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June 7, 1995

Pulmonary and Critical Care Medicine

Author Affiliations

University of Kansas Medical Center, Kansas City

JAMA. 1995;273(21):1717-1718. doi:10.1001/jama.1995.03520450087045

Asthma is a chronic lung disease characterized by increased airway responsiveness to a variety of stimuli, airways inflammation, and recurrent airways obstruction that is reversible spontaneously or in response to appropriate treatment but not completely reversible in some patients. Despite substantial gains in understanding its pathophysiologic features and in developing effective therapy, deaths due to asthma are increasing. Asthma mortality has increased not only in the United States but also across the world. Rates of death due to asthma increased from 0.8 per 100000 in 1977 to 1.9 in 1990 and 2.1 in 1991.1 In fact, not only is mortality increasing but hospitalization for asthma, emergency department visits, and the general prevalence of the disorder are also on the rise.2 The reasons are not known with certainty, but several explanations appear likely. Exposure to indoor and outdoor allergens is increased.3 Socioeconomic conditions, such as poverty in minority

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