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.
5 affiliations
- 1Department of Cardiothoracic Surgery, The Affiliated Hospital of Jiaxing University, Jiaxing, China.
- 2Department of Medical Administration, The Affiliated Hospital of Jiaxing University, Jiaxing, China.
- 3Department of Blood Transfusion, The Affiliated Hospital of Jiaxing University, Jiaxing, China.
- 4College of Rehabilitation and Health Care, Hunan Traditional Chinese Medical College, Zhuzhou, China.
- 5Department of Clinical Laboratory, The Affiliated Hospital of Jiaxing University, Jiaxing, China.
Abstract
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.
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BibTeX
@article{sun2026trends,
title = {{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.}},
author = {Yu Sun and Shu Li and Dan Xu and Yao Li and Wei Li},
journal = {Tobacco induced diseases},
year = {2026},
month = oct,
doi = {10.18332/tid/228906},
url = {https://europepmc.org/article/MED/42898698},
note = {CC BY},
}
RIS
TY - JOUR
TI - 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.
AU - Yu Sun
AU - Shu Li
AU - Dan Xu
AU - Yao Li
AU - Wei Li
PY - 2026
DA - 2026/10/16
JO - Tobacco induced diseases
DO - 10.18332/tid/228906
UR - https://europepmc.org/article/MED/42898698
AB - 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.
SN - 2070-7266
SN - 1617-9625
ER -