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RD-13 Data Details

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RD-13 (Developmental) Increase the proportion of adults with abnormal lung function whose underlying obstructive disease has been diagnosed

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Changed Since the Healthy People 2020 Launch: 
*** Missing ***

Number of adults 45 to 79 years of age with lung function below the lower limit of normal who have ever been diagnosed with emphysema or are still diagnosed with chronic bronchitis


Number of adults 45 to 79 years of age with lung function below the lower limit of normal

Comparable Healthy People 2010 Objective: 
Not applicable
Questions Used to Obtain the National Baseline Data: 

    From the 2007-2008 National Health and Nutrition Examination Survey:


    Has a doctor or other health professional ever told {you/[PERSON]} that [you/s/he]

    • had emphysema
    • had chronic bronchitis?

    {Do you/Does [PERSON]} still have chronic bronchitis?

Data Collection Frequency: 
Methodology Notes: 

    Abnormal lung function is based on a (FEV/FVC) percent less than or equal to 70 in spirometric testing. Participants perform the spirometry test using a spirometer, a device that measures the amount of air a subject exhales and the rate at which he or she exhales the air. The basic standard spirometric test requires the subject to exhale as forcefully as possible after taking in a full, deep breath. Forced Vital Capacity (FVC) is the maximum volume of air exhaled forcefully after a maximal inspiration. Forced Expiratory Volume in One Second (FEV1) is the volume of air exhaled during the first second of a forced expiratory maneuver. Normally, a healthy person can be expected to exhale from 70 to 80 percent of the FVC in the first second of a forced expiration maneuver. In the current NHANES spirometry study, the primary measurement used to assess obstructive lung disorders will be the ratio of forced expiratory volume in 1 second to forced vital capacity expressed as a percentage, or FEV1/FVC%.

    Adults who report being diagnosed with asthma but not emphysema or chronic bronchitis are excluded from this measure based on the definitions of COPD from the American Thoracic Society COPD Guidelines. These guidelines state that asthma differs from COPD in its pathogenic and therapeutic response and should therefore be considered a different clinical entity. However, these guidelines also recognize that COPD and asthma may co-exist in many individuals and that FEV1 does not return to normal after use of bronchodilators in these individuals and frequently worsens over time. By excluding asthma from the definition, it is possible that the proportion of adults with abnormal lung function with an obstructive lung disease diagnosis will be overestimated. Although the prevalence of individuals with asthma and coexisting but undiagnosed obstructive lung disease is believed to be small, it cannot be estimated with available surveillance data. The ATS COPD Guidelines recommend additional research to better discern the prevalence, clinical course and therapeutic response in these individuals.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2015, this objective was archived due to concerns about the percent of the NHANES 2007-10 eligible sample missing spirometry data due to exclusion criteria necessary for population based surveys, which may lead to a biased estimate.


Additional resources about the objective

  1. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease

  2. HHS, NCHS. National Health and Nutrition Examination Survey, 2007-2008, Examination Data Files. Respiratory Health - Spirometry Procedural Manual. Hyattsville, MD: CDC, 2008.
  3. Johannessen A, Lehmann S, Omenaas ER, Elder GE, Bakke PS, Gulsvik A. Post-bronchodilator spirometry reference values in adults and implications for disease management. Am J Respir Crit Care Med 2006;173: 1316–1325.