The institute's analysis of chronic respiratory disease deaths between 1980 and 2014 showed an overall 29.7 percent increase in such deaths. Of those 4.6 million deaths, 85 percent were from COPD, with the highest percentage of COPD deaths occurring in central Appalachia and the Mississippi Valley. During that 35-year period, COPD went from the fourth-leading cause of death in the US to third place.
Asthma, asbestos exposure (especially near petrochemical facilities) interstitial lung disease, and smoking were also significant causes of death. One of the researchers, Laura Dwyer-Lindgren, said that regional rates of tobacco use are mostly responsible for the county-level differences in mortality. "County-level changes in the mortality rate from COPD during the study period ranged from a 60.5% decline in deaths to a 263.7% increase," Boyles reports.
In an editorial accompanying the study, Drs. David Mannino and Wayne Sanderson of the University of Kentucky said that the findings provide insight about where interventions should be focused. "For example, pneumoconioses should be nearly completely preventable by occupational safety measures," they wrote. "For asthma, these data demonstrate success in reducing mortality over 35 years in most, but not all, parts of the country; future success will require focusing interventions in the counties that have lagged behind in the overall mortality decrease." COPD, they said, is a "particularly pressing" challenge that will require major investments in smoking prevention and cessation, and research to develop better COPD treatments.
The study was funded by the Robert Wood Johnson Foundation, the National Institute on Aging, and John W. Stanton and Theresa E. Gillespie.