Trends in asthma prevalence and population changes in South Australia, 1990-2003

Objectives: To examine changes in asthma prevalence in the context of other population changes between 1990 and 2003, for specific age and sex groups. Design: Cross-sectional survey based on household interviews, repeated annually. Setting and participants: Representative samples of the South Australian population between 1990 and 2003 (around 3000 people per year). Main outcome measures: Current prevalence of doctor-diagnosed asthma and other health and demographic variables potentially associated with asthma, and asthma management. Results: Response rate was over 71%. Between 1990 and 2003, asthma prevalence increased significantly, doubling in females (from 7.3% in 1990 to 14.6% in 2003), with a smaller increase in males (from 7.8% to 9.4%). Asthma also increased in all age groups, but the largest relative increases occurred in people aged 55 years and older. Logistic regression analyses showed that obesity was a major predictive variable for every age group studied. The prevalence of asthma morbidity (waking at night and days lost from usual activities because of asthma) among those with asthma showed no significant changes between 1990 and 2003. Asthma action plans (introduced on a population basis in 1992) peaked in their distribution at 42% in 1994, and then declined to half that percentage in 2003. The increase in asthma prevalence occurred at the same time as increases in population prevalence of obesity (10.3% to 18.7%) and diabetes (3.1% to 6.9%), and decline in recent vigorous exercise (42.4% to 32.7%). Conclusions: The increase in asthma prevalence over a decade was large, but concentrated among specific sex and age groups. The increase accompanied population increases in obesity and diabetes and a decline in vigorous exercise.