Epidemiology: health disparities identified

Nationally, COPD is the fourth leading cause of death and of the top five causes of death; it is the only disease on the rise. During 2001, 13.3 million U.S. adults were estimated to have COPD and 24 million reported evidence of difficulty breathing indicating that COPD was and still is significantly under diagnosed (NHANES III). In the greater metropolitan Chicago area alone, there are an estimated 430,000 individuals affected by COPD and half of them are unaware that they are afflicted by this disease.

Prevalence

The demographic of those identified with COPD is changing. Although prevalence of COPD is high among Caucasians, the incidence is rising at an alarming rate especially among Caucasian women, African American (AA) men and AA women, with AA women having the highest mortality rate among all groups. It is estimated that 64,000 women die annually from COPD (National Center for Health Statistics. Report of Final Mortality Statistics, 2002).

The COPD Needs Assessment Survey conducted under the auspices of the National Emphysema/COPD Association (NECA) indicates that at least half of patients reported that they were diagnosed with COPD by age 45 or younger. Demographic data indicates that approximately 30% of those with COPD are between the ages of 45 and 64, which is significantly younger than recently reported (National Center for Health Statistics, Current Estimates of the National Health Interview Survey, United States, selected years, 1979-2002).

Emerging disparity is shown by the following data. The highest prevalence rate of Chronic bronchitis, in the 45 to 64 age group, was 56.3 per 1,000 among AA. Chronic bronchitis prevalence among all age groups of Hispanic Americans is 27.7 per 1,000. Prevalence of emphysema is 22.0 per 1,000 among Caucasians between 45 to 64 years of age.

Data also indicates that women are twice as likely to be diagnosed with chronic bronchitis than men (Pleis JR, Lethbridge-Cejku M. Summary health statistics for U.S. adults: National health interview survey, 2005. National Center for Health Statistics. Vital Health Stat 10(232). 2006. Since 2000, data shows that more women are dying from COPD than men, an unfortunate outcome of higher smoking rates among women over the last decades (National Center for Health Statistics, Raw Data from the National Health Interview Survey, United States, 1997-2002).