Cause-specific mortality for 240 causes in China during 1990-2013: a systematic subnational analysis for the Global Burden of Disease Study 2013
- PMID: 26510778
- DOI: 10.1016/S0140-6736(15)00551-6
Cause-specific mortality for 240 causes in China during 1990-2013: a systematic subnational analysis for the Global Burden of Disease Study 2013
Abstract
Background: China has experienced a remarkable epidemiological and demographic transition during the past three decades. Far less is known about this transition at the subnational level. Timely and accurate assessment of the provincial burden of disease is needed for evidence-based priority setting at the local level in China.
Methods: Following the methods of the Global Burden of Disease Study 2013 (GBD 2013), we have systematically analysed all available demographic and epidemiological data sources for China at the provincial level. We developed methods to aggregate county-level surveillance data to inform provincial-level analysis, and we used local data to develop specific garbage code redistribution procedures for China. We assessed levels of and trends in all-cause mortality, causes of death, and years of life lost (YLL) in all 33 province-level administrative units in mainland China, all of which we refer to as provinces, for the years between 1990 and 2013.
Findings: All provinces in mainland China have made substantial strides to improve life expectancy at birth between 1990 and 2013. Increases ranged from 4.0 years in Hebei province to 14.2 years in Tibet. Improvements in female life expectancy exceeded those in male life expectancy in all provinces except Shanghai, Macao, and Hong Kong. We saw significant heterogeneity among provinces in life expectancy at birth and probability of death at ages 0-14, 15-49, and 50-74 years. Such heterogeneity is also present in cause of death structures between sexes and provinces. From 1990 to 2013, leading causes of YLLs changed substantially. In 1990, 16 of 33 provinces had lower respiratory infections or preterm birth complications as the leading causes of YLLs. 15 provinces had cerebrovascular disease and two (Hong Kong and Macao) had ischaemic heart disease. By 2013, 27 provinces had cerebrovascular disease as the leading cause, five had ischaemic heart disease, and one had lung cancer (Hong Kong). Road injuries have become a top ten cause of death in all provinces in mainland China. The most common non-communicable diseases, including ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and cancers (liver, stomach, and lung), contributed much more to YLLs in 2013 compared with 1990.
Interpretation: Rapid transitions are occurring across China, but the leading health problems and the challenges imposed on the health system by epidemiological and demographic change differ between groups of Chinese provinces. Localised health policies need to be implemented to tackle the diverse challenges faced by local health-care systems.
Funding: China National Science & Technology Pillar Program 2013 (2013BAI04B02) and Bill & Melinda Gates Foundation.
Copyright © 2016 Elsevier Ltd. All rights reserved.
Comment in
-
Trends in cause-specific mortality in Chinese provinces.Lancet. 2016 Jan 16;387(10015):204-5. doi: 10.1016/S0140-6736(15)00553-X. Epub 2015 Nov 4. Lancet. 2016. PMID: 26510777 No abstract available.
Similar articles
-
Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021.Lancet. 2024 May 18;403(10440):2100-2132. doi: 10.1016/S0140-6736(24)00367-2. Epub 2024 Apr 3. Lancet. 2024. PMID: 38582094 Free PMC article.
-
Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017.Lancet. 2018 Nov 10;392(10159):1736-1788. doi: 10.1016/S0140-6736(18)32203-7. Epub 2018 Nov 8. Lancet. 2018. PMID: 30496103 Free PMC article.
-
Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016.Lancet. 2017 Sep 16;390(10100):1151-1210. doi: 10.1016/S0140-6736(17)32152-9. Lancet. 2017. PMID: 28919116 Free PMC article.
-
Global and regional causes of death.Br Med Bull. 2009;92:7-32. doi: 10.1093/bmb/ldp028. Br Med Bull. 2009. PMID: 19776034 Review.
-
Measuring the global burden of disease and epidemiological transitions: 2002-2030.Ann Trop Med Parasitol. 2006 Jul-Sep;100(5-6):481-99. doi: 10.1179/136485906X97417. Ann Trop Med Parasitol. 2006. PMID: 16899150 Review.
Cited by
-
The lactate-to-albumin ratio relationship with all-cause mortality in cerebral infarction patients: analysis from the MIMIC-IV database.Front Neurol. 2024 May 1;15:1334097. doi: 10.3389/fneur.2024.1334097. eCollection 2024. Front Neurol. 2024. PMID: 38779217 Free PMC article.
-
Risk factors and their association network for young adults' suicidality: a cross-sectional study.BMC Public Health. 2024 May 22;24(1):1378. doi: 10.1186/s12889-024-18860-9. BMC Public Health. 2024. PMID: 38778312 Free PMC article.
-
Development and validation of risk prediction model for recurrent cardiovascular events among Chinese: the Personalized CARdiovascular DIsease risk Assessment for Chinese model.Eur Heart J Digit Health. 2024 Apr 8;5(3):363-370. doi: 10.1093/ehjdh/ztae018. eCollection 2024 May. Eur Heart J Digit Health. 2024. PMID: 38774379 Free PMC article.
-
Confronting health disparities: Lessons from the USA.Aging Med (Milton). 2024 Apr 18;7(2):158-161. doi: 10.1002/agm2.12303. eCollection 2024 Apr. Aging Med (Milton). 2024. PMID: 38725693 Free PMC article. No abstract available.
-
Clinical efficacy of lenvatinib, trans-arterial chemoembolization, and PD-1/L1 inhibitors in advanced hepatocellular carcinoma: a systematic review and network meta-analysis.Clin Transl Oncol. 2024 Apr 26. doi: 10.1007/s12094-024-03458-9. Online ahead of print. Clin Transl Oncol. 2024. PMID: 38671328 Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Miscellaneous