Rationale: Pulmonary rehabilitation (PR) has demonstrated physiological, symptom-
reducing, psychosocial, and health economic benefits for patients with chronic respiratory
diseases, yet it is underutilized worldwide. Insufficient funding, resources, and
reimbursement; lack of healthcare professional, payer, and patient awareness and
knowledge; and additional patient-related barriers all contribute to the gap between the
knowledge of the science and benefits of PR and the actual delivery of PR services to …

Background: Health disparities, defined as a significant difference in health between
populations, are more common for diseases of the respiratory system than for those of other
organ systems, because of the environmental influence on breathing and the variation of the
environment among different segments of the population. The lowest social groups are up to
14 times more likely to have respiratory diseases than are the highest. Tobacco smoke, air
pollution, environmental exposures, and occupational hazards affect the lungs more than …