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Objective@#To analyze the lung cancer deaths attributable to ambient PM2.5 exposure in China in 2016.@*Methods@#All data were from the Global Burden of Disease Study 2016 (GBD 2016). Multiple-source data, including satellite observation, ground measurement, chemical migration model simulation, etc., and the data integration model for air quality (DIMAQ) were used to estimate the grid-level exposure to ambient PM2.5. Data from the vital registry and cancer registry were used to establish statistical model to estimate the lung cancer deaths by province, age and gender. The lung cancer deaths attributable to PM2.5 were calculated based on the calculation of population attributable fraction (PAF). The GBD world population age structure was adopted to calculate age-standardized rates for comparison among provinces (including 31 provinces, autonomous regions and municipalities directly under the central government, as well as Hong Kong and Macao special administrative regions, excluding Taiwan of China).@*Results@#In 2016, the lung cancer deaths attributable to ambient PM2.5 exposure in China were 14.56×104 (95% uncertainty interval (UI): 9.63×104-19.55×104), accounting for 24.66% (95%UI: 16.38%-33.12%) of total lung cancer deaths. The lung cancer death rate attributable to PM2.5 increased with age, with the lowest among 25-29 age group (0.25/105, 95%UI: 0.17/105-0.34/105), the highest among ≥80 age group (90.70/105, 95%UI: 59.85/105-122.20/105). The lung cancer death rate attributable to PM2.5 among males (14.84/105, 95%UI: 9.78/105-19.93/105) was higher than that in females (6.21/105, 95%UI: 4.07/105-8.40/105). The age-standardized death rates (ASDR) of lung cancer attributable to PM2.5 among males and females in China were higher than the global average level. The attributable ASDR of lung cancer varied among provinces, highest in Shandong (13.51/105, 95%UI: 9.14/105-18.20/105) and lowest in Tibet (0.85/105, 95%UI: 0.44/105-1.51/105).@*Conclusion@#In 2016, the lung cancer deaths attributable to ambient PM2.5 exposure in China was heavy, and varied in different age groups, genders and provinces.
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Objective@#To analyze the disease burden of pancreatic cancer in China in 1990 and 2017.@*Methods@#Province-specific data in China from the Global Burden of Disease Study (GBD) 2017 were used to describe the change of death status, disease burden of pancreatic cancer in Chinese population by specific province and age groups, including incidence, mortality, disability-adjusted life years (DALY), years of life lost (YLL) due to premature mortality and years lived with disability (YLD) in 1990 and 2017. Meanwhile the incidence, mortality, DALY rate, YLL rate, YLD rate were standardized by the GBD global standard population in 2017.@*Results@#In 2017, the new cases of pancreatic cancer, incidence and age-standardized incidence accounted for 83.6 thousand, 5.92/100 000 and 4.37/100 000 in China, with an increase of 230.94%, 180.45% and 49.88% compared with 1990, respectively. The total number of deaths, mortality and age-standardized mortality appeared as 85.1 thousand, 6.02/100 000, 4.48/100 000, with an increase of 236.08%, 184.80% and 47.51% respectively. The incidence and mortality of pancreatic cancer increased with age and accelerated from the age of 55 to 59 both in 1990 and 2017. The highest incidence and mortality showed in 85-89 years old in 2017 and in 90-94 years old in 1990. The standardized DALY rate of pancreatic cancer increased from 71.00/100 000 in 1990 to 94.32/100 000 in 2017, increased by 32.84%. The standardized YLL rate increased from 70.39/100 000 to 93.42/100 000, increased by 32.72%. The standardized YLD rate increased from 0.62/100 000 to 0.90/100 000, increased by 45.80%. In terms of age distribution, DALY rate, YLL rate and YLD rate of pancreatic cancer basically showed an increasing trend with age in 1990 and 2017. In 2017, Jiangsu (7.61/100 000), Shanghai (7.52/100 000) and Liaoning (6.84/100 000) ranked the top three provinces in terms of standardized mortality. Compared with 1990, Henan (104.28%), Sichuan (94.02%) and Hebei (90.39%) saw the fastest increase in standardized mortality.@*Conclusions@#The incidence, mortality and disease burden of pancreatic cancer in China increased significantly from 1990 to 2017. Prevention and control measures should be strengthened to reduce the disease burden of pancreatic cancer.
