机构地区:[1]广州医科大学公共卫生学院,广东广州511436 [2]广州医科大学卫生管理学院,广东广州511436
出 处:《疾病监测》2024年第3期369-375,共7页Disease Surveillance
基 金:广东省医学科学技术研究基金项目(No.B2021096);广州医科大学科研能力提升项目(No.广医大发[2022]66号)。
摘 要:目的 了解2015-2021年我国居民死亡率及死亡原因,为制定卫生政策和疾病防控提供依据。方法 利用《中国死因监测数据集》和《中国卫生健康统计年鉴》中2015-2021年城乡居民死亡数据,分析死亡率、平均年度变化百分比(AAPC)、构成比等指标。结果 2015-2021年我国城市、农村、男性、女性年均粗死亡率分别为627.87/10万、693.31/10万、765.15/10万、574.01/10万,均呈上升趋势(AAPC=0.71%、1.54%、1.13%、1.42%,P=0.007、0.004、0.005、0.002);标化死亡率分别为676.60/10万、748.67/10万、895.45/10万、565.41/10万,均呈现下降趋势(AAPC=-4.16%、-1.95%、-2.37%、-2.89%,P<0.001、0.015、0.001、0.005)。农村居民年均粗死亡率(χ^(2)=27 188.022,P<0.001)和年均标化死亡率(χ^(2)=30 570.094,P<0.001)均高于城市居民,男性年均粗死亡率(χ^(2)=258 728.380,P<0.001)和年均标化死亡率(χ^(2)=706 679.858,P<0.001)均高于女性。城市新生儿、婴儿、5岁以下儿童、孕产妇死亡率均高于农村(χ^(2)=30 241.791、48 081.135、86 265.732、101.718,均P<0.001),城乡合计死亡率均呈逐年下降趋势(AAPC=-9.02%、-7.71%、-6.89%、-3.67%,均P<0.001)。心脏病、恶性肿瘤、脑血管病、呼吸系统疾病、损伤及中毒占据城乡居民死因顺位前五,至2021年共占城市和农村居民整体死亡人数的85.87%和87.35%。结论 我国农村居民死亡率明显高于城市,且孕产妇与儿童死亡率仍有较大差距;循环、呼吸系统疾病和恶性肿瘤等慢性非传染病是威胁居民身体健康的主要疾病;政府应在医疗公共资源分配上进行合理倾斜,加强重大死因的防治工作。Objective To understand the mortality rate and causes of death in the population in China from 2015 to 2021,and provide evidence for health policy formulation and disease prevention and control.Methods The mortality data in urban and rural residents in China from 2015 to 2021 were collected from China Cause of Death Surveillance Dataset and the China Health and Wellness Statistical Yearbook to analyze the mortality rates,average annual percentage change(AAPC),and composition ratios.Results During 2015−2021,the average annual crude mortality rates in urban residents,rural residents,men,and women in China were 627.87/100000,693.31/100000,765.15/100000,and 574.01/100000,respectively,all showed increasing trends(AAPC=0.71%,1.54%,1.13%,1.42%,P=0.007,0.004,0.005,0.002),and the standardized mortality rates were 676.60/100000,748.67/100000,895.45/100000,and 565.41/100000,respectively.All showed decreasing trends(AAPC=−4.16%,−1.95%,−2.37%,−2.89%,P=<0.001,0.015,0.001,0.005).The average annual crude mortality rate(χ^(2)=27188.022,P<0.001)and the average annual standardized mortality rate(χ^(2)=30570.094,P<0.001)were higher in rural residents than in urban residents,and the average annual crude mortality rate(χ^(2)=258728.380,P<0.001)and the average annual standardized mortality rate(χ^(2)=706679.858,P<0.001)were higher in men than in women.The mortality rates in neonates,infants,children under 5 years old,and pregnant and lying-in woman were higher in urban area than in rural area(χ^(2)=30241.791,48081.135,86265.732 and 101.718,respectively,all P<0.001),and the combined urban and rural mortality rate showed a decreasing trend from year to year(AAPC−9.02%,−7.71%,−6.89%,and−3.67%,respectively,all P<0.001).Heart disease,malignant neoplasm,cerebrovascular disease,respiratory disease,and injury and poisoning were the top five causes of death in urban and rural area,accounting for 85.87%and 87.35%of the overall urban and rural mortality by 2021.Conclusion The mortality rate was significantly higher in rural
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