COPD Trends Brief: Prevalence

View chronic bronchitis, emphysema, and COPD prevalence (number of cases) trends and disparities by age, gender, and race/ethnicity, overlapping diagnoses, underdiagnosis, and state.

Historically, the number of people living with chronic obstructive pulmonary disease (COPD) was based on how many answered yes to having been diagnosed with either chronic bronchitis or emphysema, the two primary components of COPD. Trends and demographic differences for these two diseases are examined before moving on to recent changes in COPD questions and resulting statistics.

Chronic Bronchitis

Prevalence - 2018
  • In 2018, 9.0 million adults, or 3.6% of those ages 18 or older, had chronic bronchitis.
  • Rates were greater among:
    • Non-Hispanic whites compared to other racial and ethnic groups
    • Women compared to men
    • Those ages 65 and older compared to younger age groups

Trends in Chronic Bronchitis by Race/Ethnicity, Sex and Age
  Non-Hispanic  
  Total (2) White Black Other Hispanic
  Number Rate Number Rate Number Rate Number Rate Number Rate
1999 8,847,646 4.4% 7,272,319 4.9% 805,128 3.6% 238,877 3.1% 531,322 2.6%
2000 9,354,982 4.6% 7,680,117 5.1% 922,045 4.0% 186,426 2.2% 566,394 2.7%
2001 11,198,602 5.5% 9,066,921 6.1% 1,193,632 5.2% 258,092 2.9% 679,957 3.1%
2002 9,113,581 4.4% 7,177,946 4.8% 1,081,002 4.6% 225,054 2.5% 629,579 2.8%
2003 8,560,342 4.0% 6,847,649 4.5% 924,572 3.9% 184,526 2.1% 603,595 2.3%
2004 9,047,481 4.2% 7,302,106 4.7% 899,836 3.7% 184,526 1.8% 603,595 2.5%
2005 8,912,375 4.1% 6,953,547 4.5% 1,074,702 4.4% 218,340 2.2% 665,786 2.4%
2006 9,463,082 4.3% 7,315,058 4.7% 1,145,153 4.5% 358,802 3.1% 644,069 2.2%
2007 7,604,098 3.4% 6,008,449 3.9% 843,346 3.2% 249,254 2.0% 503,049 1.7%
2008 9,832,089 4.4% 7,905,680 5.1% 1,023,702 3.9% 272,056 2.2% 630,651 2.1%
2009 9,901,580 4.4% 7,723,276 4.9% 1,073,307 4.0% 291,369 2.3% 819,628 2.6%
2010 9,883,229 4.3% 7,635,860 4.9% 1,127,051 4.1% 242,232 1.9% 878,086 2.7%
2011 10,070,851 4.4% 7,471,900 4.7% 1,332,164 4.9% 324,065 2.4% 942,722 2.9%
2012 8,657,776 3.7% 6,548,082 4.2% 1,042,900 3.7% 277,581 1.9% 789,213 2.3%
2013 8,940,169 3.7% 6,571,132 4.1% 1,181,491 4.0% 290,456 1.7% 897,090 2.3%
2014 8,691,757 3.6% 6,432,295 4.1% 1,258,551 4.4% 355,539 2.3% 645,372 1.8%
2015 9,274,331 3.8% 6,973,289 4.4% 1,223,784 4.2% 254,405 1.5% 822,853 2.2%
2016 8,940,169 3.7% 6,571,132 4.1% 1,181,491 4.0% 290,456 1.7% 897,090 2.3%
2017 8,567,531 3.5% 6,190,270 3.9% 1,169,776 3.9% 378,696 2.1% 828,789 2.1%
2018 9,003,287 3.6% 6,495,241 4.1% 1,125,335 3.7% 387,286 2.1% 995,425 2.4%
 
