Australian Institute of Health and Welfare (2020) Chronic obstructive pulmonary disease (COPD), AIHW, Australian Government, accessed 30 November 2022.
Australian Institute of Health and Welfare. (2020). Chronic obstructive pulmonary disease (COPD). Retrieved from https://www.aihw.gov.au/reports/chronic-respiratory-conditions/copd
Chronic obstructive pulmonary disease (COPD). Australian Institute of Health and Welfare, 25 August 2020, https://www.aihw.gov.au/reports/chronic-respiratory-conditions/copd
Australian Institute of Health and Welfare. Chronic obstructive pulmonary disease (COPD) [Internet]. Canberra: Australian Institute of Health and Welfare, 2020 [cited 2022 Nov. 30]. Available from: https://www.aihw.gov.au/reports/chronic-respiratory-conditions/copd
Australian Institute of Health and Welfare (AIHW) 2020, Chronic obstructive pulmonary disease (COPD), viewed 30 November 2022, https://www.aihw.gov.au/reports/chronic-respiratory-conditions/copd
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COPD is a major leading cause of death in Australia. In 2018, 7,113 people were recorded as having died from COPD (3,783 men and 3,330 women) making it the fifth leading cause of death after coronary heart disease, dementia and Alzheimer disease, cerebrovascular disease, and lung cancer.
Underlying cause of death
Coronary heart disease (I20─I25)
Dementia and Alzheimer disease (F01, F03, G30)
Cerebrovascular disease (I60─I69)
Lung cancer (C33, C34)
Source: AIHW analysis of the AIHW National Mortality Database.
It is worth noting that COPD is more likely to be reported as an associated cause of death rather than the underlying cause of death. In 2018, there were 11,385 deaths where COPD was listed as an associated cause in addition to the 7,113 deaths where COPD was listed as the underlying cause.
The statistics presented here relate to deaths where COPD was listed as the underlying cause of death. For information on long-term trends, see General Record of Incidence of Mortality (GRIM) books. For more information on how deaths are registered, coded and updated, see Deaths data.
In Australia, the COPD mortality rate among men aged 45 and over decreased dramatically by almost two thirds between 1980 and 2006, from 228 to 84 per 100,000 population, and then fluctuated between 2007 and 2013. After that, it dropped slightly from 2014 (91 per 100,000 population) to 2018 (76 per 100,000 population). Over the same period, the mortality rate for women aged 45 and over fluctuated, with the lowest at 39 per 100,000 population in 1980 and highest at 66 per 100,000 population in 1996.
The main risk factor for the development and progression of COPD is smoking, with smokers being 12 to 13 times more likely to die from COPD than non-smokers (U.S. Department of Health and Human Services 2014). The improvements in COPD mortality rates are expected to follow improvements in smoking rates, with a time-lag between smoking and COPD mortality. This is because chronic conditions, such as COPD, have a long latency period, that is, smoking early in life is involved in initiating disease processes prior to disease diagnosis (Lynch & Smith 2005). In Australia, the smoking rate of adults aged 18 and over decreased dramatically from 1980 to 2016 (men: 41% to 16%; women: 30% to 12%) (Scollo & Winstanley 2019).
As shown in Figure 1, smoking rates in Australia have decreased from 1980 onwards among both among men and women, with men having consistently higher smoking rates than women (Scollo & Winstanley 2012). For more information on the history of smoking and COPD, see Mortality from asthma and COPD in Australia, which presents detailed analysis of COPD mortality for the period 1965 to 2010.
Sources: AIHW analysis of AIHW National Mortality Database, Scollo & Winstanley 2019 (Data table).
COPD mortality rates are higher for people living in remote areas and for people living in lower socioeconomic areas (AIHW: Poulos et al. 2014). In 2018, the COPD mortality rate for those aged 45 and over living in Remote and very remote areas (103 deaths per 100,000 population) was 1.9 times as high as the rate for those living in Major cities (54 deaths per 100,000 population). Meanwhile, the COPD mortality rate for this same age group in the lowest socioeconomic areas (102 deaths per 100,000 population) was 2.8 times as high as the rate in the highest areas (36 deaths per 100,000 population).
