Chronic obstructive pulmonary disease (COPD) is the world’s most common chronic respiratory condition.
This potentially deadly disease inflames the lungs, making it difficult for people to catch their breath. While COPD is manageable through medications, vaccinations and other care, many people fail to manage it, worsening their condition and increasing the risk of dying.
To better understand COPD, and develop new strategies to help patients, Mehdi Mirsaeidi, M.D., M.P.H., pulmonary and critical care expert at the University of Miami Health System at the University of Miami Miller School of Medicine, and Baharan Zarrabian, M.D., a medical resident at Jackson Memorial Hospital, recently studied COPD mortality trends in the United States. The research was published in the Annals of the American Thoracic Society.
Good news, bad news
“The good news is that general mortality for COPD is declining,” Dr. Mirsaeidi says. “However, when we break that down into ethnicities, mortality for African American women is actually rising. Perhaps they are not being diagnosed properly, receiving good care, don't trust COPD management, or are not being vaccinated for pneumonia or flu.”
In the study, the scientists studied CDC mortality data between 2004 and 2018 for Americans 40 and older. Reduced smoking rates, better care, and other factors have driven down overall COPD mortality. In 2004, the COPD death rate was 72.9 per 100,000 people, declining to 67.4 by 2018. Death rates declined for men but remained unchanged for women. This was driven mostly by increases among African American women.
While the death rates for COPD and pneumonia decreased, the rates for COPD and flu increased, particularly among African American women, indicating they may not be seeking or given flu vaccinations. This mirrors overall flu vaccination rates, which declined from 396 per 1,000 in 2011 to 268 per 1,000 in 2018.
Tip of the iceberg
The researchers are also concerned the CDC data may be undercounting the number of Americans affected by COPD, as many people go undiagnosed.
“This could be the tip of the iceberg,” Dr. Mirsaeidi says.
The team is proposing a three-pronged program to improve COPD management in Miami. The first step is identifying people who are suffering from the disease but have not yet been diagnosed. From there, they want to educate people with COPD about their options and encourage them to vaccinate for respiratory diseases.
“We are communicating with University of Miami psychologists to determine how we can change attitudes and increase knowledge in these communities,” Dr. Mirsaeidi says. “We need to actively detect people who have COPD and help them get care. That could mean smoking cessation programs, lung cancer screening, and pulmonary rehabilitation. Most important, they need to be vaccinated. Many of the deaths from COPD combined with flu or pneumonia are quite preventable.”
Originally written by Josh Baxt for Inventum.