Chronic Obstructive Pulmonary Disease in United States

United States

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease that slowly damages air sacs in the lungs, decreasing airflow and making it difficult to breathe. Chronic lower respiratory diseases, mainly COPD, are the sixth-leading cause of death in the United States. The symptoms of COPD include shortness of breath, wheezing, chest tightness, needing to clear the throat frequently and having a chronic cough.

Risk factors for COPD include cigarette smoking, secondhand smoke exposure, exposure to smoke from burning fuels, asthma and long-term exposure to lung irritants. While COPD has no cure, its progress and symptoms can be managed. Untreated, COPD may lead to other health complications, including respiratory infections, heart disease, lung cancer and depression. Further, adults with COPD are more likely to miss work than those without COPD. 

Medical costs attributed to COPD were $30 billion in 2010. A 2018 study found the direct and indirect costs for employers to be $6,650 per year for a COPD-afflicted worker, nearly double the amount for a worker without COPD. 

According to America’s Health Rankings, populations with a higher prevalence of COPD include: 

• Women compared with men.
• Adults ages 65 and older. The prevalence increases with age.
• American Indian/Alaska Native and multiracial adults compared with Asian adults.
• Adults with less than a high school education compared with those with higher levels of educational attainment. 
• Adults with an annual household income less than $25,000 compared with adults with higher levels of income. This is likely due to a number of factors, including occupational and environmental hazards, health behaviors and air pollution in lower-income areas. 
• Adults living in non-metropolitan areas compared with those living in metropolitan areas. 
• Adults who have difficulty with self-care compared with adults without a disability.
• Adults who have served in the U.S. armed forces compared with those who have not served. 

The best way to prevent COPD is to never smoke or stop smoking immediately. The American Lung Association (ALA) offers many smoking cessation programs that can aid in preventing COPD. Moreover, the ALA provides COPD management tools to guide those with COPD through developing a treatment plan with their health care provider. 

Other strategies to prevent and/or treat COPD include:

• Avoiding secondhand smoke at home and work.
• Asking physicians about pulmonary rehabilitation, which is a personalized COPD management program that improves an individual’s lifestyle.
• Taking medications that could lessen symptoms like coughing and wheezing.
• Receiving supplemental oxygen therapy.

Healthy People 2030 has multiple goals related to COPD, including:

• Reducing COPD deaths among adults ages 45 and older.
• Reducing emergency visits for COPD among adults ages 45 and older. 
• Reducing hospitalizations for COPD. 

Guarascio, Anthony, Shaunta Ray, Christopher Finch, and Timothy Self. “The Clinical and Economic Burden of Chronic Obstructive Pulmonary Disease in the USA.” ClinicoEconomics and Outcomes Research, June 2013, 235. https://doi.org/10.2147/CEOR.S34321.

Patel, Jeetvan, Anna Coutinho, Orsolya Lunacsek, and Anand Dalal. “COPD Affects Worker Productivity and Health Care Costs.” International Journal of Chronic Obstructive Pulmonary Disease 2018, no. 13 (July 2018): 2301–11. https://doi.org/10.2147/COPD.S163795.

Pleasants, Roy, Isaretta Riley, and David Mannino. “Defining and Targeting Health Disparities in Chronic Obstructive Pulmonary Disease.” International Journal of Chronic Obstructive Pulmonary Disease Volume 11 (October 2016): 2475–96. https://doi.org/10.2147/COPD.S79077.