  Male Female 18-44 45-64 65+
  Number Rate Number Rate Number Rate Number Rate Number Rate
1999 2,661,435 2.8% 6,186,211 5.9% 3,978,344 3.7% 2,962,010 5.1% 1,907,292 5.9%
2000 3,013,616 3.1% 6,341,366 6.0% 3,876,505 3.6% 3,353,176 5.5% 2,125,301 6.5%
2001 3,718,647 3.8% 7,479,955 7.1% 4,913,277 4.5% 4,073,615 6.5% 2,211,710 6.7%
2002 2,891,596 2.9% 6,221,985 5.8% 3,761,235 3.5% 3,563,498 5.5% 1,788,848 5.4%
2003 2,740,594 2.7% 5,819,748 5.3% 3,253,728 2.9% 3,310,933 4.9% 1,995,681 5.8%
2004 2,756,777 2.7% 6,290,704 5.6% 3,483,038 3.2% 3,412,969 4.9% 2,151,474 6.2%
2005 2,886,344 2.8% 6,026,031 5.3% 3,504,174 3.2% 3,543,899 4.9% 1,864,302 5.3%
2006 2,912,124 2.7% 6,550,958 5.8% 3,182,026 2.9% 4,107,558 5.5% 2,173,498 6.1%
2007 2,558,623 2.4% 5,045,475 4.4% 2,515,141 2.3% 3,225,607 4.2% 1,863,350 5.2%
2008 3,120,941 2.9% 6,711,148 5.8% 3,486,419 3.2% 4,251,214 5.5% 2,094,456 5.6%
2009 3,189,161 2.9% 6,718,419 5.7% 3,092,989 2.8% 4,411,101 5.6% 2,403,490 6.4%
2010 3,399,111 3.1% 6,484,118 5.5% 3,265,484 3.0% 4,246,593 5.3% 2,371,152 6.1%
2011 3,316,488 3.0% 6,754,363 5.7% 3,170,362 2.9% 4,355,878 5.4% 2,544,611 6.4%
2012 3,199,371 2.8% 5,458,405 4.5% 2,721,083 2.5% 3,831,239 4.7% 2,105,454 5.0%
2013 3,037,594 2.6% 5,902,575 4.7% 2,264,122 2.0% 4,202,623 5.0% 2,473,424 5.2%
2014 2,993,149 2.6% 5,698,608 4.6% 2,834,778 2.5% 3,600,089 4.4% 2,256,890 5.0%
2015 3,122,615 2.7% 6,151,716 4.9% 2,528,407 2.2% 3,982,192 4.8% 2,763,732 6.0%
2016 3,037,594 2.6% 5,902,575 4.7% 2,264,122 2.0% 4,202,623 5.0% 2,473,424 5.2%
2017 2,556,328 2.1% 6,011,203 4.7% 2,272,295 2.0% 3,782,294 4.5% 2,512,942 5.1%
2018 2,854,929 2.4% 6,148,358 4.8% 2,547,743 2.2% 3,733,816 4.5% 2,721,728 5.3%

Source:
Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey, 1999-2018. Analysis by the American Lung Assocation Research and Program Services Division using SPSS software.

  • (1) Chronic Bronchitis prevalence was defined as answering "yes" to "Have you been told by a doctor or other health professional that you had chronic bronchitis in the past 12 months
  • (2) Due to rounding, numbers across may not sum up to totals.
Adult Prevalence, 1999-2018
  • From 1999 to 2018, chronic bronchitis rates decreased at an average of 1.5 percent per year.

Emphysema

Prevalence - 2018
  • In 2018, 2.0 million adults, or 1.6% of those ages 18 or older, had emphysema.
  • Rates were greater among:
    • Non-Hispanic whites compared to other racial and ethnic groups
    • Men compared to women
    • Those ages 65 and older compared to younger age groups

