Chronic Obstructive Pulmonary Disease (COPD): Mortality Trends and Epidemiological Analysis (1999–2020)

Abstract Background: Chronic Obstructive Pulmonary Disease (COPD) remains a leading cause of morbidity and mortality globally. Despite medical advancements, it continues to impose a significant burden on healthcare systems due to its complex pathophysiology and increasing prevalence. Methods: This study utilized de-identified mortality data from the CDC WONDER database spanning 1999 to 2020, focusing on individuals aged 25 and older. COPD-related deaths were identified using ICD-10 codes (J44.0, J44.1, J44.8, J44.9), including both underlying and contributing causes of death. Age-adjusted mortality rates (AAMRs), crude mortality rates, and annual percent changes (APCs) were calculated and stratified by sex, race/ethnicity, and geographic region using the Joinpoint Regression Program. Results: Between 1999 and 2020, a total of 5,481,686 COPD-related deaths were recorded among U.S. adults aged ≥25 years, with an overall AAMR remaining stable (1999: 118.986; 2020: 119.207; APC: –0.152, 95% CI: –0.292 to –0.013). Males exhibited higher mortality (AAMR: 142.087) than females (AAMR: 96.393), with divergent trends (APC: –0.881 vs. 0.374). Among Hispanics, AAMR declined until 2018 (APC: –1.39) but rose sharply in 2020 (APC: 7.887). In non-Hispanic groups, AI/AN and Black populations showed increasing trends, while API experienced a decline (APC: –1.98); the White population had the highest overall AAMR. Regional disparities were evident: AAMRs rose in the Midwest and South (APC: 0.266 and 0.27) but declined in the Northeast and West (APC: –0.887 and –0.953). Rural areas had a consistently higher AAMR (145.56) than urban areas (107.579), with opposing trends (APC: 0.711 vs. –0.383). State-level variation ranged from West Virginia (195.01) to Hawaii (50.04), highlighting substantial geographic heterogeneity in COPD mortality. Conclusion: COPD mortality rates remained largely unchanged from 1999-2020, with persistent disparities affecting men, racially and ethnically diverse populations, rurual residents, and those in Midwest and South. Addressing these gaps require targeted prevention, improved access to care, and integrated public health strategies.