An analysis of 2011 Behavioral Risk Factor Surveillance System (BRFSS) data by CDC showed that in all 50 states, the District of Columbia, and Puerto Rico, 6.3% of BRFSS respondents reported a diagnosis of chronic obstructive pulmonary disease (COPD) by a health professional. The results were reported by CDC in the November 23 Morbidity and Mortality Weekly Report (MMWR). 2011 was the first year in which CDC included a COPD module in the BRFSS questionnaire, in order to determine state-specific and other demographic prevalences of the disease.
COPD prevalences varied substantially by state/territory (from <4% in Puerto Rico, Washington, and Minnesota to >9% in Alabama and Kentucky), with a median prevalence by state of 5.8% (range 3.1–9.3%). CDC reported that states concentrated along the Ohio and lower Mississippi rivers were in the highest quartile for COPD prevalence (see figure in MMWR report).
For the 39,038 BRFSS respondents with COPD in all states, 36.4% were former smokers, 38.7% were current smokers, and 43.7% had a history of asthma. Among respondents reporting COPD and completing the module, 76.0% said they had been given a diagnostic breathing test, 64.2% indicated that shortness of breath impaired their quality of life, and 55.6% said they took at least one daily medication for COPD.
The median age-adjusted percentage of COPD respondents who reported having a breathing test was 73.6% (range from 57.3% in Puerto Rico to 81.2% in Nevada). Non-Hispanic black (80.2%) and non-Hispanic white (71.7%) respondents were more likely to report having a breathing test than Hispanic respondents (58.5%). Prevalence of having a breathing test also was higher among those who were unable to work (82.2%) than among employed adults (67.2%) and among adults with a history of asthma (81.4%) than among those without asthma (61.9%). Breathing test prevalence did not differ among respondents by sex, education level, household income, marital status, or smoking status.
In an editorial note accompanying the MMWR report, CDC stated: "The overall prevalence of COPD and its associations with health-care utilization and quality of life make it a serious public health burden that needs to be addressed, especially in areas where the prevalence remains well above the national average."
The agency further stated the critical need for continued COPD surveillance at state and local levels to (1) identify areas that would reap the greatest benefit from awareness and outreach campaigns and (2) evaluate the effectiveness of public health efforts (such as the National Heart, Lung, and Blood Institute's COPD Learn More Breathe Better campaign) regarding COPD prevention, treatment, and control.