After heart disease and cancer -- chronic obstructive pulmonary disease (COPD): A critical public health issue

Background: Chronic lower respiratory diseases (CLRD) surpassed stroke as the third leading cause of death in 2008. Chronic obstructive pulmonary disease (COPD) accounted for over 97% of CLRD deaths. COPD's prevalence, associated morbidities, and economic costs have an enormous impact on the healthcare system. Methods: We used data from the National Health Interview Survey, National Hospital Discharge Survey, and National Vital Statistics Reports to present an overview of COPD within the context of chronic lower respiratory diseases. We also examined prevalence and other COPD-related findings from the 2009 North Carolina Behavioral Risk Factor Surveillance System. Results: From 2000 to 2008, CLRD mortality rates declined by only 0.5% in comparison to heart disease (-27.5%), cancer (-12.1%), and stroke (-33.3%). COPD deaths increased by 6% from 2000 (117,440 deaths) to 2007 (124,391 deaths). While COPD hospitalization rates have remained relatively stable from 2000 (23.8 per 10,000 population) to 2006 (22.5 per 10,000 population), the economic burden is notable. In 2010, COPD is projected to cost $29.5 billion in healthcare expenditures, of which $13.2 billion are for hospital care. North Carolina's hospitalization rate in 2009 was 34 per 10,000 population and associated with total charges of over $470 million. Conclusions: Recognition of COPD, a progressive chronic disease as a critical public health issue includes an understanding of its magnitude and burden at both national and local levels. Disease and cost data are available to drive and support community-based programs and state and local policies to prevent and control COPD.