ASTHMA MORTALITY - THE WORLDWIDE RESPONSE

All over the world, but especially in western countries, there has bee n a rise in asthma mortality. Air pollution, increasing concentrations of house dust mite allergen, poverty, limited access to adequate medi cal care among urban minorities, inappropriate use of Pz-adrenergic ag onists and underutilization of disease-modifying antiinflammatory ther apies have been among the most frequently postulated causes for this w orrisome trend(1-4). This has occurred despite continued gains in our understanding of the underlying inflammatory nature of this disease. I ndeed, increasing asthma mortality is a paradox, since the mortality o f all other non-malignant chronic illnesses has declined with advances in understanding and treatment(5). Table 1 makes some international c omparisons for the year 1980. During the past 10 years many countries have begun to fight back against the rising tide of asthma deaths. The barriers that limit an asthmatic's access to urgent health care, ther apeutic drugs, and preventive measures all stem from an individual sou rce-namely, lack of adequate patient, family and health-professional e ducation. In this paper we focus on the predicament of their response and the progress they have made.