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Objective To assess the disease burden on uterine fibroids in China in 1990 and 2016.Methods Data were extracted from the Global Burden of Disease Study 2016.Burdens of uterine fibrosis among different age groups and provinces were measured in 1990 and 2016,with key indicators including number of cases,prevalence rates,disability-adjusted life year (DALY) and the rates of DALY.The WHO world standard population,2010-2035 was used to calculate the agestandardized rates.Results In 1990 and 2016,there were 13 695 567 and 27 169 312 women aged 15 years and older,suffered from uterine fibrosis respectively,with prevalence rate as 2.48％ and 4.10％,DALY as 146 045.05 life years and 281 976.67 life years,and the DALY rate as 26.40/100 000 and 42.50/100 000,in 1990 and 2016 respectively.Both the prevalence rate and the DALY rate increased with age,reaching the peak on the 45-49 years-old,in both 1990 and 2016.Women aged 40-54 years accounted for 55.60％ (1990) and 66.74％ (2016) of the total cases while 48.37％ (1990) and 60.65％ (2016) of the total DALY.The first three provinces with highest DALYs were Shandong (1990:12 574.67 life year;2016:22 728.12 life year),Henan (1990:10 849.29 life year;2016:18 454.32 life year) and Jiangsu (1990:10 501.55 life year;2016:18 274.10 life year),while the three provinces with leading standardized DALY rates were Heilongjiang (1990:48.20/100 000;2016:47.00/100 000),Shanxi (1990:44.50/100 000;2016:47.70/100 000) and Tianjin (1990:43.80/100 000;2016:46.40/100 000) in both 1990 and 2016.Compared with 1990,the number of cases with uterine fibroids increased by 13 473 745 (with rate of change as:98.38％),standardized prevalence rate increased by 1.88％,DALY value increased by 135 931.62 life years (with the rate of change as 93.08％) and standardized DALY rate increased by 5.92％ among Chinese women,in 2016.Conclusion Menopausal women were the ones hard hit by uterine fibrosis.Compared with data from 1990,the disease burden of uterine fibrosis increased rapidly in China,in 2016.
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Objective To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016.Methods Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI.Measurements for attributable BOD of diabetes included disability adjusted life years (DALY),years of lost life (YLL),years living with disability (YLD),death number and mortality rate.The average world population from 2010 to 2035 was used as a reference.Results In 2016,death number of diabetes attributable to high BMI was 40 310,which was significantly higher than that in 1990 (15 008).Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016,which showed a more significant increasing trend in both males and people aged 15-49 years.DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years.YLL and YLD also showed increasing trends.The highest increasing rate of YLD was in people aged 15-49 years.High BMI was responsible for 26.01％ of the diabetes deaths in 2016 in China,an increase of 39.39％ compared with that in 1990 (18.66％).Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016.Inner Mongolia,Xinjiang,Zhejiang,Macao SAR,Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period.Conclusions There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI,causing a heavy disease burden,in China from 1990 to 2016.The BOD varied in both different age and gender groups.More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.
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Objective To assess the disease burden on uterine fibroids in China in 1990 and 2016.Methods Data were extracted from the Global Burden of Disease Study 2016.Burdens of uterine fibrosis among different age groups and provinces were measured in 1990 and 2016,with key indicators including number of cases,prevalence rates,disability-adjusted life year (DALY) and the rates of DALY.The WHO world standard population,2010-2035 was used to calculate the agestandardized rates.Results In 1990 and 2016,there were 13 695 567 and 27 169 312 women aged 15 years and older,suffered from uterine fibrosis respectively,with prevalence rate as 2.48％ and 4.10％,DALY as 146 045.05 life years and 281 976.67 life years,and the DALY rate as 26.40/100 000 and 42.50/100 000,in 1990 and 2016 respectively.Both the prevalence rate and the DALY rate increased with age,reaching the peak on the 45-49 years-old,in both 1990 and 2016.Women aged 40-54 years accounted for 55.60％ (1990) and 66.74％ (2016) of the total cases while 48.37％ (1990) and 60.65％ (2016) of the total DALY.The first three provinces with highest DALYs were Shandong (1990:12 574.67 life year;2016:22 728.12 life year),Henan (1990:10 849.29 life year;2016:18 454.32 life year) and Jiangsu (1990:10 501.55 life year;2016:18 274.10 life year),while the three provinces with leading standardized DALY rates were Heilongjiang (1990:48.20/100 000;2016:47.00/100 000),Shanxi (1990:44.50/100 000;2016:47.70/100 000) and Tianjin (1990:43.80/100 000;2016:46.40/100 000) in both 1990 and 2016.Compared with 1990,the number of cases with uterine fibroids increased by 13 473 745 (with rate of change as:98.38％),standardized prevalence rate increased by 1.88％,DALY value increased by 135 931.62 life years (with the rate of change as 93.08％) and standardized DALY rate increased by 5.92％ among Chinese women,in 2016.Conclusion Menopausal women were the ones hard hit by uterine fibrosis.Compared with data from 1990,the disease burden of uterine fibrosis increased rapidly in China,in 2016.
