Reflections on the Rise in Asthma Morbidity and Mortality

Morbidity and mortality for asthma appear to be on the increase in the United States and many other Western countries.¹⁻⁷The prevalence of this common condition may also be increasing.⁸,⁹These trends are worrisome, because they come at a time when morbidity and mortality from many chronic diseases are decreasing, when we think we have a fairly sound understanding of the pathophysiology of asthma, and when we believe we have more effective drugs for its management. Asthma mortality rates declined in the United States and Canada from 1965 through 1978 and then started to rise again. From 1980 to 1987, total deaths from asthma in the United States increased from 2891 to 4360.3 This represents a 31% increase in the death rate, from 1.3/100 000 population to 1.7/100 000. The rate for females increased more rapidly than the rate for males, and death rates were generally higher for