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Introduction:

The chronic disease of obstructive pulmonary is caused by the high airflow obstruction into the
lungs and creates difficulty during the process of breathing but this chronic is treatable. The
persons having this type of disease mainly experience pain while breathing and cough. The
COPD availability is very high in the societies of down socioeconomics rather than societies of
high socioeconomics. The biggest problems for patients with COPD are that they are not able to
identify their symptoms easily until it affects their lungs.

It is a type of disease in which the patient experience the illness burden and this burden is high in
aging people because it leads to developing many respiratory problems, poor life quality, as well
as immediate hospital admission. This is also linked with the disease of heart, osteoporosis, and
depression. In Australia, people of age 45 or more than that are at high risk to receive this disease
(Burney et al., 2015). According to the survey of National Health in 2017-2018, almost 460,000
people of high age were found to be COPD affected in Australia. In this group of age, among
COPD-affected people, the number of females was high as compared to males. Females were
found at 6.2% while males were found at 3.6%.

The frequency of chronic disease of obstructive pulmonary found among the people of age 45
and more than 45 according to their age group and sex, 2017 and 2018.

It this worth nothing that differentiation between asthma and COPD can be made. Both of the
diseases are found to have the same type of symptoms so it is necessary to differentiate them
when the diagnosis is being made so that the accurate therapeutic measurement can be done for
patients.

The difficult type of link or interaction among genes and environment is the reason for this
disease in old age people. The main and risky element that is found for COPD is smoking and
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consumption of and tobacco and these reasons were also found in the population of Australia and
this is the reason that causes an impact on active and passive smokers. Additionally, inhaling
dust, gas, chemical agents, polluted air, or smoke is those environmental elements that are
responsible for COPD while breathing. This study will tell about the COPD burden among aged
people but using three different types of indicators such as recommendations, social determinants
as well as an intervention program (Erbas et al., 2012).

The COPD burden with the three different indicators:

 Life quality
 Rate of mortality
 Rate of incidence

COPD can affect activities performed in daily life by people such as their sleeping pattern and
their potential of doing exercises. According to the survey of national health 2-17, the life's
quality is one out of five that have 45 years of age or more than 45 having COPD. That one was
very poor and almost 17 percent up to age 45 have the poor condition of health. It was noticed
that the people that have less difference in their age were dealing with more psychological issues
instead of those who haven’t COPD as 19 percent and 8 percent. This is the 5 th biggest reason for
the death of people in Australia. according to the General Record of Incidence, between 1922
and 2005, the mortality rate among specific age groups was found to be 100,000 per individual in
Australia. in 2014 and 2015 which is the financial year, the COPD incident rate was found to be
5.264 per one thousand individual, and it was almost 95 % of the population (Effing et al., 2007).
According to the conclusion, the people of age 45 or more than that, 71262 individuals were
admitted in hospital and 65 percent of them were in metropolitan hospitals while 70 percent were
found those hospitals that are funded publically.

Socioeconomic status:

It is one of the major determinants regarding the health of the public according to chronic
diseases. It shows the economic and social conditions of people among different social groups. It
includes education, housing, and participation in different social committees. The individual with
a high rank or income is less likely to have a COPD attack. The middle and lower-income
regions are highly impacted by this disease. Between 2001-2008, tremendous changes were
noticed at the Australian demographic level that had a direct impact on the people's economic
status. According to the data, there was a $750.50 million economic burdens per person which
was related to COPD and the expenses of the hospital were $473 million

Social determinants:

The economic and social situation like wealth distributions and power between individuals that
directly impact to gain good facilities of health are called social determinants according to the
health. The division of WHO about the social determinants are made by combining natural

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conditions of people as well as toxic strategies of the political public like employment status,
living environment, political empowerment, and resource availability. It is said that these are
factors that tell whether a person will reach their full potential or not (Monninkhof et al., 2003).

Resource availability:

The advanced countries having high qualified doctors, good medical facilities, as well as
respiratory consultants will offer good services to their COPD patients. The organized hiring
with resources abundant as good respiratory departments will give help in enhancing the
patient’s lifestyle in hospitals. Those patients that were hospitalized for more than one week
were decreased because of many respiratory consultants. The limited availability of resources is
directly linked to the high individual numbers having COPD in the country. So, better facilities
and resources in clinics are providing effective results for the patients.

Occupational environment:

The working environment has an important role for COPD patients in old age because it is
negatively related to the physical activities of the people at the workplace. Air pollution is
hurting the physical activities of the people that have COPD. There is a need for meticulously
study for the analysis of smoker employees and non-smoker employees as well. Many
investigations said that the disease increases and leads to stress, anxiety as well as behavioral
issues (Stoilkova et al., 2013). In some cases, the employee chose to quit their job because of less
tolerance capacity in a highly polluted environment.

