U.S. COPD mortality from 2018-2023 showed an overall net decline of 0.7%, but increased significantly among Other Pacific Islanders (AAPC +6.9%), rural residents, and low-education groups.
Observational
Despite overall declines in U.S. COPD mortality, significant increases persist among Pacific Islanders, rural residents, and low-education groups, highlighting widening disparities.
Abstract Background Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of respiratory mortality in the United States. Although overall COPD deaths have declined over past decades, recent trends suggest diverging patterns across racial and demographic groups. We analyzed national mortality data from 2018-2023 to quantify annualized trends and identify populations with the greatest increases or reductions in mortality. Methods Mortality data were obtained from the CDC WONDER database for COPD (ICD-10: J40-J44) from 2018-2023. Deaths were grouped by single race, census region, 2013 urbanization level, 10-year age group, sex, Hispanic origin, and education. Annualized Average Percent Change (AAPC) was estimated for each subgroup using log-linear regression: ln (deaths) = β0 + β1 (year). AAPC = (e^β1 - 1) × 100; 95% confidence intervals (CIs) were derived from β1 ± 1. 96×SE. Significance was set at p 0. 05. Results From 2018-2023, the highest AAPC in death due to COPD was observed in Other Pacific Islanders (+6. 9%, 95% CI 2. 6-11. 5; p = 0. 033), followed by Native Hawaiians (+4. 8%, 95% CI 1. 2-8. 1). The largest declines occurred among Chinese (-4. 3%, 95% CI -6. 5 to -1. 9; p = 0. 024) and White individuals (-1. 1%, 95% CI -2. 0 to -0. 1). Regionally, mortality increased in the South (+2. 3%) and West (+1. 5%), but decreased in the Northeast (-1. 9%) and Midwest (-0. 8%). By urbanization, non-metro rural areas showed an AAPC of + 2. 6%, contrasting with large central metros (-0. 7%). Age-stratified analysis revealed the sharpest rise in ≥ 75 years (+3. 8%), while ages 45-54 declined slightly (-0. 9%). By sex, male deaths decreased modestly (AAPC = -0. 8%), whereas female deaths increased (+0. 5%), narrowing the sex gap. Educational disparities were striking: individuals with ≤high school education had an AAPC of + 2. 9%, versus -1. 7% among those with college education. Hispanic origin analysis showed mortality rose among non-Hispanic Blacks (+1. 6%) and non-Hispanic Pacific Islanders (+5. 2%), but declined among Hispanic Whites (-1. 2%). Conclusion Between 2018 and 2023, U. S. COPD mortality displayed heterogeneous trends, with a net decline of -0. 7% overall but significant increases among Pacific Islanders, rural residents, and low-education groups. Declines were limited to higher-educated and Asian populations. These data underscore widening racial and socioeconomic disparities despite national tobacco-control success, emphasizing the need for race- and region-specific prevention and care access strategies. This abstract is funded by: None
Trivedi et al. (Fri,) conducted a observational in Chronic Obstructive Pulmonary Disease (COPD). U.S. COPD mortality from 2018-2023 showed an overall net decline of 0.7%, but increased significantly among Other Pacific Islanders (AAPC +6.9%), rural residents, and low-education groups.
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