MMWR Morb Mortal Wkly Rep

During 2009\u20132011, higher death rates for COPD among persons aged 6555 years were associated with more rural localities, with rates increasing steadily from the least to the most rural county. For males, the age-adjusted COPD death rate in rural counties was 59% higher than in large central metropolitan counties (284.3 versus 178.9 deaths per 100,000 population). For females, the age-adjusted COPD death rate in rural counties was 39% higher than in large central metropolitan counties (193.6 versus 139.3 deaths per 100,000 population). COPD death rates for males were 21% to 47% higher than for females, with the largest differentials observed in nonmetropolitan counties (i.e., town/city and rural counties).Sources: National Vital Statistics System. County-level mortality file. Available at http://www.cdc.gov/nchs/deaths.htm and http://wonder.cdc. gov/mortsql.html.Ingram DD, Franco SJ. 2013 NCHS urban-rural classification scheme for counties. Vital Health Stat 2014;2(166). Available at http://www.cdc.gov/ nchs/data/series/sr_02/sr02_166.pdf.Reported by: Deborah D. Ingram, PhD.2014PMC5779485727