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Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

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1. In this retrospective analysis of mortality data from a number of national databases, the mortality rates from respiratory diseases increased between 1980 and 2014.

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2. The mortality rates for individual respiratory diseases showed significant variation over time when examined by county and sex.

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Evidence Rating Level: 3 (Fair)

Study Rundown:

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A recent estimate in 2015 suggested that 6.7% of all deaths in the US were due to respiratory diseases, representing the 5th leading cause of death and 8th leading cause of health burden overall. However, significantly less has been reported about how mortality rates due to individual respiratory diseases have changed on a county to county basis. In this retrospective analysis of many national mortality registries, it was found that respiratory disease mortality rates have increased overall from 1980 to 2014 with significant variation in mortality rates by county. Of all respiratory diseases, COPD caused the greatest number of mortalities followed by interstitial lung disease and pulmonary sarcoidosis, asthma, other chronic respiratory disease, and pneumoconiosis. In addition, COPD mortality rates for males declined over this period while mortality rates for females increased by a much greater amount. Overall, this curation of data may help to reveal trends in lung disease that could lead to better public health interventions and prevention strategies.

In-Depth [cross-sectional study]:

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From 1980 to 2014, there were an estimated 177.3 thousand (CI95 172.8 to 182.2) deaths due to respiratory disease according to data from the National Center for Health Statistics, US Census Bureau, and Human Mortality Database. COPD accounted for 85.3% of respiratory disease deaths with the highest COPD mortality rates in Central Appalachia and the Southern US west to Colorado while the lowest rates were found near Washington, DC, New York City, New York, and San Francisco, California. Overall, COPD mortality in men declined by 10.9% while COPD mortality in women increased by 107.4%. Interstitial Lung Disease and Pulmonary Sarcoidosis made up 10.3% of respiratory disease deaths with the highest mortality rates in Southwest, Northern Great Plains, New England, and South Atlantic region while the lowest rates were in parts of Colorado, Nevada, Texas, South Dakota, and Florida. Asthma made up 2.2% of all respiratory deaths with the highest mortality rates in southern half of the Mississippi River, Georgia, and South Carolina. Pneumoconiosis made up 0.9% of respiratory disease deaths with the highest mortality rates in central Appalacia and parts of Mississippi, Colorado, Utah, and Montana. Overall, there were increases in the mortality rates for COPD (30.8%; CI95 25.2-39.0%), Interstitial Lung Disease and Pulmonary Sarcoidosis (100.5%; CI95 5.8 to 155.2%), and other chronic respiratory diseases (42.3%; CI95 32.4 to 62.8%) and declined for asthma (46.5%; CI95 27.0 to 51.8%) and pneumoconiosis (48.5%; CI95 38.7 to 53.7%).

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