New report highlights region-specific patterns in COPD mortality over last decade in US

From 1999 to 2019, overall age-adjusted COPD mortality did not change significantly among women in the U.S., but rates increased among women living in the Midwest and in small metropolitan or nonmetropolitan areas.

Among men, overall age-adjusted COPD mortality rates decreased during the same period (–1.3%), but rates remained higher than in women. Rates for men declined in all urban-rural areas and in all regions of the U.S., according to a new report published in Morbidity and Mortality Weekly Report.

“Although rates in men remain higher than those in women, declines have occurred among men but not women,” Susan A. Carlson, PhD, from the division of population health at the National Center for Chronic Disease Prevention and Health Promotion at the CDC, and colleagues wrote.

The researchers evaluated geographic variation in sex-specific trends in age-adjusted COPD mortality rates among adults in the U.S. The researchers assessed mortality data from the CDC National Vital Statistics System from 1999 to 2019 and identified COPD mortality among adults aged 25 years or older for each year by sex and geographic characteristics.

In 2019, differences between men and women in annual age-adjusted COPD deaths per 100,000 population were smaller (62.8 vs. 53, respectively) compared with 1999 (88.2 vs. 54.6, respectively). Researchers reported an inverse relationship between COPD mortality rates and urbanicity in men in 1999 and 2019 and women in 2019.

In 2019, age-adjusted COPD mortality rates in women were lowest in the Northeast (42.1 deaths per 100,000 population) and highest in the South (59.3 deaths per 100,000 population) and Midwest (58.9 deaths per 100,000 population). In 1999, the highest mortality rates were in the West (61.6 deaths per 100,000 population).

From 1999 to 2019, COPD mortality rates in women increased significantly in the Midwest (0.6%) and decreased significantly in the Northeast (–0.5%) and in the West (–1.2%). Among men, from 1999-2019, COPD mortality rates decreased significantly in all regions, ranging from –2% in the West to –0.9% in the Midwest.

When the researchers assessed urban-rural status, COPD mortality rates in women significantly decreased by –0.9% in large central areas and by –0.4% in metropolitan areas from 1999 to 2019. Mortality rates in women significantly increased in small metropolitan areas (0.6%), micropolitan areas (1.2%) and noncore areas (1.9%). Among men, COPD mortality rates decreased in all urban-rural categories, ranging from –1.9% in large central areas to –0.4% in noncore areas.

“To reduce COPD deaths, strategies to improve the prevention, treatment and management of COPD are needed, especially strategies that address geographic differences and improve the trend among women,” the researchers wrote.