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Objective To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016.Methods Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI.Measurements for attributable BOD of diabetes included disability adjusted life years (DALY),years of lost life (YLL),years living with disability (YLD),death number and mortality rate.The average world population from 2010 to 2035 was used as a reference.Results In 2016,death number of diabetes attributable to high BMI was 40 310,which was significantly higher than that in 1990 (15 008).Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016,which showed a more significant increasing trend in both males and people aged 15-49 years.DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years.YLL and YLD also showed increasing trends.The highest increasing rate of YLD was in people aged 15-49 years.High BMI was responsible for 26.01％ of the diabetes deaths in 2016 in China,an increase of 39.39％ compared with that in 1990 (18.66％).Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016.Inner Mongolia,Xinjiang,Zhejiang,Macao SAR,Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period.Conclusions There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI,causing a heavy disease burden,in China from 1990 to 2016.The BOD varied in both different age and gender groups.More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.
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Objective To investigate the epidemiological characteristics of obesity and its relationships to five common chronic diseases among the Chinese elderly population.Methods In 2013,The 4th Chronic Non-communicable Disease & Risk Factor Surveillance in China was conducted in 31 provinces.A multistage cluster sampling method was used at 298 National Disease Surveillance Points(DSPs).A total of 51778 adults aged 60 and over received a standardized questionnaire,physical examinations,and laboratory tests for blood lipid & glucose levels.The body mass index(BMI)was used for obesity measurement and waist circumference(WC)for central obesity measurement.After weighting adjustment of the sample,the prevalence of obesity and central obesity was compared between different genders,among different age groups,and among different regions.The unconditional Logistic regression model was applied to analyze the relationships of five selected chronic diseases with BMI and WC.Population attributable fractions (AFP)were also calculated.Results Among the elderly,the prevalence of obesity and central obesity was 13.2 ％ and 55.4 ％,respectively.Both were higher in women(16.3％ and 64.4％)than in men(9.9％ and 46.0％)and higher in the urban areas (15.6％ and 62.0％) than in the rural areas (12.0％ and 52.1％) (all P ＜ 0.05).The increased prevalence of five common chronic diseases was correlated with increased BMI and WC(all P＜0.05).After adjustment for confounders,obesity was associated with increased prevalence of hypertension,diabetes,dyslipidemia,and stroke (ORs:1.43-2.68,AFP s:0.05-0.18);central obesity was associated with increased prevalence of the five chronic diseases (ORs:1.35-1.88,AFPs:0.16-0.33)Conclusions High prevalence of obesity and central obesity can be seen in aged women and the urban elderly population.Obesity and central obesity are both related to hypertension,diabetes,dyslipidemia,and stroke.Besides,central obesity is also associated with myocardial infarction.
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Objective To assess the disease burden for gynecological disease in China in 2016. Methods Data were extracted from the global burden of disease study 2016(GBD 2016). The burden of gynecological disease among age groups and provinces groups was assessed by prevalence rate, mortality rate, years lived with disability (YLD), years of life lost due to premature mortality (YLL) and disability-adjusted life years(DALY). An average world population age-structure for the period 2010-2035 was adopted to calculate age-standardized rates. Results In 2016, the prevalence rate of gynecological disease in women aged 15 years and above in China was 24.94%, of which was 36.71%to women of childbearing age. The number of DALY from gynecological disease was 2727637.82 life years in 2016, with the DALY rate was 411.12/100000 and standardized DALY rate was 341.80/100000. The first three gynecological diseases with highest DALY and DALY rate among Chinese women aged ≥15 years were premenstrual syndrome(815004.64 life years, 122.84/100000), uterine fibroids(281976.67 life years, 42.5/100000) and endometriosis (154792.89 life years, 23.33/100000). The DALY caused by gynecological disease in Guangdong (220871.19 life years), Shandong (190968.72 life years), Henan (171273.92 life years), Jiangsu(168404.27 life years)and Sichuan(144358.5 life years)were higher than other provinces. The standardized DALY rate attributable to gynecological disease were highest in Xinjiang Uygur Autonomous Region(404.00/100000), Shanghai(394.90/100000), Heilongjiang(382.00/100000), Beijing(365.70/100000)and Jiangsu (357.50/100000). Conclusions Gynecological disease is a great threat to women' s reproductive health. Effective measures should be taken to address the issue, especially to women of childbearing age.
