Death from asthma in Auckland: circumstances and validation of causes.

New Zealand has experienced an epidemic of asthma deaths since 1977 with mortality rates of over 3.0/100 000 for people aged 5-34 years, more than three times the rate of comparable countries. To examine the reasons for this high mortality rate all deaths from asthma in people under 70 years in the Auckland region in 1981-82 were investigated. A total of 84 possible cases were studied and the validity of death certificates was found to be excellent for people under the age of 50 years. Fifty-three cases had usefully reversible asthma at the time of death and the mortality rate was almost four times higher in Pacific Islanders than in caucasians, with the Maori rate being intermediate. Sixty-seven percent (35) of the deaths in people with usefully reversible asthma occurred at home. In only 40% of cases had the patient reached some form of medical care. No deaths occurred in the patients admitted to hospital with the diagnosis of asthma during this period.