Intervention programs:

1. The intervention program has a high role in minimizing the COPD impact. This part of the
study will tell about intervention programs related to old age people having COPD and they
are diagnosed at early stages, pulmonary rehabilitation, education programs, pharmacologic
programs of intervention, and programs of smoking cessation.
2. The pharmacological intervention is the starting stage of COPD is helpful for the patient. The
exacerbation of COPD is the basic reason behind morbidity and mortality that increase the
cost of medical treatment. The intervention at the early stages with the help of a spirometric
test will help the patient in starting stage and it will reduce the speed of disease. The patients
should be notified regarding modifiable elements of risks such as ignore to irritants,
vaccination, and COPD stages knowledge (Terry et al., 2017). The modifiable elements of
risks availability in the patients of hospitals show that 86 percent of people were not present
in the program of rehabilitation, 28 percent didn't receive therapy, and 43 percent consumed a
poor system of inhaling and 28 percent didn't get their vaccines.

This is correlated with health burden and medical cost and the early-stage diagnosis will be a
productive effort. It is also revealed that the majority of people are not aware of their
conditions in starting time, nevertheless, the testing for diagnosis with different health

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 programs as well as primary care promise to check and identify the symptoms and diseases at
early stages. It shows society, family, and roles of the authority of the nation to minimize the
COPD impact.

3. COPD patients must be provided with enough education at the diagnosis stage and
throughout his life because it is a beneficial factor linked to the social determinants. The
habit of smoking has many negative effects on the management of COPD so the education of
the public has the main purpose to stop the smoking habit of people to reduce the progression
of the disease. The education provides skills of self-management to take control over the
disease and it helps them in behavior management (Troosters et al., 2005). It also produces
positive outcomes.
4. The combination of reach, RE-AIM program, adoption, efficiency, maintenance elements,
and implications emphasize the weakness and strength of patients to know the accurate
program according to their requirements. In these requirements, the patient's kind, resources
availability, and economic conditions will be considered. It will help to quickly rectify the
diseases by assessing the current conditions of the patients.
5. Pulmonary rehabilitation is an important and useful method of multidisciplinary intervention
for COPD. It is the combination of social workers, occupational therapists, the efforts of a
physiotherapist, and social workers. They help in providing behavioral intervention and
training with the highest resources degrees. It is made with exercises combinations as well as
activities of education to enhance the quality of life of the patients (Ybarra et al., 2012). The
rehabilitation program is very effective in minimum utilization of medical services and
providing a better profile of health.
6. The program of smoking cessation is operating in different ways to reduce the number of
COPD patients. It is operating through online platforms by sending educational text
messages to individuals and asking them to stop smoking. It also gives support, advice, and
reminders to quit smoking.
7. Apart from the above programs of intervention, the government of Australia along with
different physiotherapists has initiated a program to overcome air pollution. This will be done
by promoting cycling. Cycling will also help in physical exercise promotion.

Conclusion:

This study has provided the necessary information for the makers of policies to provide
preference to the medical services of the public to target people with the help of programs
interventions to reduce the inequalities of health. The aim is to enhance and improve the quality
of life of individuals suffering from COPD in old age. They will be facilitated with early
diagnosis as well as better treatment that will minimize the burden on individuals. Elder people
with COPD became impaired frequently in social settings because of mortality rate, poor life
quality, and rate of incidence that are linked with social determinants. That is why it is necessary
to highlight the programs of intervention to make the lives of people better.

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References:

Burney, P. G., Patel, J., Newson, R., Minelli, C., & Naghavi, M. (2015). Global and regional
trends in COPD mortality, 1990–2010. European Respiratory Journal, 45(5), 1239-1247.

Erbas, B., Ullah, S., Hyndman, R. J., Scollo, M., & Abramson, M. (2012). Forecasts of COPD
mortality in Australia: 2006-2025. BMC medical research methodology, 12(1), 1-9.

Effing, T., Monninkhof, E. E., Van Der Valk, P. P., Zielhuis, G. G., Walters, E. H., Van Der
Palen, J. J., & Zwerink, M. (2007). Self‐management education for patients with chronic
obstructive pulmonary disease. Cochrane Database of Systematic Reviews, (4).

Monninkhof, E., van der Valk, P. D. L. P. M., Van der Palen, J., Van Herwaarden, C., Partridge,
M. R., & Zielhuis, G. (2003). Self-management education for patients with chronic obstructive
pulmonary disease: a systematic review. Thorax, 58(5), 394-398.

Stoilkova, A., Janssen, D. J., & Wouters, E. F. (2013). Educational programmes in COPD
management interventions: a systematic review. Respiratory medicine, 107(11), 1637-1650.

Terry, D., Robins, S., Gardiner, S., Wyett, R., & Islam, M. R. (2017). Asthma hospitalisation
trends from 2010 to 2015: variation among rural and metropolitan Australians. BMC public
health, 17(1), 1-11.

Troosters, T., Casaburi, R., Gosselink, R., & Decramer, M. (2005). Pulmonary rehabilitation in
chronic obstructive pulmonary disease. American journal of respiratory and critical care
medicine, 172(1), 19-38.

Ybarra, M. L., Holtrop, J. S., Bosi, A. T. B., & Emri, S. (2012). Design considerations in
developing a text messaging program aimed at smoking cessation. Journal of Medical Internet
Research, 14(4), e103.