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JAMA editorial: Big data on COPD shows the need for big changes to US public health infrastructure

Chronic Obstructive Pulmonary Disease (COPD) is the third-leading cause of death in the United States, yet few Americans are aware of its toll on the population. Every November, COPD Awareness Month passes without the flurry of media coverage, awareness ribbons, and and fundraising merchandise that attends days dedicated to cancer or heart disease. Yet the data is irrefutable – COPD is a problem with which America must reckon sooner rather than later, contend two University of Kentucky scholars who authored an editorial in the Journal of the American Medical Association (JAMA), systemic change is needed to address the issue.

 

Dr. David M. Mannino, former chair of Preventive Medicine and Environmental Health at the University of Kentucky College of Public Health (now with GlaxoSmithKline and the UK College of Medicine), and Dr. Wayne T. Sanderson, professor of Epidemiology in the UK College of Public Health, are the authors of an editorial appearing alongside the new Dywer-Lindgren, et al., study in JAMA. Mannino and Sanderson note that “unlike other leading causes of death, COPD has not seen the improvements in mortality and morbidity that have been a result of large-scale public health campaigns focused on improving recognition of early symptoms, community screening efforts, and chronic disease self-management education. To bring about these improvements, COPD must be embedded in the public health infrastructure of the nation.”

 

Citing the findings of Dwyer-Lindgren et al., which are drawn from “big data” analyzing 80,000,000 deaths across the US over a period of time from 1980 to 2014, Mannino and Sanderson cite the multifactorial nature of the COPD epidemic. They note the intersections of occupational and environmental exposures, tobacco use, poverty, and health care access issues impacting populations disproportionately affected by COPD and other respiratory diseases. Mannino and Sanderson further outline proposed interventions to identify, treat, and ultimately prevent COPD.

 

The complete editorial appears in the September 26, 2017, issue of JAMA.