social vulnerability scores. Counties with fewer pulmonary rehab centers and reduced digital infrastructure demonstrated disproportionately higher mortality rates. Exploratory analysis suggests relationship between healthcare accessibility, digital equity, and ILD outcomes. Conclusion Geographic and socioeconomic disparities are strongly associated with the ILD mortality in North Carolina. Limited specialty workforce, inadequate pulmonary rehab access, and digital inequities may contribute to poorer outcomes in rural communities. Targeted interventions in conjunction with providers, administration, local, and state level authorities should be developed to mitigate these disparities and improve pulmonary health equity across the state. This abstract is funded by: none
Cate et al. (Fri,) studied this question.