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Report shows increasing rate of COPD in women

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Women are 37% more likely to have chronic obstructive pulmonary disease than men and now account for more than half of all deaths attributed to COPD in the United States, according to a report by the American Lung Association.

The association’s latest health disparity report, “Taking Her Breath Away: The Rise of COPD in Women,” examines the nation’s third-leading cause of death and its increased prevalence among women.

More than 7 million women in the U.S. have COPD, and millions more have symptoms but have yet to be diagnosed. The number of deaths among women from COPD has more than quadrupled since 1980, and since 2000 the disease has claimed the lives of more women than men in the U.S. each year.

“What we now know is that more women than men in this country are dying from COPD — and nearly half of women currently living with COPD don’t even know they have it,” MeiLan Han, MD, medical director of the Women’s Respiratory Health Program at the University of Michigan Health System, and national spokesperson for the report, said in a news release.

“It’s what we do with this knowledge that will help determine the fate of millions. Leadership in public health and healthcare at the national, state and local levels must urgently confront this deep-rooted and deadly disease head-on.”

Only heart disease and cancer kill more Americans than COPD, according to the news release. Smoking is the primary cause of COPD, but there are other important causes such as air pollution.

The report identifies an interplay of risk-factor exposures, biological susceptibility and sociocultural factors contributing to COPD’s disproportionate burden on women.

Foremost, the rise of COPD in women is closely tied to the success of tobacco industry marketing. Cigarette smoking was rare among women in the early 20th century, but started increasing in earnest in the late 1960s after the tobacco industry began aggressively targeting its products specifically to women. While nationwide anti-tobacco campaigns and policy changes have successfully decreased smoking rates for both women and men in the recent past, the tobacco industry’s past success in addicting women smokers continues to result in new cases of COPD and other tobacco-related illness in those women as they have aged.

Other key findings include:

• Since COPD historically has been thought of as a “man’s disease,” women are underdiagnosed and undertreated for COPD.

• Women are more vulnerable than men to lung damage from cigarette smoke and other pollutants. Women especially are more vulnerable to COPD before age 65.

• Women with COPD have more frequent disease flare-ups, a sudden worsening of COPD symptoms that often is caused by a cold or other lung infection.

• Effective treatment of COPD is complicated, and women don’t always get the kind of care that meets their needs.

• The quality of life for women with COPD is impaired at an earlier age, and is worse overall than that of men with similar severity of disease.

The American Lung Association calls on government agencies, the research and funding community, insurers and health systems, employers, clinicians, women and their families to take steps to address this deadly disease.

As part of these steps, detailed in the report, the CDC could help strengthen the public health response to COPD by creating and supporting a comprehensive program similar to what already is in place for other major public health problems. Other steps include increased investment in gender-specific COPD research; expanded efforts to protect everyone from harmful exposures that cause COPD, such as cigarette smoke and outdoor air pollution; and implementation of healthcare systems changes to improve the timeliness and quality of COPD care.

Read the report: www.lung.org/assets/documents/publications/lung-disease-data/rise-of-copd-in-women-full.pdf (an executive summary is available at www.lung.org/assets/documents/publications/lung-disease-data/rise-of-copd-in-women-summary.pdf).

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