Asthma deaths among coloured and white South Africans: 1962 to 1988

To determine whether death rates from asthma have been rising in South Africa, asthma mortality rates among coloured and white South Africans were calculated from official figures for the years 1962-1988. Sharp increases in the 1960s were noted in both groups. Since the early 1970s whites rates have generally shown a downward trend. In contrast, coloured rates have remained high, with a marked excess of male deaths. In the age stratum 5-34 years, there has been considerable fluctuation, with the long-term trend being slightly downward. Some increase in death rates occurred among the young in the early 1980s, but coloureds in this age group have shown falling rates in the most recent years. Coloured death rates in the younger age stratum have, however, continued to exceed whites rates, although by a decreasing margin, and have been high by international comparison. These group disparities are unlikely to be due to differences in certification or in coding. Variation in prevalence or severity of asthma may explain some of the disparity. However, these group differences, taken with well-known inequalities in medical care, suggest that preventable determinants of asthma deaths related to access to and quality of medical care may be important and accordingly a target for preventive strategies.