Trends in Emphysema by Race/Ethnicity, Sex, and Age
  Non-Hispanic  
  Total (2) White Black Other Hispanic
  Number Rate Number Rate Number Rate Number Rate Number Rate
1999 2,798,963 1.4 2,539,202 1.7 117,378 0.5 52,932 0.7 89,451 0.4
2000 3,124,699 1.6 2,792,954 1.9 208,025 0.9 32,847 0.4 90,873 0.4
2001 2,983,598 1.5 2,632,331 1.8 164,628 0.7 55,941 0.6 130,698 0.6
2002 3,131,410 1.5 2,809,643 1.9 197,404 0.8 45,193 0.5 79,170 0.4
2003 3,114,666 1.5 2,798,537 1.8 193,157 0.8 43,126 0.5 79,846 0.3
2004 3,575,684 1.7 3,086,086 2.0 238,734 1.0 95,553 1.0 155,311 0.6
2005 3,791,006 1.7 3,412,355 2.2 192,838 0.8 54,026 0.5 131,787 0.5
2006 4,068,667 1.9 3,619,091 2.3 190,398 0.7 147,078 1.3 112,100 0.4
2007 3,736,000 1.7 3,131,359 2.0 217,083 0.8 125,740 1.0 261,818 0.9
2008 3,789,224 1.7 3,286,507 2.1 214,072 0.8 97,161 0.8 191,484 0.6
2009 4,895,246 2.2 4,232,303 2.7 357,281 1.3 106,044 0.8 199,618 0.6
2010 4,313,991 2.0 3,644,268 2.3 290,143 1.1 148,228 1.2 231,352 0.7
2011 4,680,381 2.0 3,780,946 2.4 489,434 1.8 178,285 1.3 231,716 0.7
2012 4,108,479 1.7 3,508,081 2.2 341,593 1.2 80,765 0.6 178,040 0.5
2013 3,831,063 1.6 3,221,780 2.0 342,232 1.2 94,507 0.6 172,544 0.5
2014 3,399,869 1.4 2,764,697 1.7 295,010 1.0 102,904 0.7 237,258 0.6
2015 3,515,092 1.5 2,991,855 1.9 291,947 1.0 95,685 0.6 135,605 0.4
2016 3,417,624 1.4 2,783,153 1.7 246,033 0.8 146,106 0.8 242,332 0.6
2017 4,313,991 2.0 3,644,268 2.3 290,143 1.1 148,228 1.2 231,352 0.7
2018 3,779,970 1.5 3,028,141 1.9 318,024 1.0 124,408 0.7 309,397 0.8
 
  Male Female 18-44 45-64 65+
  Number Rate Number Rate Number Rate Number Rate Number Rate
1999 1,637,536 1.7 1,161,367 1.1 224,033 0.2 * 936,939 1.6 1,637,991 5.0
2000 1,690,500 1.8 1,434,199 1.4 256,030 0.2 * 1,141,600 1.9 1,727,069 5.3
2001 1,678,868 1.7 1,304,730 1.2 200,259 0.2 * 1,099,638 1.8 1,683,701 5.1
2002 1,821,630 1.8 1,309,780 1.2 287,302 0.3 * 1,271,992 2.0 1,572,116 4.8
2003 1,701,065 1.7 1,413,601 1.3 154,649 0.1 * 1,261,139 1.9 1,698,878 5.0
2004 1,871,241 1.8 1,704,443 1.5 309,071 0.3 * 1,393,431 2.0 1,873,182 5.4
2005 2,060,742 2.0 1,730,264 1.5 340,694 0.3 1,429,606 2.0 2,020,706 5.8
2006 2,481,386 2.3 1,587,281 1.4 290,075 0.3 1,764,620 2.4 2,013,972 5.7
2007 2,017,689 1.9 1,718,311 1.5 226,384 0.2 1,765,325 2.3 1,744,291 4.8
2008 1,769,048 1.6 2,020,176 1.7 222,120 0.2 1,572,766 2.0 1,994,338 5.4
2009 2,578,428 2.4 2,316,818 2.0 369,226 0.3 2,064,627 2.6 2,461,393 6.5
2010 2,247,665 2.0 2,066,326 1.7 360,739 0.3 1,703,187 2.1 2,250,065 5.8
2011 2,128,540 1.9 2,551,841 2.1 365,033 0.3 2,146,121 2.7 2,169,227 5.5
2012 2,293,022 2.0 1,815,457 1.5 292,037 0.3 1,852,778 2.3 1,963,664 4.7
2013 2,093,860 1.8 1,737,203 1.4 220,492 0.2 1,668,645 2.0 1,941,926 4.5
2014 1,622,655 1.4 1,777,214 1.4 98,071 0.1 1,510,560 1.8 1,791,238 4.0
2015 1,891,569 1.6 1,623,523 1.3 194,139 0.2 1,373,621 1.7 1,947,332 4.2
2016 1,871,267 1.6 1,652,779 1.3 178,910 0.2 1,527,235 1.8 1,817,901 3.8
2017 1,703,221 1.4 1,714,403 1.3 130,219 0.1 1,441,855 1.7 1,845,550 3.7
2018 1,970,037 1.6 1,809,933 1.4 249,791 0.2 1,348,951 1.6 2,181,228 4.2

