Chronic Respiratory Disease Death Toll Rising in Recent Decades

A new analysis finds that the mortality rate from chronic respiratory diseases has risen by almost 30% between 1980 and 2014 in the United States, and that data reflect significant differences in death rates across counties and regions.

The investigation recently published in JAMA explains that chronic respiratory diseases accounted for about 1 in 15 deaths in 2015 and resulted in approximately $132 billion in health spending in 2013. Prior research has found wide geographic variation in death rates from the most common respiratory disorder, chronic obstructive pulmonary disease (COPD), but the new study aims to provide annual estimates since 1980 of the mortality rates for each type of pulmonary disease, broken down by location and region.

Researchers used 1980-2014 death records from the National Center for Health Statistics, as well as population data from the US Census and other national databases. They specifically focused on deaths from several chronic respiratory diseases: COPD, interstitial lung disease and pulmonary sarcoidosis, asthma, pneumoconiosis (and its subtypes), and all other respiratory diseases.

At the end of the study period, in 2014, there were around 177,300 deaths from chronic respiratory diseases, largely due to COPD, which was responsible for 151,2000 deaths. There were wide variations in mortality rates across counties, ranging from 14.3 to 161 deaths per 100,000 population in 2014. Counties in the 90th percentile of mortality had 41.1 more deaths per 100,000 population than those in the 10th percentile.

The researchers observed that the mortality rates for chronic respiratory diseases as a whole and for some diseases had trended upwards across the study period. The nationwide respiratory disease mortality rate began at 40.8 per 100,000 population in 1980, peaked at 55.4 in 2002, then declined to 52.9 deaths per 100,000 by 2014. This equates to a 29.7% increase in the US mortality rate from 1980 to 2014.

Mortality rates for COPD and the combined category of interstitial lung disease and pulmonary sarcoidosis increased during the study period by 30.8% and 100.5%, respectively. The mortality rate decreased by 46.5% for asthma and by 48.5% for pneumoconiosis. There was a 42.3% increase in the mortality rate from other chronic respiratory diseases.

The study authors also identified geographic patterns in mortality rates across the study period. For instance, the changes in the mortality rate from COPD varied from a 60.5% decline to a 263.7% increase across all counties. The largest increases in COPD death rates were observed in the South, especially in a band stretching from north Texas to the Carolinas.

This information could potentially be used to help local public health officials and clinicians address the burden of chronic respiratory diseases in their communities, the study authors wrote. They suggested that efforts to provide heightened screening and earlier treatment could be implemented in targeted areas in order to reduce the geographic disparities in respiratory disease deaths.