Background Asthma is a highly-prevalent chronic disease. Prevalence and mortality are particularly high in Puerto Ricans living in the US as compared with other populations. Objective To determine asthma mortality rates in Puerto Rico (1980 to 2007) and to assess the socio-demographic variables that may be associated with these rates. Methods Data was obtained from the Vital Statistics Office at the Puerto Rico Department of Health. Crude mortality rates and their 95% confidence intervals were used to evaluate differences between age groups and across years. Mortality risk ratios by socio-demographic variables were estimated using generalized lineal models with a Poisson link function to identify at-risk groups. Results . During the study period, there were 4,232 deaths recorded with asthma as the cause of death. From 1980 to 1998 annual asthma mortality rates fluctuated between 3.32 and 6.56 deaths per 100,000 (Mean 4.77), followed by a decline after implementation of the ICD-10 for reporting cause of death in 1999. Between 1999 and 2007 the mean asthma death rate declined to 3.01 (4.89 in 1999 to 2.02 in 2007). Overall, asthma mortality rates were between 1.77 and 4.0 times higher in Puerto Rico than in the US. Throughout the whole study period, mortality rates were higher in older age groups. In addition, the adjusted regression model for asthma deaths showed that persons divorced or widowed, and persons with only elementary education had significantly higher risk of asthma mortality than their counterparts. Conclusion . Asthma death rates were higher in Puerto Rico than in the US general population. Although asthma mortality in Puerto Rico declined, rates continued to be significantly higher than those recorded in the US. There was a progressive decline in asthma mortality rates after 1999 that may be explained by changes in reporting classification, increased use of corticosteroids, and improved asthma awareness. After controlling for possible confounding variables, age and elementary education were found to increase the risk of mortality due to asthma among Puerto Ricans.
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