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Objective To analyze the deaths attributed to ambient air pollution in China between 2006 and 2016.Methods The data were collected from the project of Global Burden of Disease in 2016 (GBD2016).The Data Integration Model for Air Quality were used to estimate exposure to particulate matter smaller than 2.5 μm in aerodynamic diameter (PM2.5).The attributable death number was calculated based on the calculation of population attributable fraction (PAF),and the results were compared by gender,diseases and provinces.An average world population age structure was adopted to calculate age-standardized rates.Results In 2016,a total of 1 075 000 deaths attributed to ambient air pollution occurred in China,accounting for 11.1％ of the total deaths,and 57.6％ of the deaths attributed to ambient air pollution were due to ischemic heart disease and stroke.The death number among men was 1.7 times higher than that in women,Compared with 2006,the proportion of ambient air pollution related deaths in total deaths decreased by 6.8％;the agestandardized death rate attributed to ambient air pollution decreased by 26.5％ and the decrease rate of lower respiratory infections (37.6％) and chronic obstructive pulmonary disease (42.1％) were greater than ischemic heart disease (5.3％).The age-standardized rate of death attributed to ambient air pollution decreased both in men and in women,but the decrease rate was higher in women (34.8％) than that in men (20.4％).The PAFs varied among provinces,it was highest in Tianjin (13.9％),lowest in Tibet (6.1％),and it was relatively higher in Beijing,Hebei,Shandong,Henan and the three provinces in the northeast and relatively lower in Hong Kong,Macao,Fujian and Hainan etc..The agestandardized rate of death attributed to ambient air pollution was highest in Xinjiang (120.1/100 000) and lowest in Hong Kong (30.9/100 000),and it was relatively higher in Qinghai,Guizhou,Henan and relatively lower in Macao,Shanghai and Fujian,etc..Compared with 2006,the PAFs of 17 provinces decreased,the decrease rate ranged from 4.1％ to 16.8％,whereas the PAF of Jilin (5.0％) and Heilongjiang (8.1％) increased,and the PAFs of other 14 provinces showed no significant change.The attributable age-standardized death rate decreased in all provinces with the decrease rate ranging from 11.9％ (Heilongjiang) to 43.2％ (Fujian),and the decrease rate was relatively higher in Guangdong,Zhejiang and Guizhou,and lower in the three provinces in the northeast,Hubei and Hebei etc.Conclusions In 2016,the disease burden attributable to PM2.5 in China was heavy,but mitigated compared with 2006.The gender and area specific distributions of deaths attributed to ambient air pollution were observed.
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Objective To analyze the rates on prevalence,awareness,status on treatment and control of type 2 diabetes mellitus among Chinese premenopausal women aged 18-49,in 2013.Methods Data on China Chronic and Non-Communicable Disease Surveillance in year 2013 was used for analysis.Source of data covered 302 surveillance points which were selected by Multi-stage cluster random sampling method that including 176 534 adults over 18 years of age,with 46 674 premenopausal women aged 18-49.Plasma glucose and hemoglobin A 1 c levels were determined after a 10-hour overnight fast for all the participants,before a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes.Diabetes was defined according to the 1999 WHO diagnostic criteria-fasting blood glucose level as ≥7.0 mmol/L and/or 2 hours oral glucose tolerance test (OGTT-2 h) level as ≥ 11.1 mmol/L.After being weighed,according to complex sampling scheme and post-stratification,the sample was used to estimate the rates of prevalence,awareness,treatment and control of type 2 diabetes mellitus by age,education,urban and rural areas,and geographic locations.Results The overall prevalence of type 2 diabetes mellitus was 5.6％ among the Chinese premenopausal women aged 18-49.No statistical difference on the prevalence rates (5.7％ and 5.4％,respectively) was seen,between participants from the rural or the urban areas.Prevalence rates in the eastern,central or western geographic areas were 5.8％,6.2％ and 4.4％ respectively.The rates of awareness,treatment and control of diabetes appeared as 29.3％,27.9％ and 29.4％ in childbearing women aged 18-49.The rate of treatment was 95.4％ among those who knew their diabetic situation in childbearing women aged 18-49 years.The control rate of diabetes was 38.9％ among those who had taken measures to control glucose,in 18-49-year-old childbearing women.The rate of awareness on diabetes in childbearing women aged 18-49 years in urban areas was higher than that in the rural areas.There were significantly statistical differences on the treatment rates among groups of different education levels but not in the trend test.Conclusion The prevalence of type 2 diabetes mellitus in childbearing women aged 18-49 appeared high,but with low rates on awareness,treatment and control.However,statistical difference was seen on awareness,between urban and rural areas.
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Objective To analyze the deaths attributable to alcohol use and its impact on people's life expectancy in China in 2013.Methods The mortality data from the Disease Surveillance Points System and alcohol use data from China Chronic Disease Surveillance (2013) were used.The deaths attributed to alcohol use and its impact on the life expectancy of Chinese residents were estimated based on the principle of comparative risk assessment by calculating population attributable fraction.Results In 2013,alcohol use resulted in 381 200 deaths,including 97 100 hemorrhagic stroke deaths,88 200 liver cancer deaths,61 400 liver cirrhosis deaths and 48 700 esophageal cancer deaths,and prevented 76 500 deaths,including 68 500,4 900 and 3 100 deaths which might be caused by ischemic heart disease,hemorrhagic stroke and diabetes respectively.If risk factor of alcohol use is removed,the people's life expectancy would rise by an average of 0.43 years,especially in westem China by 0.52 years,which was 0.12 years higher than that in eastern and central China,and the life expectancy of the population in rural and urban areas would rise by 0.48 years and 0.31 years respectively.Conclusions Although alcohol has a protective effect on reducing ischemic heart disease,stroke and diabetes deaths,alcohol use is still a risk factor influencing the mortality and life expectancy of residents in China.It is necessary to take targeted measures to reduce the health problems caused by harmful use of alcohol.
