Changing patterns of asthma mortality: identifying target populations at high risk

Correct analysis of trends in diseases and mortality requires careful work. Sometimes, the apparent increase in a disease might reflect improvements in its recognition and diagnosis, rather than a real increase in incidence. However, this does not appear to be the case for the increase in deaths due to asthma, which occurred during the 1980s. Almost 10 million Americans are affected by asthma; children, blacks, and the poor are disproportionately affected. (The rate of asthma among blacks is twice that of whites.) An analysis of the US Vital Records from 1968 through 1987 revealed a 7.8 percent annual decline in asthma-related mortality in children and young adults during the 1970s. This decline was more rapid among women and nonwhites. However, the 1980s witnessed a reversal of this trend when asthma deaths increased at a rate of 6.2 percent per year. Children seemed to suffer the most; the mortality rate for those under 15 years of age rose more rapidly than for patients between 15 and 34. The increased mortality rates seem to be similar for whites and nonwhites. However, the distribution of the increase in mortality is not geographically uniform. Much of the nation's asthma mortality can be accounted for by increases in New York City and Cook County, Illinois (the Chicago area). The mortality rate for asthma in New York City was 10.1 per million population between 1982 and 1985, almost three times that of the nation as a whole. Only mortality data was included in this study; it is not known if other health problems related to asthma have shown a similar increase over the past decade. (Consumer Summary produced by Reliance Medical Information, Inc.)