Between 1999 and 2023, age-adjusted CLRD mortality among U.S. women increased from 37.7 to 46.0 per 100,000 (AAPC +0.83%), driven by aging and widening geographic and sociodemographic disparities.
Observational
Despite some regional and demographic declines, the absolute burden of CLRD mortality among U.S. women is rising, driven by aging and geographic disparities.
Effect estimate: AAPC +0.83%
Absolute Event Rate: 46% vs 37.7%
Abstract Background Chronic lower respiratory diseases (CLRD)—comprising COPD, chronic bronchitis, and emphysema—remain a leading cause of female mortality in the United States. Despite substantial progress in tobacco control, population aging, cumulative exposure to air pollutants, and regional inequities continue to shape disease patterns. Sex-specific vulnerability to lung damage and uneven access to healthcare further amplify the burden. Methods We analyzed CLRD mortality among U.S. women from 1999-2023 using CDC WONDER data. Two overlapping datasets (1999-2020 and 2018-2023) were harmonized to form a continuous series; minor 2018-2020 discrepancies, largely from race-classification and registration updates, were adjusted through cross-validation. Annualized percent change (AAPC) in absolute and age-adjusted mortality was estimated using log-linear regression, stratified by region, state, urbanization, race, ethnicity, and age group. Results From 1999 to 2023, the total number of deaths due to CLRD among U.S. women rose from 61,766 to 77,863, reflecting a 26.0% absolute increase. The age-adjusted mortality rate increased from 37.7 to 46.0 per 100,000, corresponding to an AAPC of + 0.83% per year. Regionally, the West (AAPC = −1.66%) and Northeast (AAPC = −1.09%) showed significant declines, while the Midwest (AAPC = 0.03%) and South (AAPC = −0.01%) remained stable. Absolute deaths increased most rapidly in the South (+2.14% per year) and Midwest (+1.25%), followed by the West (+0.72%), but were stable in the Northeast. Among states, Arkansas (+2.20%), Mississippi (+2.08%), and Oklahoma (+1.26%) showed the strongest upward trends, while California (−2.33%), Washington (−2.05%), and Maryland (−1.87%) recorded the greatest declines. Urban areas experienced decreasing mortality (−1.15% in large central metros), whereas nonmetropolitan regions showed marked growth (Noncore +1.67%, Micropolitan +1.11%). Mortality declined in both Hispanic (−1.24%) and non-Hispanic (−0.33%) women, with sharper declines among Hispanic women. Across races, reductions were observed in Asian (−6.46%), Native Hawaiian or Other Pacific Islander (−4.69%), Asian or Pacific Islander (−1.76%), American Indian or Alaska Native (−0.83%), and White (−0.34%), while Black women exhibited a slight increase (+0.16%). Mortality counts declined in younger women but rose progressively in middle-aged and older groups, peaking at 55-64 years (+2.72%) and 85+ years (+2.06%), indicating an aging-driven shift in the absolute disease burden. Conclusions Despite modest improvements in age-adjusted mortality, the absolute CLRD burden among U.S. women continues to rise, driven by aging, population growth, and widening geographic and sociodemographic disparities. Targeted prevention, early detection, and region-specific interventions are urgently needed to mitigate this expanding burden in older and rural female populations. This abstract is funded by: None
Pragya et al. (Fri,) conducted a observational in Chronic lower respiratory diseases (CLRD). Between 1999 and 2023, age-adjusted CLRD mortality among U.S. women increased from 37.7 to 46.0 per 100,000 (AAPC +0.83%), driven by aging and widening geographic and sociodemographic disparities.