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Objective To analyze the deaths attributed to ambient air pollution in China between 2006 and 2016.Methods The data were collected from the project of Global Burden of Disease in 2016 (GBD2016).The Data Integration Model for Air Quality were used to estimate exposure to particulate matter smaller than 2.5 μm in aerodynamic diameter (PM2.5).The attributable death number was calculated based on the calculation of population attributable fraction (PAF),and the results were compared by gender,diseases and provinces.An average world population age structure was adopted to calculate age-standardized rates.Results In 2016,a total of 1 075 000 deaths attributed to ambient air pollution occurred in China,accounting for 11.1％ of the total deaths,and 57.6％ of the deaths attributed to ambient air pollution were due to ischemic heart disease and stroke.The death number among men was 1.7 times higher than that in women,Compared with 2006,the proportion of ambient air pollution related deaths in total deaths decreased by 6.8％;the agestandardized death rate attributed to ambient air pollution decreased by 26.5％ and the decrease rate of lower respiratory infections (37.6％) and chronic obstructive pulmonary disease (42.1％) were greater than ischemic heart disease (5.3％).The age-standardized rate of death attributed to ambient air pollution decreased both in men and in women,but the decrease rate was higher in women (34.8％) than that in men (20.4％).The PAFs varied among provinces,it was highest in Tianjin (13.9％),lowest in Tibet (6.1％),and it was relatively higher in Beijing,Hebei,Shandong,Henan and the three provinces in the northeast and relatively lower in Hong Kong,Macao,Fujian and Hainan etc..The agestandardized rate of death attributed to ambient air pollution was highest in Xinjiang (120.1/100 000) and lowest in Hong Kong (30.9/100 000),and it was relatively higher in Qinghai,Guizhou,Henan and relatively lower in Macao,Shanghai and Fujian,etc..Compared with 2006,the PAFs of 17 provinces decreased,the decrease rate ranged from 4.1％ to 16.8％,whereas the PAF of Jilin (5.0％) and Heilongjiang (8.1％) increased,and the PAFs of other 14 provinces showed no significant change.The attributable age-standardized death rate decreased in all provinces with the decrease rate ranging from 11.9％ (Heilongjiang) to 43.2％ (Fujian),and the decrease rate was relatively higher in Guangdong,Zhejiang and Guizhou,and lower in the three provinces in the northeast,Hubei and Hebei etc.Conclusions In 2016,the disease burden attributable to PM2.5 in China was heavy,but mitigated compared with 2006.The gender and area specific distributions of deaths attributed to ambient air pollution were observed.
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Objective To analyze the rates on prevalence,awareness,status on treatment and control of type 2 diabetes mellitus among Chinese premenopausal women aged 18-49,in 2013.Methods Data on China Chronic and Non-Communicable Disease Surveillance in year 2013 was used for analysis.Source of data covered 302 surveillance points which were selected by Multi-stage cluster random sampling method that including 176 534 adults over 18 years of age,with 46 674 premenopausal women aged 18-49.Plasma glucose and hemoglobin A 1 c levels were determined after a 10-hour overnight fast for all the participants,before a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes.Diabetes was defined according to the 1999 WHO diagnostic criteria-fasting blood glucose level as ≥7.0 mmol/L and/or 2 hours oral glucose tolerance test (OGTT-2 h) level as ≥ 11.1 mmol/L.After being weighed,according to complex sampling scheme and post-stratification,the sample was used to estimate the rates of prevalence,awareness,treatment and control of type 2 diabetes mellitus by age,education,urban and rural areas,and geographic locations.Results The overall prevalence of type 2 diabetes mellitus was 5.6％ among the Chinese premenopausal women aged 18-49.No statistical difference on the prevalence rates (5.7％ and 5.4％,respectively) was seen,between participants from the rural or the urban areas.Prevalence rates in the eastern,central or western geographic areas were 5.8％,6.2％ and 4.4％ respectively.The rates of awareness,treatment and control of diabetes appeared as 29.3％,27.9％ and 29.4％ in childbearing women aged 18-49.The rate of treatment was 95.4％ among those who knew their diabetic situation in childbearing women aged 18-49 years.The control rate of diabetes was 38.9％ among those who had taken measures to control glucose,in 18-49-year-old childbearing women.The rate of awareness on diabetes in childbearing women aged 18-49 years in urban areas was higher than that in the rural areas.There were significantly statistical differences on the treatment rates among groups of different education levels but not in the trend test.Conclusion The prevalence of type 2 diabetes mellitus in childbearing women aged 18-49 appeared high,but with low rates on awareness,treatment and control.However,statistical difference was seen on awareness,between urban and rural areas.
