Abstract
Background: Chronic Obstructive Pulmonary Disease (COPD) moved from fourth to third commonest cause of death in the world between 1990 and 2010, but little is known of what is driving this change. COPD has been associated with age, poverty and smoking.
Methods: We compared COPD mortality among those aged 40 years and older in 1990 and 2010, using data from the Global Burden of Disease programme. Mortality in 2010 was standardised to the 1990 population to quantify the difference in mortality rates attributable to changes in population. Regional COPD mortality rates for 1990 and 2010 were regressed against age, sex, gross national income/capita and an index of cumulative smoking exposure. Finally, we estimated the percentage of change in COPD mortality risk attributable to changes in age distribution, gross national income and smoking index.
Findings: Total deaths over the age of 40 years fell slightly from 2,995,058 in 1990 to 2,837,877 in 2010, though the number would have risen to 5,231,916 if the age-sex specific rates had remained constant. Changes in smoking led to a small increase in age-sex specific rates, but the main association with the changes in age-sex specific COPD mortality rates was a change in gross national income.
Interpretation: The main drivers of changes in COPD mortality between 1990 and 2010 are changes in age distribution, associated with increased deaths, and improving economic conditions, associated with reduced COPD mortality rates.
- © 2014 ERS