In 2008, chronic lower respiratory disease, primarily chronic obstructive pulmonary disease (COPD), became the third leading cause of death in the United States after only heart disease and cancer. A group of progressive, debilitating respiratory conditions, including emphysema and chronic bronchitis, COPD often results in difficulty breathing, lung airflow limitations, cough, and other symptoms. Yet despite the burden of the disease nationally, until recently no research had been conducted to determine the prevalence of COPD on the state-level.
As a result, in early 2011 the Center for Disease Control and Prevention (CDC) set out to measure the prevalence of COPD among U.S. adults by state, the impact of COPD on their quality of life, and their use of healthcare resources. The study, “Chronic Obstructive Pulmonary Disease Among Adults — United States, 2011,” found that nearly 6.3% of U.S. adults (about 15 million people) had been told by a healthcare professional that they had COPD.
“This is the first study that looked at COPD prevalence at a state level,” said Nicole M. Kosacz, MPH, Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, and corresponding contributor of the study. “This number differed by state, ranging from less than 4% in Puerto Rico, Washington and Minnesota to more than 9% in Alabama and Kentucky. States in the southern and Appalachian states [also] had a higher prevalence.”
In addition, researchers found that COPD prevalence increased with age and was higher among women, those without a high school diploma, those who were divorced, widowed or separated, and those who were unable to work, unemployed or retired.
“As expected, COPD was more common among persons with a history of smoking or among those with a history of asthma,” said Kosacz. However, she continued, “it’s important to note that even though cigarette smoke is the leading cause of COPD, 39% of respondents with COPD continued to smoke.”
To reach these conclusions, researchers with the CDC analyzed the data from the 2011 Behavioral Risk Factor Surveillance System (BRFSS), a state-based, random-digit–dialed telephone survey of the noninstitutionalized U.S. civilian adult population aged 18 years or older, which is administered annually by state health departments in collaboration with the CDC.
Respondents of the survey, which was administered in all 50 states, Washington D.C. and Puerto Rico, answered the question “Have you ever been told by a doctor or health professional that you have COPD, emphysema, or chronic bronchitis?” In addition, survey administrators in 21 states, Washington D.C. and Puerto Rico chose to ask those who reported that they had been diagnosed with COPD additional questions about their quality of life and use of healthcare resources.
“In the states that used the optional module, 64.2% of respondents with COPD felt that their COPD symptoms significantly affected their quality of life,” said Kosacz. “Only 55.6% were taking daily medication to manage their symptoms, 43.2% had seen a physician about their COPD symptoms and 17.7% visited the hospital in the past 12 months.”
While only half of respondents indicated that they were taking daily medication to manage their symptoms, Kosacz notes that the use of these medications can help control symptoms and prevent exacerbations, thus increasing quality of life.
The most shocking information revealed as a result of this survey, though, was the number of people who had been diagnosed with COPD yet continue to smoke.
“A significant proportion of people with COPD continue to smoke. [However,] it’s not too late to quit,” said Kosacz. “Quitting can slow the progression of COPD and reduce symptoms and exacerbations.”
While it is difficult to quit smoking, there are helpful resources. For more information, call 1-800-QUIT-NOW (1-800-784-8669) or speak with your healthcare provider.
Chronic obstructive pulmonary disease (COPD) remains a significant killer, according to a recent report from the Centers for Disease Control and Prevention (CDC). The report, which tracks COPD statistics from 1998 to 2009, states that though the prevalence of COPD has not declined, the death rate has, but only in men.
According to the report, roughly 5% of American adults had COPD in 2007 to 2009—nearly 12 million people over the age of 18. Women account for the majority of that number, with 7.4 million cases. Additionally, COPD was found to be more prevalent in older age groups, in particular women age 65 to 74 and men age 75 to 84. In nearly every age group, women with the disease were the majority.
The study also found that COPD was more prevalent among Puerto Rican and non-Hispanic white adults than among Hispanic, black and Mexican-American adults. Less than 3% of Mexican-Americans had the disease, the lowest of any group for which estimates are available.
Income level also played a significant role in determining one’s risk for developing the disease, with 8.3% of adults with family income below the poverty line having COPD, compared to 4.3% of adults with income at least 200% of the poverty level.
“Adults with family income below the federal poverty level had the highest COPD prevalence,” the authors write. “Within each racial and ethnic group, COPD prevalence among poor adults (those with income less than 100% of the poverty level) was higher than for adults with income levels above the poverty level.”
Risk was also determined based on geographic location, with the prevalence of COPD almost twice as high in the southeastern Central U.S. (7.5%) as in the Pacific (3.9%). Tennessee, Kentucky, Mississippi and Alabama were found to be the states with the highest rates, while the lowest were reported in California, Oregon, Washington, Alaska and Hawaii.