Sly R M
Children's National Medical Center, Washington, DC.
Ann Allergy. 1994 Sep;73(3):259-68.
Rates of death from asthma in the United States have increased progressively since 1978.
To identify recent trends in asthma mortality.
The National Center for Health Statistics supplied asthma mortality data (ICD 493), and the Bureau of the Census supplied population data that permitted calculation and graphing of mortality data by age group, race, sex, and region and calculation and tabulation of mortality rates by state. The Departments of Health and Vital Statistics of Australia, Canada, Great Britain, and New Zealand provided data that permitted calculation and graphing of rates of death from asthma (ICD 493) in those countries.
Rates of death from asthma in the United States increased from 0.8 per 100,000 in 1977 and 1978 to 2.0 in 1989, fell to 1.9 in 1990 and then increased again to 2.0 in 1991. Rates have been much higher for blacks than whites; age-adjusted rates for blacks increased from 1.5 in 1977 and 1978 to 3.5 in 1991; those for whites, from 0.5 in 1977 to 1.2 in 1991. Rates of death from asthma have increased with age and across time have increased in almost all age groups. The greatest proportional increase has occurred at 10 to 14 years of age with rates of 0.1 in 1979, 0.5 in 1987, and 0.4 in 1991. Rates of death at 5 through 34 years of age have increased for both blacks and whites in all regions of the country. Increases in rates of death from asthma have also occurred in other countries, but rates have been falling in New Zealand since the peak of 8.1 in 1980 and in Australia since the peak of 5.7 in 1989.
The recent plateau in increases in rates of death from asthma in the United States may suggest effectiveness of improved management of asthma that may have followed increased awareness of the importance of optimal management.
自1978年以来，美国哮喘死亡率呈逐步上升趋势。
确定哮喘死亡率的近期趋势。
国家卫生统计中心提供哮喘死亡率数据（国际疾病分类代码493），人口普查局提供人口数据，可据此按年龄组、种族、性别和地区计算并绘制死亡率数据，以及按州计算并列表死亡率。澳大利亚、加拿大、英国和新西兰的卫生与生命统计部门提供的数据可用于计算和绘制这些国家的哮喘死亡率（国际疾病分类代码493）。
美国哮喘死亡率从1977年和1978年的每10万人0.8例增至1989年的2.0例，1990年降至1.9例，随后又增至1991年的2.0例。黑人的死亡率远高于白人；黑人的年龄调整死亡率从1977年和1978年的1.5例增至1991年的3.5例；白人则从1977年的0.5例增至1991年的1.2例。哮喘死亡率随年龄增长而上升，且几乎所有年龄组在不同时期都有所增加。比例增长最大的是10至14岁年龄组，1979年为0.1例，1987年为0.5例，1991年为0.4例。该国所有地区5至34岁黑人及白人的死亡率均有所上升。其他国家哮喘死亡率也出现上升，但新西兰自1980年达到8.1例的峰值后死亡率一直在下降，澳大利亚自1989年达到5.7例的峰值后也在下降。
美国哮喘死亡率近期增长趋于平稳，这可能表明随着对最佳管理重要性认识的提高，哮喘管理得到改善并产生了效果。