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Objective To analyze the deaths attributable to alcohol use and its impact on people's life expectancy in China in 2013.Methods The mortality data from the Disease Surveillance Points System and alcohol use data from China Chronic Disease Surveillance (2013) were used.The deaths attributed to alcohol use and its impact on the life expectancy of Chinese residents were estimated based on the principle of comparative risk assessment by calculating population attributable fraction.Results In 2013,alcohol use resulted in 381 200 deaths,including 97 100 hemorrhagic stroke deaths,88 200 liver cancer deaths,61 400 liver cirrhosis deaths and 48 700 esophageal cancer deaths,and prevented 76 500 deaths,including 68 500,4 900 and 3 100 deaths which might be caused by ischemic heart disease,hemorrhagic stroke and diabetes respectively.If risk factor of alcohol use is removed,the people's life expectancy would rise by an average of 0.43 years,especially in westem China by 0.52 years,which was 0.12 years higher than that in eastern and central China,and the life expectancy of the population in rural and urban areas would rise by 0.48 years and 0.31 years respectively.Conclusions Although alcohol has a protective effect on reducing ischemic heart disease,stroke and diabetes deaths,alcohol use is still a risk factor influencing the mortality and life expectancy of residents in China.It is necessary to take targeted measures to reduce the health problems caused by harmful use of alcohol.
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Objective@#To assess the disease burden for low back pain in China in 2013 and analyzed the change of it between 1990 and 2013.@*Methods@#Data was from the Global Burden of Disease Study 2013 (GBD 2013). The burden of low back pain (LBP) among age groups, gender groups, provinces (excluding Taiwan China) groups was assessed by years lived with disability (YLD), including YLD, YLD rate, proportion of YLD due to LBP. The change of the YLD for LBP was analyzed between 1990 and 2013 by age-standardized YLD rate using the world standard population of 2000-2025 WHO.@*Results@#In 2013, The YLD for LBP was 16 347 thousand (the leading cause of YLD in China), and the proportion of YLD in age group 30-59 years old was 54.6% (8 929/16 347) . The age-standardized rate in China was 1 072.6/100 000, and the rates in Guangdong (1 742.2/100 000) , Shanghai (1 227.8/100 000) and Beijing (1 136.6/100 000) were higher than in other provinces. The proportion of YLD due to LBP was 11.8%. LBP was the leading cause of YLD in China. Compared with 1990, the growth rates of age-standardized rate, proportion of YLD and YLD, were 5.6%, 25.5% and 72.1%, desperately.@*Conclusion@#Low back pain was the leading cause of YLD in China in 2013. Compared with 1990, the disease burden for low back pain increased rapidly.
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Objective@#To analyze the rate of prevalence, awareness, treatment and control of hypertension among women at reproductive age (18-49 years old) in China in 2013.@*Methods@#The analysis used data obtained from the China Chronic and non-communicable disease surveillance in 2013.The surveillance included 176 534 adults aging ≥18 years old, who were selected from 302 surveillance points by multi-stage cluster random sampling method. A total of 46 674 women at reproductive age (18-49 years old) were investigated. Blood pressures were measured by electronic blood pressure monitor. After being weighted according to complex sampling scheme and post-stratification, the rate of prevalence, awareness, treatment and control of hypertension were compared by different characteristics such as age, education, urban and rural areas, and geographic locations.@*Results@#The prevalence of hypertension among women at reproductive age (18-49 years old) in China in 2013 was 13.5%. The rate in the rural areas was higher than that in urban areas (χ2=46.23, P<0.05), which were 14.5% and 12.3%, respectively. The prevalence in eastern, central and western geographic locations were separately 13.9%, 13.2% and 13.1%, there was no statistical difference (χ2=0.56, P>0.05). The hypertension prevalence in all age groups (18-24, 25-29, 30-34, 35-39, 40-44, 45-49 years old) were 6.6%, 9.2%, 9.6%, 12.0%, 17.9% and 28.3%, respectively. The prevalence of hypertension showed a rising trend with age increasing (t=12.32, P<0.05). The awareness, treatment and control rates of hypertension were separately 25.8%, 22.7% and 7.4% in women at reproductive age (18-49 years old), which were 31.6%, 28.2% and 9.4%, respectively in urban areas; and 21.3%, 18.5% and 5.9%, respectively in rural areas. The rates in urban areas were all higher than those in rural areas (chi square were separately 18.98, 21.31, and 6.80, P values <0.05). The treatment rate of hypertension was 86.8% among who had been aware of hypertension, and the treatment rate of hypertension was 31.8% among who received control of hypertension. The treatment rate among who had been aware of hypertension in eastern, central and western locations were 89.3%, 88.3% and 79.5%, respectively. The control rates in eastern, central and western locations were 8.5%, 8.1% and 4.7%, respectively. The treatment rate among who had been aware of hypertension and control rate in the eastern and central geographic locations was higher than that in western locations (chi square were separately 10.05 and 7.25, P values <0.05).@*Conclusion@#The prevalence of hypertension in women at reproductive age (18-49 years old) was comparatively high, and the rates of awareness, treatment and control were low. The differences showed statistical significance between urban and rural areas.
