Gaps and improvements in the public health surveillance of chronic obstructive pulmonary disease (COPD)

Background: In 2008, chronic lower respiratory diseases—primarily chronic obstructive pulmonary disease (COPD)—became the 3rd leading cause of death. COPD is defined by a diagnosis of either chronic bronchitis or emphysema. Future prevention efforts require an assessment and resolution of the gaps in the national and state-level surveillance of COPD. Methods: We calculated annual estimates of COPD mortality, prevalence, hospitalizations, and office visits from US surveillance systems and state COPD prevalence from North Carolina—one of few states with such data. Surveillance system gaps were identified and solutions proposed. Results: Nationally there were over 123,000 COPD deaths and 12 million individuals identified with COPD in 2007. There were an estimated 670,000 hospitalizations and 16,343,000 office visits for COPD in 2006 in the US. The majority of COPD patients in the US are aged >65 years; Medicare hospitalizations (1995-2006) for COPD clustered in Appalachia and southeastern US. The age-adjusted prevalence of COPD was 5.4% in 2007 among North Carolina adults. Conclusions: National and state surveillance of COPD have improved but several surveillance system gaps remain that impact the ability of public health partners to promote prevention and control programs. This session presentation will discuss surveillance gaps and recent public health partnerships to improve COPD surveillance.