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A recent study finds that deep regional disparities persist, although the global asthma burden has declined significantly over the past three decades.

Over the past three decades, the global burden of asthma has declined meaningfully; however, pronounced regional disparities remain entrenched. Findings published in Clinical and Experimental Pharmacology and Physiology reveal that, despite significant reductions in age-standardized mortality and disability-adjusted life years (DALYs), low-socio-demographic index (SDI) regions continue to experience disproportionately high asthma-related morbidity and mortality. These inequities stem from limited healthcare infrastructure, environmental hazards such as air pollution, and insufficient preventive care.

“Asthma presents a significant challenge to global healthcare systems and imposes a heavy socioeconomic burden,” wrote Yu Wang, PhD, of Shanghai University of Traditional Chinese Medicine, and colleagues. “Previous studies had geographical limitations and lacked comprehensive global analysis.” By synthesizing data across 21 regions and 204 countries, the investigators aimed to elucidate temporal trends and furnish policymakers with rigorous evidence to guide equitable resource allocation and targeted interventions.

Assessing Asthma Burden

Drawing from the 2021 Global Burden of Disease study, researchers estimated asthma incidence, prevalence, mortality, and DALYs from 1990 through 2021, employing standardized case definitions to ensure comparability across diverse health systems. A smoothing spline model captured nonlinear associations between disease burden and SDI—a composite of per capita income, educational attainment, and fertility—while decomposition analyses quantified the contributions of population growth, aging, and epidemiological transitions.

Over the thirty-year interval, global age-standardized mortality declined by 46% and DALY rates by 44%. Yet, the absolute number of asthma-related deaths rose by 17%, predominantly among women in low- and low-middle SDI regions. High-SDI areas achieved the greatest gains using established clinical guidelines, widespread access to medication, and robust care networks. In contrast, low-SDI regions remain burdened by environmental pollutants, limited specialist availability, and evolving risk profiles. High body mass index persisted as the leading modifiable determinant of asthma DALYs, with smoking and occupational exposures also contributing substantially.

Looking Ahead

“The global burden of asthma has declined, yet significant regional disparities persist, with low-SDI regions experiencing higher mortality and DALYs due to limited healthcare access and environmental risks,” the authors concluded, advocating for “targeted public health interventions and lifestyle modifications” to mitigate inequities and optimize asthma control in underserved populations.