ABSTRACT
This chapter focuses on the epidemiological approach for studying asthma mortality epidemics. Infectious disease incidence rates can have extreme volatility from year to year, thus causing changes in the mortality rates. This is less often seen with so-called “chronic” diseases. However, the decline in death rates due to coronary heart disease has been shown to be partly due to a decline in the incidence rates since about 1965. A striking increase in asthma mortality was first noticed in England and Wales in the 1960s when asthma mortality showed a sevenfold increase in certain age-groups. Stolley summarized asthma mortality rates by year and by country and also summarized per capita sales of bronchodilator aerosol nebulizers for the same years. Whereas per capita sales were generally higher in England and Wales (an epidemic country) than in the United States (a nonepidemic country), the United States (nonepidemic) and New Zealand (epidemic) had similar consumption rates.
