Chronic obstructive pulmonary disease in blacks and whites: mortality and morbidity.

Previous reports cite puzzling racial differences in several indicators of chronic obstructive pulmonary disease (COPD). An extensive review of data from the National Center for Health Statistics and from population-based studies confirmed lower overall COPD but higher asthma mortality in blacks compared with whites, and lower chronic bronchitis and emphysema but similar or higher asthma prevalence in blacks compared with whites. The excess of asthma mortality and hospitalization out of proportion to the excess prevalence in blacks may be due to greater disease severity, poorer outcomes of outpatient treatment in blacks than whites, or both. Further investigations of racial differences may enhance understanding of COPD etiology and prevention. Physicians and public health organizations should vigorously strive for smoking prevention and cessation in blacks and whites.