Prevalence of chronic obstructive pulmonary disease (COPD) and the disease's burden varies significantly by state. Understanding this variation could help address public health gaps to ease the burden on people with COPD and the health care system, according to a new study. The study is published in the March 2025 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, a peer-reviewed, open-access journal.
COPD is an inflammatory lung disease, comprising several conditions, including chronic bronchitis and emphysema, and can be caused by genetics and irritants like smoke or pollution. The COPD Foundation estimates that the disease (both diagnosed and undiagnosed cases) affects more than 30 million Americans. It is the fourth leading cause of death worldwide, according to the World Health Organization.
This new study used Medicare fee-for-service, Medicaid, and commercial health insurance claims data to examine COPD prevalence and burden by state and payer type. In 2021, approximately 11.7 million insured people had diagnosed COPD. The study found COPD prevalence at the state level varied widely, with West Virginia having the highest rate (143 per 1,000 insured individuals) and Utah having the lowest rate (44 per 1,000 insured individuals).
The authors also analyzed acute inpatient hospitalizations and emergency department visits in 2021. Nationwide, there were 1.8 million acute inpatient hospitalizations and 1.4 million emergency department visits related to COPD.
The study also examined mortality rates among people with COPD insured under Medicare and found that 12 states (West Virginia, Kentucky, Mississippi, Oklahoma, Alabama, Maine, Louisiana, Arkansas, Indiana, Ohio, Tennessee, and Georgia) and the District of Columbia all had higher than average all-cause mortality rates but lower than average ages.
"Information about people with COPD and their health care utilization is lacking, particularly when examining state level and insurance type data," said Carol Bazell, M.D., MPH, lead author of the study and Principal at Milliman, Inc. "By exploring the variation in COPD prevalence and disease burden across states and payer types, we can better inform public health strategies to help reduce the burden of COPD on both people living with the disease and the health care system."
To access current and past issues of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, visit journal.copdfoundation.org .
