Trends of mortality from chronic respiratory diseases by sex and ethnicity in the USA: a secular analysis from 1979 to 2021 using data from death certificates

BMJ Open Respir Res. 2024 Nov 24;11(1):e002296. doi: 10.1136/bmjresp-2024-002296.

Abstract

Background: Over the past decades, the prevalence of chronic respiratory diseases (CRDs) has undergone significant changes. Analysing long-term mortality trends by sex and ethnicity can inform more targeted public health interventions.

Methods: Using data from death certificates, we calculated age-standardised mortality rates of chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), asthma and pneumoconiosis among the US population from 1979 to 2021, stratified by sex and ethnicity. Trend analyses of mortality rates were conducted using joinpoint regression models.

Results: Mortality trends varied significantly by demographic groups and disease types. Specifically, COPD mortality exhibited an overall increasing trend among females and white individuals throughout the study period while remaining stable among males and black individuals. ILD mortality showed an overall increasing trends for both males and females as well as individuals of white ethnicity. Asthma mortality showed an increase before 1996 followed by a consistent decline across all populations from about 1996 to 2021. In contrast, pneumoconiosis mortality has risen among white individuals since 2001 with a notable increase among females after 2009.

Conclusion: Our analysis reveals fluctuating trends in CRD mortality rates from 1979 to 2021 with varying patterns across sex, ethnicity and disease types. These findings underscore the need for ongoing research and tailored interventions to address these disparities.

Keywords: Asthma; Asthma Epidemiology; COPD epidemiology; Interstitial Fibrosis; Pulmonary Disease, Chronic Obstructive.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asthma* / ethnology
  • Asthma* / mortality
  • Chronic Disease / ethnology
  • Chronic Disease / mortality
  • Death Certificates*
  • Ethnicity / statistics & numerical data
  • Female
  • Humans
  • Lung Diseases, Interstitial / ethnology
  • Lung Diseases, Interstitial / mortality
  • Male
  • Middle Aged
  • Mortality / ethnology
  • Mortality / trends
  • Pneumoconiosis / ethnology
  • Pneumoconiosis / mortality
  • Pulmonary Disease, Chronic Obstructive / ethnology
  • Pulmonary Disease, Chronic Obstructive / mortality
  • Sex Distribution
  • Sex Factors
  • United States / epidemiology