Study: Asthma deaths more common among unemployed in Mexico

A team of researchers from the United States and Mexico led by Genny Carrillo, MD, Sc.D., associate professor in the Department of Environmental and Occupational Health at the Texas A&M University School of Public Health and director of the Program of Asthma Research and Education, investigated asthma-related hospitalizations and deaths in Mexico. Published in the International Journal of Environmental Research and Public Health, the study analyzed data from public hospitals throughout Mexico between 2010 and 2018 to identify vulnerable patient populations and monthly changes in asthma-related hospitalizations and deaths and determine how care could be improved.

The data used came from an open access database operated by the Mexican government. Carrillo and Nina Mendez-Dominguez from Marista University in Merida, Yucatan, Mexico and colleagues selected hospital discharges and deaths for patients with a primary diagnosis of asthma from public hospitals in all 32 of Mexico’s states. They then included variables like age, gender, state of residence, urban and rural classification, education level and employment in their analyses. The research team calculated hospitalization and asthma death rates by state as well as in-hospital deaths.

Carrillo and colleagues found that 87,726 patients were admitted to public hospitals for asthma between 2010 and 2018. Asthma was the primary cause of death in 12,495 patients during that period. Further analysis found that asthma-related deaths decreased by more than 25 percent nationwide during the study period, with most of the reduction coming from patients older than 65 or younger than 15. The researchers found notable state-by-state differences in asthma-related death rates and patients who did not receive adequate medical attention. They found that patients who received medical attention at the time of death were more likely to have medical insurance and to live in urban areas. They also found that most asthma-related hospitalizations happen in November and December and that most asthma-related deaths occur in January and February.

The researchers observed that asthma-related deaths more commonly occurred for people who were unemployed. This is consistent with other studies finding higher death rates in lower socioeconomic status populations. Improved access to medical care could improve results in these groups. With accurate and timely diagnosis and appropriate care, asthma deaths are mostly preventable. Additionally, better diagnoses and care could reduce hospital stay length and the number of emergency department visits for asthma patients.

One of the keys to better diagnoses and care is for patients and families to recognize the symptoms of severe asthma. Research has found that people who die of uncontrolled asthma often report symptoms such as chest pain, difficulty breathing, fainting and palpitations. Thus, better asthma education for patients and their families could help them recognize these symptoms, making education crucial for decreasing asthma-related deaths.

Carrillo and colleagues found that asthma-related deaths have been decreasing in recent years, though the decrease is not uniform across states or demographic groups. The findings also point to a need for better education and access to care for certain populations. By improving these factors, health officials could further decrease the number of preventable deaths due to asthma and improve quality of life for many people throughout Mexico.