| BackgroundThe general morality rates and the changes of its cause are an important index to reflect the population health status. Thus the registration and statistical analysis of the cause of death can help the study of the population death level, death causes, change rules and population management, and also provide a significant basis for the development plans of social economy and health care and the evaluation of general health and social health conditions. With the rapid development of global economy and the progress of industrialization and urbanization in our country, the lifestyle and behaviors of urban and rural residents have also changed dramatically. The rate of high-fat, high-calorie diet, smoking, alcohol dependence, lack of exercise and meditation lifestyle and mental pressure have risen, together with the environment, an aging population and other social conditions, which has great impact on the causes and development of diseases, leading to changes in disease patterns. At present, with the continuous improvement of medical technology, non-communicable chronic diseases in the sequence of death spectrum has gradually increased, especially high in proportion to the disease of heart head blood-vessel, malignant tumor, become the major diseases that affect the residents’ health. Since the starting of the death cause test in 2009, the death rate has increased from 604.56/100 thousand in 2011 to 727.42/100 thousand in 2015, which reaches the national standard. And the date quality is improving year by year. However, there are no detailed and systematic analysis on the causes of death. Therefore, learning about the residents’death causes and evaluating the general health can provide the basis for local governments and administrative department to adjust the control policies of diseases and optimize the health resources rationally.PurposeThe analysis of the general death level in Zichuan, the cause-of-death structure, the death cause sequence and the changes of main disease death rates can provide basis for assess the people health status, the understanding of the health prevention, the evaluation of the quality of health and health care intervention effect,and the health policies of the government and the administrative department of public health, and optimizing the allocation of resources.MethodsThis study belongs to the monitoring data analysis descriptive epidemiology research methods. Based on the death surveillance data in Zichuan from 2011 to 2015, some tables and charts have been done by MS Excel 2007 using SPSS20.0 software statistical analysis. Data in this study for categorical data, comparison between groups by chi-square test, mortality trends by using linear-by-linear chi-square test. The situation of general death is described by crude mortality rate, constituent ratio and other indicators, and the annual trend of crude mortality of major diseases from 2011 to 2015 will be described and analyzed in the same way;using death fill in correctly, mesh coincidence rate, the highest diagnostic unit and diagnosis based on proportion, capture-make-recapture (CMR) estimate indicators such as mortality, non-response rates to evaluate data quality in 2014.Results1. The total number of people in Zichuan in 2011-2015 is 3238658 with 21091 deaths and average crude mortality per 651.23/100 thousand people, standardized mortality rate per 420.51/100 thousand, the annual crude mortality is between 604.56/100 thousand and 727.42/100 thousand, standardized mortality rate per 402.28/100 thousand and 457.15/100 thousand. Among these,12088 cases are male deaths, crude mortality rate and standardized mortality rate are per 744.82/100 thousand and per 488.26/100 thousand; 9003 cases are female deaths, crude mortality rate and standardized mortality rate are per 557.21/100 thousand and per 350.97/100 thousand. Crude mortality rate of male deaths are higher than females, with 1.34 times higher than females (χ2=441.430, P<0.001). From 2011 to 2015, the death rate increases like" √" with age (χ2=26.634,*P <0.001).In addition to high neonatal mortality,,the mortality rate began to decline to the lowest at the age of 10, while after the age of 10, the mortality rate increased rapidly and has maintained high growth levels, and a after the age of 85, the mortality rate reaches its peak.2. The results of the death structure analysis show that the chronic diseases are the main cause of death in the study site, followed by injury and infection, maternal and infant nutritional deficiency diseases. The male crude mortality rate is higher than females in general from the three types of diseases. The structures are different according to the age differences.The characteristics of the death distribution are as follows:maternal and infant nutritional deficiency disease as the main cause of death among people aged 0, chronic diseases as the main cause of death among people aged 1-4,5-14 people groups mainly die of chronic non-communicable diseases and injuries, population aged 15 and above years old mainly die of non-communicable chronic disease.3. The results of the sequence of the total death show, the top five causes of death is cardiovascular disease, followed by malignant tumor, cerebrovascular disease respiratory disease injury poisoning. The top five death causes account for 86.74% of all death. Sequence of the top five cause of death in men is malignant tumor, cardiovascular disease, cerebrovascular disease, injury, respiratory system disease. Sequence of the death causes of in women is cardiovascular diseases, malignant tumors, cerebrovascular disease, respiratory disease and injury.4. The results of the death change analysis show that there is an upward trend in crude mortality of cardiovascular disease in Zichuan district from 2011 to 2013,the cardiovascular disease (CVD) in 2014 crude mortality rates dropped to the bottom, the crude mortality rate is relatively higher in 2015 (higher than 2011 but less than every other year). There is an upward trend of cerebrovascular disease, malignant tumor mortality rate in general.5. The data integrity of the sampling area in Zichuan is estimated based on the Capture-make-recapture [CMR]. With the adjustment of CMR method, the crude mortality rate is 802.27/100 thousand, non-response rates is 1.54%. The accuracy of the data analysis results show that, the accuracy rate of the cause of death in the sampling areas in 2014 is 88.46%, the cause net coincidence rate is 76.92%, both are between 70-90%, the cause of death card is medium quality. The reliability of data analysis results show that, the highest diagnosis unit for level 2 and above hospital 3672 cases account for 88.12% of all death reports, the highest diagnostic basis and a reliable diagnosis and clinical diagnosis account for 85.58% of all death reports, which shows that the research field death monitoring data quality is reliable. Conclusions and recommendationsFrom 2011 to 2015, the death rate increases like "√" with age from the year 2011 to 2015.In addition to high neonatal mortality, the mortality rate began to decline to the lowest at the age of 10, while after the age of 10, the mortality rate increased rapidly and has maintained high growth levels, and a after the age of 85, the mortality rate reaches its peak; crude mortality rate of male deaths are higher than females. The chronic diseases are the main cause of death in the study site Zichuan, followed by injury and infection, maternal and infant nutritional deficiency diseases. The male crude mortality rate is higher than females in general from the three types of diseases. The structures are different according to the age differences. The top five causes of death is cardiovascular disease, followed by malignant tumor, cerebrovascular disease respiratory disease injury poisoning. The whole Zichuan data complete and accurate and reliable quality. Crude mortality trends, crude mortality gender differences, three categories of qualifying disease, sequence of the top five causes of death are similar between Zichuan and 2010-2011 of Zibo.The cause of death situations between Zichuan in 2011-2015 and Zibo in 2011-2015 are similar.Chronic diseases have been a serious threat to Zichuan residents’ health and life. We should fully recognize the urgency and the severity of disease prevention and control work. On the basis of Zibo Non-communicable Chronic Diseases prevention and control measures, the comprehensive prevention and control mechanism and system of chronic disease shall be established to suit Zichuan’s situation as a government-led, multi-sectorial cooperative and communal participated one to establish and improve the prevention and control system of chronic diseases, improving the chronic disease management information system, popularizing the health knowledge, encouraging residents to develop a healthy lifestyle, in order to eliminate risk factors leading to chronic diseases as much as possible, and improve the health level of the residents. |
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