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Trends in COPD (Chronic Bronchitis and Emphysema): Morbidity and Mortality

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Trends in COPD (Chronic Bronchitis and Emphysema): Morbidity and Mortality Trends in COPD (Chronic Bronchitis and Emphysema): Morbidity and Mortality Please note, this report is designed for double-sided printing American Lung Association Epidemiology and Statistics Unit Research and Health Education Division March 2013 Page intentionally left blank Table of Contents COPD Mortality, 1999-2009 COPD Prevalence, 1999-2011 COPD Hospital Discharges, 1999-2010 Glossary and References List of Tables Table 1: COPD – Number of Deaths by Ethnic Origin and Sex, 1999-2009 Figure 1: COPD – Number of Deaths by Sex, 1999-2009 Figure 2: COPD – Age-Adjusted Death Rates by Ethnic Origin and Sex, 2009 Table 2: COPD – Age-Adjusted Death Rate per 100,000 Population by Ethnic Origin and Sex, 1999- 2009 Figure 3: COPD – Deaths and Age-Adjusted Death Rate by Sex, 2009 Figure 4: COPD – Diagnosed Cases and Evidence of Impaired Lung Function Figure 5: Chronic Bronchitis – Prevalence Rates per 1,000, 2011 Table 3: Chronic Bronchitis – Number of Conditions and Prevalence Rate per 1,000 Population by Ethnic Origin, Sex and Age, 1999-2011 Figure 6: Emphysema – Prevalence Rates per 1,000, 2011 Table 4: Emphysema – Number of Conditions and Prevalence Rate per 1,000 Population by Ethnic Origin, Sex and Age, 1997-2011 Table 5: COPD – Adult Prevalence by Sex and State, 2011 Figure 8: COPD – Age-Adjusted Prevalence in Adults by State, 2011 Table 6: Characteristics Among Those Reporting a Diagnosis of COPD by State (%), 2011 Figure 9: COPD – First-Listed Hospital Discharge Rates per 10,000, 2010 Table 7: COPD – Number of First-Listed Hospital Discharges and Rate per 10,000 Population by Race, Sex and Age, 1999-2010 Figure 9: National Projected Annual Cost of COPD, 2010 Introduction Chronic obstructive pulmonary disease (COPD) is a term which refers to a large group of lung diseases characterized by obstruction of air flow that interferes with normal breathing. Emphysema and chronic bronchitis are the most important conditions that compose COPD and they frequently coexist. The following tables delineate information available from national surveys and statistics on the mortality, prevalence, hospitalization and economic costs attributable to COPD. Please note that the following tables and narrative refer exclusively to data on COPD; data on asthma are not included. COPD Mortality Mortality data is based on records of every death among the population, rather than a sample of cases. This means counts and rates are actual representations instead of estimates. COPD is the third leading cause of death in the U.S. behind cancer and heart disease. Table 1 documents the number of deaths by ethnic origin and sex between 1999 and 2009. In 2009, 133,965 people died of COPD of which more than half (52.3%) were in women. As seen in Figure 1, this is the tenth consecutive year in which the number of deaths due to COPD was higher among women than men. Nearly 80% of COPD deaths are in non-Hispanic whites; Hispanics had the least number of deaths with 3,714. 1 Table 1: COPD - Number of Deaths by Ethnic Origin and Sex, 1999-2009 (1,2) Non-Hispanic Total Hispanic White Black Other Both Both Both Both Both Year Sexes Male Female Sexes Male Female Sexes Male Female Sexes Male Female Sexes Male Female 1999 119,524 60,795 58,729 2,539 1,428 1,111 108,609 54,384 54,225 6,706 3,978 2,728 1,329 812 517 2000 117,522 58,372 59,510 2,397 1,322 1,075 107,065 52,311 54,754 6,383 3,712 2,671 1,351 840 511 2001 118,744 58,218 60,526 2,558 1,379 1,179 108,036 52,118 55,918 6,412 3,693 2,719 1,415 852 563 2002 120,555 59,133 61,422 2,771 1,511 1,260 109,408 52,767 56,641 6,647 3,794 3,853 1,419 887 532 2003 122,283 59,321 63,062 2,875 1,566 1,309 110,952 52,762 58,190 6,613 3,763 2,850 1,545 967 578 2004 118,171 57,260 60,911 2,826 1,520 1,306 107,293 51,166 56,127 6,330 3,558 2,772 1,503 888 615 2005 127,049 61,120 65,929 3,209 1,733 1,476 114,862 54,272 60,590 7,134 4,003 3,131 1,631 982 649 2006 120,970 57,964 63,006 3,053 1,614 1,439 109,313 51,555 57,758 6,714 3,677 3,037 1,665 992 673 2007 