Sources:
Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey, 1999-2018. Analysis by the American Lung Assocation Research and Program Services Division using SPSS software.

  1. Emphysema prevalence was defined as answering yes to"Have you EVER been told by a doctor or other health professional that you had emphysema?"
  2. Due to rounding, numbers across may not sum up to totals.
  3. * Estimate for which the numerator has a relative standard error of more than 30% and should be considered unreliable.
Adult Prevalence, 1999-2018
  • Historically, emphysema has been more common among men than women. However, rates have converged over the last two decades as the rate among men has decreased and the rate among females has increased.

COPD

In 2014, a third question was added, which asked if one had ever been diagnosed with COPD. This may reflect the increased use of COPD as a diagnosis on its own, with no specification of chronic bronchitis or emphysema. In 2019, the three questions were combined into one asking how many people had ever been diagnosed with COPD, chronic bronchitis, or emphysema.

Current Question
  • In 2020, 12.5 million people, or 5.0% of adults, reported a diagnosis of COPD (chronic obstructive pulmonary disease, chronic bronchitis, or emphysema.
  • Rates were greater among:
    • Non-Hispanic whites compared to other racial and ethnic groups
    • Women compared to men
    • Those ages 65 and older compared to younger age groups

Trends in COPD by Race/Ethnicity, Sex and Age
  Non-Hispanic  
  Total (2) White Black Other Hispanic
  Number Rate Number Rate Number Rate Number Rate Number Rate
2019 11,569,331 4.6% 8,892,011 5.6% 1,109,213 3.8% 520,342 2.5% 1,047,766 2.5%
2020 12,544,311 5.0% 9,789,095 6.2% 1,374,106 4.7% 662,997 3.0% 718,114 1.7%
 
  Male Female 18-44 45-64 65+
  Number Rate Number Rate Number Rate Number Rate Number Rate
2019 4,927,122 4.1% 6,642,209 5.1% 1,520,057 1.3% 4,559,776 5.5% 5,489,499 10.3%
2020 5,245,330 4.3% 7,298,981 5.6% 1,699,743 1.5% 4,942,827 6.0% 5,901,742 10.8%

Source:
Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey, 2019-2020. Analysis by the American Lung Assocation Research and Program Services Division using SPSS software.

  1. COPD prevalence was defined as answering yes to "Have you EVER been told by a doctor or other health professional that you had chronic obstructive pulmonary disease, C.O.P.D., emphysema, or chronic bronchitis?"
  2. Due to rounding, numbers across may not sum up to totals.
COPD Trend
  • COPD rates from 2014 to 2018 were flat on average year to year.
  • The large decline in both rates and counts from 2018 to 2019 is presumably due to the change in question format.
  • Neither the increase in COPD rates or counts from 2019 to 2020 were statistically significant.
Underdiagnosis

During 2007-2010, around 8.5 million adults had been diagnosed with COPD, but this may be an underdiagnosis as more than 18 million had evidence of impaired lung function consistent with COPD.

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