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Objective@#To estimate the impact of risk factors control on non-communicable diseases (NCDs) mortality, life expectancy and the numbers of labor force lost in China in 2030.@*Methods@#We used the results of China from Global Burden of Disease Study 2013, according to the correlation between death of NCDs and exposure of risk factors and the comparative risk assessment theory, to calculate population attributable fraction (PAF) and disaggregate deaths of NCDs into parts attributable and un-attributable. We used proportional change model to project risk factors exposure and un-attributable deaths of NCDs in 2030, then to get deaths of NCDs in 2030. Simulated scenarios according to the goals of global main NCDs risk factors control proposed by WHO were constructed to calculate the impact of risk factors control on NCDs death, life expectancy and the numbers of labor force lost.@*Results@#If the risk factors exposure changed according to the trend of 1990 to 2013, compared to the numbers (8.499 million) and mortality rate (613.5/100 000) of NCDs in 2013, the death number (12.161 million) and mortality rate (859.2/100 000) would increase by 43.1% and 40.0% respectively in 2030, among which, ischemic stroke (increasing by 103.3% for death number and 98.8% for mortality rate) and ischemic heart disease (increasing by 85.0% for death number and 81.0% for mortality rate) would increase most quickly. If the risk factors get the goals in 2030, the NCDs deaths would reduce 2 631 thousands. If only one risk factor gets the goal, blood pressure (1 484 thousands NCDs deaths reduction), smoking (717 thousands reduction) and BMI (274 thousands reduction) would be the most important factors affecting NCDs death. Blood pressure control would have greater impact on ischemic heart disease (662 thousands reduction) and hemorrhagic stroke (449 thousands reduction). Smoking control would have the greatest effect on lung cancer (251 thousands reduction) and chronic obstructive pulmonary disease (201 thousands reduction). BMI control would have the greatest impact on ischemic heart disease (86 thousands reduction) and hypertensive heart disease (45 thousands reduction). If the risk factors exposure changed according to the trend of 1990 to 2013, in 2030, the life expectancy of Chinese population would reach to 79.0 years old, compared to 2013, increasing by 3.3 years old, the labor force at the age of 15-64 years old would loss 1.932 million. If the risk factors get the goals in 2030, life expectancy would increase to 81.7 years old and the number of labor force lost would decrease to 1.467 million. Blood pressure, smoking and BMI control would have much greater impact on life expectancy (4.9, 4.0 and 3.8 years old respectively) and labor force lost (630 thousands, 496 thousands and 440 thousands respectively).@*Conclusion@#Risk factors control would play an important role in reducing NCD death, improving life expectancy of residents and reducing loss of labor force. Among them, the control of blood pressure raising, smoking and BMI raising would have a greater contribution to the improvement of population health status.
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Objective@#The objective of this study is to analyze the trend of burden of ischemic heart disease (IHD) in China between 1990 and 2015.@*Methods@#Data were collected from the results of 2015 Global Burden of Disease Study. We arranged and analyzed the mortality and disability-adjusted life year (DALY) for IHD by sexes, ages and provinces (excluding Taiwan, China) in China between 1990 and 2015. The age-standardized rates were determined using the average world population age structure in the period of 2010-2035 as a reference, and the changes of the related indicators were calculated.@*Results@#In 2015, IHD caused 1 461 thousand deaths, and its age-standardized death rate was 114.8 per 100 000. Number of DALYs from IHD were 25 765 thousand in 2015, with the age-standardized DALY rate at 1 760.2 per 100 000. From 1990 to 2015, the age-standardized death rate for IHD in China increased by 13.3% but age-standardized DALY rate decreased by 3.9%. Number of IHD DALYs among male (16 664 thousand) was higher than it among female (9 101 thousand) in China in 2015, and 83.5% of total DALYs from IHD occurred among people aged over 50 years old. Province with highest age-standardized death rate was Heilongjiang, with rate at 187.4 per 100 000 in 2015. Qinghai (54.0%) increased most and Macao (-52.3%) decreased most from 1990 to 2015. Province with highest age-standardized DALY rate was Xinjiang, with rate at 3 040.8 per 100 000 in 2015. Qinghai (33.2%) increased most while Macao (-59.0%) decreased most between 1990 and 2015.@*Conclusion@#Burden of IHD in China increased remarkably from 1990 to 2015, especially among males and people aged over 50 years old. The differences among provinces were obvious.
