in Western North Carolina

Why is chronic lung disease a key health issue in western North Carolina?

The percent of adults  diagnosed with Chronic Obstructive Pulmonary Disease (COPD) is significantly higher in WNC than North Carolina or the United States.

(WNCHN – WNC Healthy Impact Community Health Survey, 2018)

Click on the counties listed in "Change Filter" on top of the chart to select which counties you want to view.

The percent of adults diagnosed with COPD in WNC grew from 13.5% in 2015 to 13.9% in 2018. 

(WNCHN - WNC Healthy Impact Community Health Survey, 2015-2018)

Chronic Lower Respiratory Disease (CLRD) mortality rates have steadily risen from 51.3 in 2002-2006 to 54.1 in 2013-2017 per 100,000 population. 

(N.C. State Center for Health Statistics, 2019)

CLRD includes four chronic lung diseases: chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema, and asthma. 

(Oelsner at al., 2016)

What do the numbers say about chronic lung disease?

Western North Carolina (WNC) Data:

Approximately 14% of adults in WNC have been diagnosed with Chronic Obstructive Pulmonary Disease (COPD). The following adult populations were significantly more likely to have ever been diagnosed with COPD in 2018:

- Women (17.2%)

- Adults aged 40-64 (15.9%) and 65+ (16.9%)

- Very low income (24.3%) 

- Those identifying as either AI/AN (Native American) (26.1%) or Black (23.3%)

(WNCHN – WNC Healthy Impact Community Health Survey, 2018)

Differences in health outcomes across social groups, economic status, and racial/ethnic identity are closely linked with disparities in social determinants of health, which disproportionately burden individuals and communities who experience systemic disadvantage and/or discrimination. See our data story on the social determinants of health to learn more about how the conditions in which people are born, live, work, play, learn, worship, and age can influence their ability to achieve good health for themselves and their families. 

This map shows the mortality rate for chronic lower respiratory disease at the census tract level in western North Carolina from 2012 to 2016.


NC SCHS 2012-2016

Geographic Unit:

Census Tract

Map Produced by:


Chronic Lower Respiratory Disease (CLRD) is listed in the top 6 overall causes of death in all 16 counties in western North Carolina for 2014-2018.

(N.C. State Center for Health Statistics, 2020)

More than 16 million Americans are living with a disease caused by smoking - including chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis.

(CDC, 2018)

The percentage of adults who smoke cigarettes in WNC is similar or slightly higher than the percentage of adults who smoke cigarettes in North Carolina and the United States in 2012, 2015, and 2018. 

(WNCHN – WNC Healthy Impact Community Health Survey, 2018)

Nearly 1 in 5 (17%) adults in WNC have breathed someone else's smoke at work in the past week.

(WNCHN – WNC Healthy Impact Community Health Survey, 2018)

State and National Findings:

In 2015, CLRD, including COPD, accounted for 5,221 deaths in North Carolina. North Carolina ranks 23rd for the highest rate of death due to CLRD. 

(CDC, 2017)

The prevalence of COPD is higher in rural areas nationally, with a rate of 8.2% compared to metro incidence of 4.7%. 

(CDC, 2018)

In 2010, national medical costs attributable to COPD were estimated at $32.1 billion annually. 

(Ford, Murphy, Khavjou, Giles, Holt, & Croft, 2015) 

What did the region say is the story behind the chronic lung disease numbers?

Source: WNCHN - Online Key Informant Survey, 2018

The items below are paraphrased themes that emerged from a 2018 regional survey of key informants. These responses do not necessarily:

    •Reflect accurate or scientifically validated information about health determinants, outcomes, and/or strategies for change, 
    •Represent an exhaustive list of factors that can help or hurt efforts to address this key regional health issue.
The information in this section should be interpreted and used with care. It should be used only to help local health departments and agencies begin to understand community perceptions about local health issues. Communities are strongly encouraged to collect their own, local-level data to inform local planning and evaluation activities.

“Primary care physicians and other professionals are educating patients on this condition and prescribing/treating per evidence-based recommendations.” 

"Extremely limited resources, limited education, and very poor access to care.” 

How is the region prioritizing this issue?

The western North Carolina region includes 17 communities: 16 counties and Eastern Band of Cherokee Indians (EBCI)

In the 2018 CHA cycle, none of the 17 communities chose a priority related to chronic lung disease. 

6 communities prioritized chronic disease. 

Learn more about how counties in western North Carolina work to determine their local community health priorities by watching the video (right). 

What is already happening regionally?

The list below represents a sample of what is happening in the region around this key health issue. Visit for more resources. 

The regional dataset (WNC Healthy Impact Community Health Survey and Online Key Informant Survey) is available thanks to contributions from hospitals in the 16-county region of western North Carolina. Thank you!