COPD mortality rates are also higher for Indigenous Australians. In the 5-year period from 2014 to 2018, 835 Aboriginal and Torres Strait Islander people aged 45 and over died from COPD, with a mortality rate of 114 per 100,000 population, based on the five jurisdictions with adequate Indigenous identification (NSW, Qld, WA, SA and NT). After adjusting for differences in age structure, for people aged 45 and over, the mortality rate of COPD among Indigenous Australians (189 per 100,000 population) was 2.7 times as high as the non-Indigenous Australians rate (70 per 100,000 population).
The differences between these population subgroups may be due to differences in smoking rates, access to health services, or other factors. Smoking rates are higher among people living in more remote areas, among people living in areas of lower socioeconomic area, and among Indigenous Australians (AIHW 2018).
For more information about COPD mortality rates among Indigenous Australians, see Coronary heart disease and chronic obstructive pulmonary disease in Indigenous Australians.
Burden of disease measures the gap between the ideal of living to old age in good health, and the current situation where healthy life is shortened or lost by illness, injury, disability and death (AIHW 2019a). It combines health loss from living with illness and injury (non-fatal burden, or years lived with disability [YLD]) and dying prematurely (fatal burden, or years of life lost [YLL]) to estimate total health loss (total burden, or disability-adjusted life years [DALY]). One DALY is one year of 'healthy life' lost due to illness and/or death.
In Australia, COPD accounted for over half (51%) of the total burden of disease due to respiratory conditions and 3.9% of the total disease burden in 2015 (AIHW 2019a). Between 2003 and 2015, there was a 6.0% decrease in the total disease burden due to COPD.
Overall, COPD was the third leading specific cause of total disease burden. COPD is the leading cause of total burden in women aged 65–74 (22.6 DALYs per 1,000 population), and the second leading cause of total burden in men aged 65–74 (33.2 DALYs per 1,000 population) and 75–84 (54.3 DALYs per 1,000 population). The total disease burden due to COPD was split fairly evenly between non-fatal burden (51%) and fatal burden (49%) in 2015 (AIHW 2019a).
For both men and women, the rate of total burden (DALY) increased with age, peaking at ages 85–94 then decreasing. The rate of fatal burden (YLL) followed a similar pattern. However, the rate of non-fatal burden (YLD) for men was highest among those aged 75–84 (Figure 2).
The bar chart shows the rate of total burden (DALY) due to COPD by sex and age in 2015. For both men and women, the DALY due to COPD increased with age, peaking at ages 85–94 then decreasing.
The disease burden due to COPD varies in different population groups. The COPD DALY rate in Remote and very remote areas was 1.3 times as high as in Major cities. Meanwhile, the COPD DALY rate in the lowest socioeconomic area was 1.8 times as high as in the highest group.
The bar chart shows the rate of total burden (DALY) due to COPD by remoteness in 2015. The DALY due to COPD in Remote and very remote areas was 1.3 times as high as in Major cities.
The bar chart shows the health expenditure on COPD in 2015–16. In general, COPD cost the Australian health system an estimated $977 million. Among them, $536 million for hospitals, $189 million for non-hospital medical services, and $252 million for pharmaceuticals.
Australian Institute of Health and Welfare (AIHW): Poulos LM, Cooper SJ, Ampon R, Reddell HK & Marks GB 2014. Mortality from asthma and COPD in Australia. Cat. no. ACM 30. Canberra: AIHW.
AIHW 2018. Australia's health 2018, Chapter 4 Determinants of health. Australia's health series no. 16. Cat. no. AUS 221. Canberra: AIHW.
AIHW 2019a. Australian Burden of Disease Study 2015: Interactive data on disease burden. Australian Burden of Disease Cat. no. BOD 24. Canberra: AIHW.
AIHW 2019b. Disease expenditure in Australia. HWE 76. Canberra: AIHW. Viewed 13 June 2019.
Lynch J & Smith GD 2005. A life course approach to chronic disease epidemiology. Annual Review Public Health 26: 1-35.
Greenhalgh EM, Bayly M & Winstanley MH 2019. 1.3 Prevalence of smoking—adults. In Scollo MM and Winstanley MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria.
U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Viewed 3 March 2020.
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