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Objective@#To analyze the burden of disease attributable to low fruit intake among Chinese population aged ≥15 years old between 1990 and 2013.@*Methods@#We used data from the 2013 Global Burden of Disease Burden of Disease Study to study the situation in China. The population attributable fraction was calculated to estimate and compare the death and disability-adjusted life years (DALY) attributed to low fruit intake between 1990 and 2013 in China (excluded Taiwan, China). An average world population age structure of the period 2000-2025 was adopted to calculate age-standardized rates.@*Results@#Deaths attributable to low fruit intake accounted for 11.02% of all death in 2013, which were higher than it in 1990 (10.38%). In 2013, the number of deaths attributed to low fruit intake in China increased to 1 046 500 from 793 800 in 1990. From 1990-2013, the age-standardized death rate attributable to low fruit intake decreased from 113.04/100 000 to 79.80/100 000. DALYs caused by low fruit intake increased from 18.346 5 million in 1990 to 21.296 7 million in 2013. Compared with 1990, the age-standardized DALY rate attributed to low fruit intake decreased by 34.67%. In 2013, the top three provinces with the highest burden of disease attributed to low fruits intake were Tibet, Guizhou and Xinjiang provinces, with standardized DALY rate at 2 612.53/100 000, 2 281.85/100 000 and 2 198.22/100 000, respectively. Compared with the results in 1990, the standardized DALY attributed to low fruits intake decreased, especially in Tianjin, where decreased by 63.61%; followed by Aomen, Zhejiang, Shanghai and Beijing, where decreased by 59.74%, 59.53%, 56.64% and 53.88%, respectively.@*Conclusion@#Compared with the situation in 1990, the burden of disease attributable to low fruit intake decreased in 2013, but the situation is still serious, especially in Tibet, Guizhou and Xinjiang provinces, where the burden decreased comparatively slowly.
ABSTRACT
Objective@#To investigate the current status, temporal trend and achieving Health China 2030 reduction target of probability of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases, tumour, diabetes, and chronic respiratory disease in China both at national and provincial level during 1990 to 2015.@*Methods@#Using the results of Global Burden of Disease study 2015 (GBD 2015), according to the method of calculating premature mortality probability recommended by WHO, the current status and temporal trend by different gender from 1990 to 2015 were calculated, analyzed, and compared. Referring to " Health China 2030" target of reduction 30% of probability of premature mortality caused by major NCDs, we evaluated the difficulty of achieving the reduction target among provinces (not including Taiwan).@*Results@#From 1990 to 2015, the probabilities of premature mortality in cardiovascular and cerebrovascular diseases, tumour, and chronic respiratory disease were all declined consistently for both men and women in China, the total of four main NCDs decreased from 30.69% to 18.54% with higher decreasing in women (from 25.97% to 12.40%) than that in men (from 34.94% to 24.19%). In 2015, the top five provinces in terms of probability of premature mortality caused by four main NCDs were Qinghai (28.81%), Tibet (25.88%), Guizhou (24.67%), Guangxi (23.56%), and Xinjiang (23.21%) in turn, while the top five provinces with the lowest probability were Shanghai (8.40%), Beijing (9.39%), Hong Kong (10.10%), Macao (10.31%), and Zhejiang (11.70%). If achieving the " Health China 2030" target, the probabilities of premature mortality in Qinghai and Tibet with the highest probability should decline to about 20.17%, and 18.12%, respectively in 2030, while 5.88%, and 6.57% in Shanghai and Beijing, respectively. From 1990 to 2015, the probability of premature mortality of four main NCDs declined by 2.00% a year on average, the top five provinces with the fastest decline were Beijing (3.48%), Shanghai (3.24%), Zhejiang (2.81%), Fujian (2.75%), and Guangdong (2.67%), and 11 provinces including these five provinces could achieve the " Health China 2030" target by the usual rate of decline, while other 22 provinces could not achieve the target, they need greater rate of decline in order to achieve the target.@*Conclusion@#From 1990 to 2015, the probabilities of premature mortality of four main NCDs were declined consistently in China both at national and provincial level, compared with women, the men had higher probabilities and declined slower, there were significant different in probabilities of premature mortality and their change speed among provinces. Based on the results from 1990 to 2015, there were about two thirds of the provinces, which the task of achieving the Health China 2030 target will be daunting.