Women are 37 percent more likely to have chronic obstructive pulmonary disease (COPD) than men and now account for more than half of all deaths attributed to COPD in our nation. The American Lung 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 in Indiana and throughout the United States.
More than seven million women in the United States currently 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 this country each year. In Indiana, 251,986 women currently have COPD which is 10.1 percent of the state’s population.
“COPD has become a major women’s health issue, on par with heart disease, breast and ovarian cancer,” said Michael Mark, RN and director of the American Lung Association Lung HelpLine. “These numbers may also reflect in part, a correction of gender bias in the diagnosis of COPD. Studies have demonstrated a tendency to diagnosis women with ‘asthma’ and men with ‘COPD’ in identical clinical situations.”
COPD is a progressive lung disease with no known cure that slowly robs its sufferers of the ability to draw life-sustaining breath. Only heart disease and cancer kill more Americans than COPD does. Smoking is the primary cause of COPD, but there are other important causes such as air pollution.
“Taking Her Breath Away: The Rise of COPD in Women,” 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 deadly products specifically to women.
“The first wave of COPD in women occurred during the second World War, when ‘Rosie the Riveters’ took the place of men in factories and started smoking, spurred by magazine and radio advertising. We are now in the second wave, as the ‘Virginia Slims’ generation has been smoking for over thirty years,” said Mark. 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 success in addicting women smokers long ago is still resulting in new cases of COPD and other tobacco-related illness in those women as they have aged.
Other key findings include:
- Since COPD has historically 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 are especially more vulnerable to COPD before the age of 65.
- Women with COPD have more frequent disease flare-ups—a sudden worsening of COPD symptoms that is often 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 now to address this deadly disease. These steps are detailed in the full report, and include the strengthening of the public health response to COPD including the U.S. Centers for Disease Control and Prevention’s (CDC) creating and supporting a comprehensive COPD program similar to what is already in place for other major public health problems; 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 health care systems changes to improve the timeliness and quality of COPD care.
“Too many women in Indiana are dying from COPD, and this clearly calls for our attention and energy,” states Lew Barfield, chief executive officer of the American Lung Association of the Upper Midwest. “The American Lung Association will continue to lead efforts on the national, state and local levels to help those who suffer, fund research to find a cure and advocate for policies that encourage smokers to quit and prevent youth and adults from starting.”
This report is part of the Lung Association’s Disparities in Lung Health Series.
