Temporal trends in chronic obstructive pulmonary disease mortality in Mexico, 1999-2014

SETTING: Country of Mexico. OBJECTIVE: To determine mortality trends due to chronic obstructive pulmonary disease (COPD) in Mexico between 1999 and 2014. DESIGN: COPD mortality data for persons aged >= 40 years from 1999 to 2014 were obtained from the official website of the Mexican Ministry of Health. Age standardised mortality rates (ASMRs) were calculated, and joinpoint regression analysis was used to identify trends over time. The annual per cent change (APC) was determined for each trend. RESULTS: A total of 313 962 COPD deaths (crude rate 66.3 per 100 000 population) was reported. Between 1999 and 2014, overall ASMRs decreased from 75.5 to 62.2/100 000 (APC 0.6, P = 0.03): from 94 to 74.7 (APC -0.8, P = 0.004) in males and from 59.7 to 51.8 (APC -0.2, P = 0.4) in females. CONCLUSIONS: COPD mortality rates in Mexico are slowly declining overall and among males. The reduction in smoking prevalence over time, and the new cigarette taxes and smoking laws implemented during the study period, have had no immediate impact on mortality. The lack of a decline in COPD mortality among females needs to be further investigated, particularly in rural areas, where the prevalence of biomass smoke exposure remains high.