A Multiple Cause-of-Death Analysis of Asthma Mortality in the United States, 1990–2001
- 1 January 2005
- journal article
- Published by Informa UK Limited in Journal of Asthma
- Vol. 42 (9), 757-763
- https://doi.org/10.1080/02770900500308189
Abstract
Most analyses of asthma mortality in the United States have relied solely on underlying cause-of-death data, which may underestimate the magnitude of asthma-related mortality. We used multiple cause-of-death data to examine asthma-related mortality trends in the United States. Data were selected from the United States Multiple Cause-of-Death Files, 1990-2001. Mortality rates and 95% confidence intervals were computed to examine differences in asthma mortality over time and by age, race/ethnicity, and gender. Location of death and seasonal variations in asthma mortality were also assessed, as well as the impact of seasonal respiratory infections. We identified 135,668 asthma-related deaths in the United States over the 12-year period, representing an age-adjusted mortality rate of 4.4 per 100,000. Only 45% of the asthma-related deaths had asthma recorded as the underlying cause. Whites and older adults were less likely to have asthma listed as the underlying cause. Asthma mortality rates mirrored underlying cause trends, increasing slightly between 1990 and 1995, declining between 1996 and 1998, and further declining after International Classification of Disease (ICD)-10 implementation in 1999. Mortality was highest among blacks and the elderly and was higher among females than males. Asthma-related deaths peaked in the winter months and were over four times more likely than non-asthma deaths to have acute upper respiratory infections, influenza, or acute bronchitis listed on the death record. The proportion of asthma-related deaths occurring outside a medical setting increased steadily over the period, from 23.3% in 1990 to 29.4% in 2001. The burden of asthma may be underestimated by relying solely on underlying cause-of-death data. Further research is needed to determine the reasons for the steady increase in out-of-hospital deaths and the continued demographic disparities in mortality.Keywords
This publication has 38 references indexed in Scilit:
- Psychological, social and health behaviour risk factors for deaths certified as asthma: a national case-control studyThorax, 2002
- Are Asthma Medications and Management Related to Deaths from Asthma?American Journal of Respiratory and Critical Care Medicine, 2001
- Decreases in asthma mortality in the United StatesAnnals of Allergy, Asthma & Immunology, 2000
- A confidential enquiry into certified asthma deaths in the North of England, 1994–1996: influence of co-morbidity and diagnostic inaccuracyRespiratory Medicine, 1999
- Risk factors for asthma deaths: a population-based, case-control studyAustralian and New Zealand Journal of Public Health, 1999
- Virus-induced Airway Hyperresponsiveness and AsthmaAmerican Journal of Respiratory and Critical Care Medicine, 1998
- Stabilization of Asthma MortalityAnnals of Allergy, Asthma & Immunology, 1997
- Exposure to an Aeroallergen as a Possible Precipitating Factor in Respiratory Arrest in Young Patients with AsthmaNew England Journal of Medicine, 1991
- A case-control study of deaths from asthma.Thorax, 1986
- Physiologic and Psychological Characteristics Associated With Deaths due to Asthma in ChildhoodPublished by American Medical Association (AMA) ,1985