Asthma death rates continue to climb.

Asthma death rates continue to climb

Asthma mortality among children and young adults rose dramatically in the United States during much of the last decade, continuing a trend that began in the late 1970s, a new study finds.

Between 1979 and 1987, asthma death rates almost doubled among 5- to 34-year-olds, rising from 2.2 deaths per million people to 4.2 deaths per million -- an average jump of 6.2 percent each year, say Kevin B. Weiss of George Washington University in Washington, D.C., and Diane K. Wagener of the National Center for Health Statistics (NCHS) in Hyattsville, Md. The increase was largest among children aged 5 to 14 -- rising 10.1 percent annually, they report in the Oct. 3 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. Mortality rates among non-whites also exceeded those for whites throughout the entire period, they found.

"The big question is why this is happening," Weiss says. "Is it because there are more asthmatic children, or because the children out there are sicker?" Perhaps asthmatic children don't visit physicians enough, don't get appropriate treatment, or are breathing more polluted air, the reserchers speculate. But the fact thaat childhood asthma-death rates rose fastest indicates the problem stems from a recent change, Weiss adds.

Earlier studies noted a rise in U.S. asthma mortality rates, but some researchers at the time suggested a 1979 change in disease classification methods accounted for the increase (SN: 1/4/86, p.1). Wagener and Weiss, however, say their study reflects a real increase, not a statistical artifact.

"This pattern is not just a one-time quirk in the data," Wagener says. The death rate "is increasing persistently, and the problem must be addressed." A change in classification or better recognition of asthma as the cause of death might have produced a sudden jump in the mortality statistics, she says, but not the steady increase found in the new study.

The number of children hospitalized for asthma also rose in the early 1980s, mainly among those under age 4, Weiss and Peter Gergen of NCHS report in a separate study, published in the same issue. Since 1979, asthma-hospitalization rates have grown 5 percent a year among newborns to 4-year-olds. Weiss suspects this trend is related to the higher death rates.

Parents should pay closer attention to the warning signs of asthma in their children, Weiss says. These include chronic wheezing, chronic coughing during the night, and refusal to play sports because of difficulty breathing.