124,477 59,961 64,516 3,292 1,785 1,507 112,329 53,303 59,026 6,937 3,765 3,172 1,744 1,002 742 2008 137,693 65,936 71,757 3,678 1,903 1,775 124,076 58,643 65,433 7,787 4,127 3,660 1,917 1,122 795 2009 133,965 63,899 70,066 3,724 1,895 1,829 120,593 56,737 63,856 7,539 4,060 3,479 1,887 1,069 818 Sources: Centers for Disease Control and Prevention. National Center for Health Statistics. CDC Wonder On-line Database, compiled from Compressed Mortality File 1999-2009 Series 20 No. 2O, 2012. Notes: (1) This table refers exclusively to data on chronic bronchitis, emphysema and other lower chronic obstructive pulmonary diseases including bronchiectasis. Data on asthma are not included. (2) Deaths from 1999-2009 are coded by the 10th revision of International Classification of Diseases, codes J40-J44, J47. Figure 1: COPD – Number of Deaths by Sex, 1999-2009 80,000 70,000 60,000 50,000 40,000 Female Male 30,000 Numberof Deaths 20,000 10,000 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Source: CDC Wonder On-line Database, 1999-2009 data. Table 2 and Figure 2 displays the age-adjusted death rate per 100,000 population by ethnic origin and sex. Numbers of death or disease (counts) are usually important for healthcare planning or defining the magnitude of disease; however, they do not provide the information necessary to compare disease and health status between groups (such as males versus females). In order to make such comparisons, statisticians develop rates. A rate is a fraction, in which the numerator is the number of people in whom an event occurred during a certain period of time (death), and the denominator is the total number of people in the population at risk for the same period of time. A common type of rate used to express mortality are age-adjusted rates; these rates specifically remove the distorting effect of age on death when comparing populations of different age structures. COPD has an age-adjusted death rate of 41.2 per 100,000 population; meaning that 41 persons out of 100,000 people died from COPD in 2009. The age-adjusted death rate in non-Hispanic whites (46.0 per 100,000) was 1.7, 2.6 and 3.1 times greater than the rate in non-Hispanic blacks, Hispanics and non-Hispanic others, respectively. Overall, non-Hispanic white males had the highest age-adjusted death rates (53 per 100,000) while non-Hispanic other women had the lowest age- adjusted death rates (11.0 per 100,000 population).2 In 2009, the age-adjusted death rate in men was 1.3 times greater than the rate seen in women despite the fact that there were more deaths due to COPD among women in 2009. This is due to the fact, that unlike counts, rates are scaled to the size of the population and there are more women in the general U.S. population than males. Figure 3 shows this relationship. 3 Figure 2: COPD – Age-Adjusted Death Rates by Ethnic Origin and Sex, 2009 53.0 41.7 39.9 Men Women 20.3 21.1 21.2 14.1 11.0 White Black Other Hispanic Non-Hispanic Source: CDC Wonder On-line Database, 1999-2009 data. Table 2: COPD - Age-Adjusted Death Rate per 100,000 Population by Ethnic Origin and Sex, 1999-2009 (1,2,3) Non-Hispanic Total Hispanic White Black Other Both Both Both Both Both Year Sexes Male Female Sexes Male Female Sexes Male Female Sexes Male Female Sexes Male Female 1999 44.0 56.8 36.2 18.2 26.1 13.3 47.5 60.3 39.8 30.4 47.7 20.2 19.8 29.1 13.2 2000 42.7 53.6 36.1 16.2 22.3 12.2 46.4 57.1 40.0 28.4 43.5 19.5 19.2 29.0 12.4 2001 42.2 52.8 35.9 19.3 26.6 14.8 45.8 56 39.7 27.7 43.7 18.7 18.3 26.9 12.4 2002 42.0 52.3 35.7 19.3 26.2 14.7 45.7 55.6 39.8 28 43.4 19.4 16.9 25.8 10.7 2003 41.9 51.2 36.2 18.9 26.0 14.4 45.9 54.5 40.5 27.3 42.1 18.9 17.2 26.5 10.9 2004 39.9 48.4 34.5 17.3 22.9 13.5 43.8 52.0 38.8 25.5 38.5 18.1 15.8 23.1 10.9 2005 42.0 50.3 36.6 18.3 24.2 14.3 46.2 54.0 41.2 28.0 42.0 19.8 16.0 23.7 10.8 2006 39.3 46.7 34.6 16.4 21.2 13.1 43.5 50.5 39.1 25.8 37.7 18.9 15.3 22.5 10.5 2007 39.7 47.2 34.8 16.7 22.0 13.0 44.1 51.2 39.4 26.1 37.9 19.2 15.1 21.2 10.9 2008 42.9 50.6 37.9 17.3 21.8 14.2 47.8 55.2 43.0 28.5 40.1 21.6 15.6 22.3 11.0 2009 41.2 48.6 36.6 17.0 21.2 14.1 46.0 53.0 41.7 27.2 39.9 20.3 15.0 21.1 11.0 Sources: Centers for Disease Control and Prevention.
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