Trends in mortality from chronic obstructive pulmonary disease among U.S. veterans: 1954 to 1979

Recent trends in chronic obstructive pulmonary disease (COPD) mortality are described for a cohort of nearly 300,000 insured veterans who were followed for survival from 1954 through 1979. Death rates from COPD for the veterans by smoking status were compared with U.S. death rates for white males 55 to 84 yr of age over the same period. The main findings were that the veterans experienced sharp increases in COPD mortality over the 26-yr study period, much like the U.S. findings. However, the observed increases were not as great as those for the United States. The COPD rates for veterans who were cigarette smokers showed the same pattern as for all veterans. Some important differences by age were noted. Thus, for ages 60 to 64 and 65 to 69, the direction of the trend among veterans appeared to change from initial increases in the COPD death rate to later decreases while at the same time the three oldest age groups (70-74, 75-79, and 80-84) continued to experience increases in mortality over the whole period. These findings were similar to those for the United States. Several possible explanatory factors for these changes are discussed.