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Chronic respiratory disease burden

ENLACE RESPIRATORY DISEASE BURDEN TECHNICAL NOTES ABOUT

 

Chronic respiratory diseases (CRDs) are leading causes of death and disability in the Region of the Americas. CRDs include chronic obstructive pulmonary disease (COPD), asthma, and other chronic respiratory diseases such as occupational lung diseases, and pulmonary hypertension. Tobacco use, household and environmental air pollution, occupational chemicals, and dust are the main risk factors for CRDs.

This visualization shows the level and time trends of mortality and disease burden from CRD by age and sex across countries of the Americas from 2000 to 2019.

Mortality

In the Region of the Americas in 2019, chronic respiratory diseases account for:

  • 534,242 deaths in both sexes,  267,516 (50%) deaths in men and 266,725 (50%) in women.
  • 35.8 deaths per 100,000 population (age-standardized), which was higher in men (42.2 deaths per 100,000) than in women (31.0 deaths per 100,000 population).

The countries with the highest death rate (age-standardized) are:

  1. Honduras: 58.7 deaths per 100,000 population 
  2. Argentina: 55.5 
  3. Haiti: 50.0 
  4. Bolivia: 46.9 
  5. Nicaragua: 43.8 
  6. Uruguay: 42.4 
  7. Guyana: 39.5 

Years of life lost due to premature mortality

Regionwide in 2019, CRDs account for:

  • 8.9 million YLLs in both sexes,  4.7 million years (53%) in men, and 4.2 million years (47%) in women.
  • 670.3 YLLs per 100,000 population (age-standardized), which was higher in men (779.5 years per 100,000) than in women (579.6 years per 100,000 population).

The countries with the highest death rate (age-standardized) are:

  1. Haiti: 1,267.5 years per 100,000 population 
  2. Honduras: 1,085.7
  3. Argentina: 1,023.8
  4. Saint Vincent and the Grenadines: 911.1
  5. Guyana:  895.3
  6. Uruguay: 837.0
  7. Bolivia:  795.1 

Years lived with disability

Regionwide in 2019, CRDs account for:

  • 5.4 million YLDs in both sexes,  2.4 million years (44%) in men and 3.0 million years (56%) in women.
  • 471.4 YLDs per 100,000 population (age-standardized), 450.6 years per 100,000 in men and 491.6 years per 100,000 population in women.

The countries with the highest death rate (age-standardized) are:

  1. United States: 764.2. years per 100,000 population 
  2. Argentina: 423.6
  3. Cuba: 407.2
  4. Uruguay: 379.9
  5. Saint Lucia: 367.0
  6. Haiti: 365.9
  7. Grenada: 358.6
Suggested citation

PAHO. The burden of chronic respiratory diseases in the Region of the Americas, 2000-2019. Pan American Health Organization, 2021.

DATA CLASSIFICATION

In the map and bar chart, the data is presented in five discrete classes created using the quantile classification method. Each class contains 20% of countries, which is easy to interpret. The quintile classes are labeled sequentially from Quintile 1 as the first quintile including the lowest fifth (0 to 20%) of the data to Quintile 5, the fifth quintile representing the class with the highest fifth (80% to 100%) of the data.

MEASURES

Measure names:

Deaths, Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLDs), and Years of Life Lost (YLLs) due to chronic respiratory diseases.

Metric: Rate. 

Unit of Measure: deaths, DALY, YLD, and YLL per 100,000 population.

Topic: Mortality and burden of disease.

Rationale: Measuring how many people die each year and why they died is one of the most important means – along with gauging how diseases and injuries are affecting people – for assessing the effectiveness of a country’s health system. Statistics of causes of death help health authorities evaluate and focalize public health actions.

Disaggregation: Age, Sex, Country, and Year.

Method of estimation: Mortality estimates by cause, age, sex, location (countries, and the region), and year were extracted from the WHO Global Health Estimates (GHE) 2019. These estimates represent WHO's best estimates, computed using standard categories, definitions, and methods to ensure cross-country comparability, and may not be the same as official national estimates. 

Methodological details:

Data sources and methods for estimating causes of deaths and burden of diseases are described in the following documents:

Method of estimation of global and regional aggregates: Global, regional and subregional aggregates were computed by summing the absolute number of the measure (deaths, DALYs, YLDs, YLL) as the numerator and summing the population estimates from the World Population Prospect, produced by the UN Population Division, as denominators for all countries included in the geographic region or subregion. Rates were computed by dividing the aggregated numerator and aggregated population and multiplying the result y 100,000 population. Age-standardized rates were computed by the direct method using the World Standard Population. 

Preferred data sources: Civil registration and vital statistics (CRVS) system with complete coverage and medical certification of cause of death.

This cluster of diseases is not curable; however, treatment can help to control symptoms and improve the quality of life for people living with chronic respiratory diseases (CRDs).

There are several actions that people with CRDs can take to improve their overall health and help control their underlying condition:

  • stop smoking – people with COPD should be offered support to quit smoking;
  • take regular exercise; and
  • get vaccinated against pneumonia, influenza, and coronavirus. 

WHO strategy for the prevention and control of CRDs

CRDs are included in the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases (NCDs) and the United Nations 2030 Agenda for Sustainable Development.

WHO is taking action to extend the diagnosis of and treatment for CRDs.

The WHO Package of Essential Noncommunicable Disease Interventions (PEN) was developed to help improve NCD management in primary health care in low-resource settings. PEN includes protocols for the assessment, diagnosis, and management of chronic respiratory diseases (asthma and chronic obstructive pulmonary disease), and modules on healthy lifestyle counseling, including tobacco cessation and self-care. 

“Rehabilitation 2030” is a new strategic approach to prioritize and strengthen rehabilitation services in health systems. Pulmonary rehabilitation for CRDs, particularly for chronic obstructive pulmonary disease (COPD), is included in the Package of Interventions for Rehabilitation, currently under development as part of this WHO initiative. 

Reducing tobacco smoke exposure is important for both primary prevention of CRDs and COPD and disease management. The Framework Convention on Tobacco Control is enabling progress in this area as are WHO initiatives such as MPOWER and mTobacco Cessation.

  1. WHO. WHO methods and data sources for country-level causes of death 2000-2019. Geneva: World Health Organization; 2020. Available online (accessed 1 February 2021).
  2. WHO. WHO methods and data sources for global burden of disease estimates, 2000-2019. Geneva: World Health Organization, 2020. Available online (accessed 1 February 2021).
  3. PAHO. Methodological Notes, NMH Data Portal. Pan American Health Organization. 2021.
  4. WHO. Factsheet: Chronic Respiratory Diseases. World Health Organization. Available online (accessed 17 June 2021).

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