Asthma is underestimated in mortality statistics that only look at the underlying cause of death. We studied deaths of residents in the Brazilian states of Ceará, Pernambuco, Bahia, Minas Gerais, Rio de Janeiro, São Paulo, and Rio Grande do Sul, as well as total deaths in Brazil, where asthma was recorded in any line or part of the death certificate. Causes of death were processed using the Multiple Cause Tabulator. In Brazil, the death rate increased about 50% when all mentions of asthma in death certificates were considered. This increase differed between 36% in Ceará and 76% in Rio Grande do Sul. The highest rates occurred among women and the elderly. The majority of deaths occurred in hospitals, except in Ceará, where the majority occurred at home. Diseases of the circulatory and respiratory systems, emphasizing chronic obstructive pulmonary diseases, were found to be underlying and associated (nonunderlying) causes in deaths related to asthma. Mortality with asthma as the underlying cause was greater in Brazil than in Australia, England and Wales, Scotland, Sweden, and the United States.
Cause of Death; Mortality Rate; Asthma
