US asthma mortality: 1941 to 1989

Area of Science:

• Epidemiology
• Public Health
• Respiratory Medicine

Background:

• Asthma mortality in the United States has significantly increased over the past decade.
• Understanding long-term trends in asthma mortality is crucial for identifying high-risk populations and potential causes.

Purpose of the Study:

• To examine long-term trends in United States asthma mortality from 1941 to 1989.
• To identify demographic groups at higher risk for asthma-related death.
• To explore potential etiological factors contributing to asthma mortality trends.

Main Methods:

• Analysis of United States vital statistics data for asthma deaths in individuals aged 5 to 34 years.
• Data collection spanned from 1941 through 1989.
• Age-adjusted, race-specific, and sex-specific mortality rates were calculated using the 1989 US population as a standard.

Main Results:

• Three distinct periods of asthma mortality were observed: 1941-1964 (gradual increase for nonwhites), 1965-1977 (marked decline for all), and 1978-1989 (near doubling for all).
• Nonwhites consistently had 4 times higher mortality rates than whites.
• Nonwhite males aged 15-34 were identified as the highest-risk group. Mortality rates were higher in the 15-34 age group compared to younger children.
• Gender disparities in mortality rates shifted over time.

Conclusions:

• Significant disparities in asthma mortality exist between racial groups and age demographics.
• The 4-fold higher mortality rate in nonwhites compared to whites, despite lower prevalence, warrants further investigation.
• Understanding the factors behind the 1967-1977 decline may provide insights into the subsequent rise in asthma mortality.