title: Asthma in Hawaii: a tradition of excess mortality.
abstract: Hawaii has the highest asthma mortality in the nation and clinically has always had high rates. In contrast, international consensus has it that deaths have been rare over the past two centuries to 1950. The objective of this study was to document Hawaii's asthma mortality over the centuries to 1950. Asthma mortality was examined from pre- and early European times through kahunas, aphorisms, historical libraries, and materia medica. In 1879, vital statistics became available locally and from 1901 from the federal government. Asthma deaths were not rare in ancient Hawaii. Vital statistics in 1879 revealed an asthma mortality of 83/100,000 which declined to 4.0 by 1950. U.S. and international mortality, at least to 1930, was almost unknown. Compared to U.S. and international rates, Hawaii's asthma mortality has been excessive since ancient days.
authors.affiliation: John A Burns School of Medicine, Honolulu, Hawaii, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Massey
authors.forename: B E
authors.initials: BE
authors.lastname: Hope
authors.forename: G
authors.initials: G
authors.lastname: Fournier-Massey
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology / Q000266:history / Q000401:mortality*; D019352:Censuses; D002648:Child; D002675:Child, Preschool; D006254:Hawaii / Q000453:epidemiology; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D008921:Religious Missions / Q000706:statistics & numerical data