Tobacco induced diseases · 2026
Trends, cross-country inequalities and risk factors in the global burden of chronic obstructive pulmonary disease mortality, 1990-2021: a secondary data analysis of the Global Burden of Disease Study 2021.
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Sun Yu, Li Shu, Xu Dan, Li Yao, Li Wei
Аннотация
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Understanding the mortality trends and influencing factors of chronic obstructive pulmonary disease is crucial for addressing systemic health disparities and informing fair decision-making.
METHODS: This is a secondary data analysis based on the Global Burden of Disease Study 2021. The mortality burden of COPD from 1990 to 2021 was evaluated using decomposition analysis, risk factor analysis, health inequality analysis, and the autoregressive integrated moving average (ARIMA) prediction model.
RESULTS: Globally, COPD deaths increased from 2495513.45 (95% UI: 2238986.25-2694755.05) in 1990 to 3719936.55 (95% UI: 3347912.32-4084218.2) in 2021, while the age-standardized mortality rate per 100000 population (ASMR) decreased from 71.92 (95% UI: 64.47-77.53) to 45.22 (95% UI: 40.61-49.7). Significant reductions in ASMR were observed in high and high-middle sociodemographic index (SDI) regions, whereas low and low-middle SDI regions saw minimal improvements. The highest ASMRs were noted in Oceania, South Asia, and East Asia. Risk factors such as environmental/occupational risks, air pollution, and tobacco use remained significant contributors to COPD mortality. Gender disparities were evident, with males having higher ASMRs than females, particularly after the age of 60 years. Cross-country health inequalities worsened, with the concentration index indicating a shift towards greater burden in low SDI countries. The future forecast indicated that ASMR will continue to decrease to 19.97 (95% CI: 10.98-28.96) by 2051.
CONCLUSIONS: Despite overall improvements in COPD mortality rates, the increasing total number of deaths underscores the challenges posed by demographic shifts and health inequalities. Differentiated prevention and control strategies targeting low SDI regions, with attention to gender and older population differences, are needed to address key risk factors and reduce health inequalities.
METHODS: This is a secondary data analysis based on the Global Burden of Disease Study 2021. The mortality burden of COPD from 1990 to 2021 was evaluated using decomposition analysis, risk factor analysis, health inequality analysis, and the autoregressive integrated moving average (ARIMA) prediction model.
RESULTS: Globally, COPD deaths increased from 2495513.45 (95% UI: 2238986.25-2694755.05) in 1990 to 3719936.55 (95% UI: 3347912.32-4084218.2) in 2021, while the age-standardized mortality rate per 100000 population (ASMR) decreased from 71.92 (95% UI: 64.47-77.53) to 45.22 (95% UI: 40.61-49.7). Significant reductions in ASMR were observed in high and high-middle sociodemographic index (SDI) regions, whereas low and low-middle SDI regions saw minimal improvements. The highest ASMRs were noted in Oceania, South Asia, and East Asia. Risk factors such as environmental/occupational risks, air pollution, and tobacco use remained significant contributors to COPD mortality. Gender disparities were evident, with males having higher ASMRs than females, particularly after the age of 60 years. Cross-country health inequalities worsened, with the concentration index indicating a shift towards greater burden in low SDI countries. The future forecast indicated that ASMR will continue to decrease to 19.97 (95% CI: 10.98-28.96) by 2051.
CONCLUSIONS: Despite overall improvements in COPD mortality rates, the increasing total number of deaths underscores the challenges posed by demographic shifts and health inequalities. Differentiated prevention and control strategies targeting low SDI regions, with attention to gender and older population differences, are needed to address key risk factors and reduce health inequalities.