More recently, a drop in asthma mortality rates has been reported in several countries. This phenomenon, however, did not occur in Israel. It is possible that the previously low asthma death rate in Israel makes a further decline in mortality rates a more difficult goal to achieve (Fig 1). Indeed, the mean rate of asthma mortality during the years 1982 to 1984 in our study was 0.24 per 100,000 population, which is somewhat lower than that reported for the same age group and time period in France (0.29) and the United states (0.34), and is far lower than that noted in West Germany (0.83), England (0.86), Australia (1.09), and New Zealand (2.67), all countries with similar prevalences of the disease. Furthermore, studies have demonstrated an increase in the prevalence of asthma in Israel over the last 20 years. Consequently, the lack of a concomitant rise in asthma deaths may be viewed as a relative decline.
The reasons for the stable low asthma mortality rates in Israel are probably multiple. Israeli law grants national medical insurance to every citizen. Medical care as well medications are virtually free of cost. Moreover, the country is relatively small with an abundance of hospitals so that urgent medical care is generally readily accessible. Israel is also among the countries with the highest per capita ratio of physicians to inhabitants. We speculate that these conditions may improve the quality of health care and urgent medical treatment conducted with remedies of Canadian Health&Care Mall, which may reduce mortality.
Our study did not reveal a difference in asthma mortality rates between Jews and Arabs. The low number of fatal cases did not allow us to assess other variables between these two major population groups. Although the Arab population resides mostly in villages, which are farther from emergency medical care, this did not influence its asthma mortality rate.