| Objective:Asthma is a major chronic respiratory disease in China and affects people of all ages.This study aims to analyze the epidemiological characteristics and the changing trend of asthma death burden in China,explore the influence of macro factors on asthma death risk,and predict the burden of asthma deaths in China from 2020 to2025.This study can provide a reference for the current and future asthma prevention and control management,the rational allocation of health resources,and the evaluation of disease prevention and control effects.Methods:Based on the asthma death burden data of the Global Burden of Disease Study2019(GBD)in the Global Health Exchange database,the change in asthma death burden in China from 1990 to 2019 was analyzed.First,descriptive analysis was used to analyze the mortality and the years of life lost(YLL)rate of asthma in China in1990 and 2019,to gain a preliminary understanding of the epidemiological characteristics.Second,the annual percentage change(APC)and average annual percentage change(AAPC)were calculated using a Joinpoint regression model to study the trend of asthma mortality and YLL rate in China from 1990 to 2019.Third,the differential decomposition method was used to explore the impact of demographic changes on asthma mortality and YLL rates in China.Fourth,the age-period-cohort model was used to assess the age effect,period effect,and birth cohort effect for the risk of asthma mortality and to explore the factors influencing asthma mortality from a macro perspective.Fifth,a Bayesian age-period-cohort(BAPC)model was used to predict the mortality and death number of asthma by age group from 2020 to 2025,and further estimate the YLL and YLL rate of asthma from 2020 to 2025 based on the predicted asthma death number,to evaluate the burden of asthma death in China in the future.Results:(1)From 1990 to 2019,the total mortality rate of asthma in China decreased from 3.41/100,000 to 1.74/100,000;the total number of deaths decreased from 40.4 to24.8 thousand.The total YLL rate of asthma in China decreased from 83.98/100,000 to 31.05/100,000;the total YLL decreased from 994.1 to 441.7 thousand person-years.Both asthma mortality and YLL rates were higher among males than among females during the observation period.(2)From 1990 to 2019,the mortality of asthma in the whole population,males and females decreased at an average annual rate of 2.34%,1.83%,and 2.86%respectively.The YLL rate of asthma in the whole population,males and females decreased at an average annual rate of 3.35%,2.96%,and 4.08% respectively.Agestandardized mortality and age-standardized YLL rates for asthma declined faster than asthma mortality and YLL rates over the same period.(3)From 1990 to 2019,the contribution rate of population structure change to the decrease of asthma mortality in the whole population,males and females was-156.89%,-198.55% and-129.04% respectively;The contribution of demographic changes to the decline of asthma YLL rate was-76.33%,-90.55% and-65.01% for the whole population,males and females,respectively.(4)According to the results of the age-period-cohort model analysis,the age effect showed that the relative risk of death from asthma increased with age in both males and females,reaching a maximum relative risk of death in the 90-94 age group(males:37.74,females: 32.44).The period effect showed a decreasing trend in the relative risk of asthma death over time(males: 1.41 to 0.72,females: 1.70 to 0.57).The cohort effects showed that the risk of asthma death decreased with the birth cohort(males:3.33 to 0.06,females:3.05 to 0.08),and the risk of asthma death was lower in the later birth cohort.(5)The burden of asthma deaths in China was predicted to show a continuous downward trend from 2020 to 2025.In 2025,the asthma mortality will be 1.89 per100,000 for males and 1.34 per 100,000 for females;the number of asthma deaths will be 13.7 thousand for males and 9.4 thousand for females;the YLL rate for asthma will be 25.33 per 100,000 for male and 16.03 per 100,000 for female;and the YLL for asthma will be 184.5 thousand person-years for male and 112.8 thousand person-years for female.Conclusion:(1)From 1990 to 2019,the death burden of asthma in China showed a continuous downward trend.The death burden of males was higher than that of females.The elderly population was the key population of asthma death.(2)2004-2008 was a period of rapid decline in asthma mortality and YLL rates,and the rate of improvement in the burden of asthma deaths has declined in recent years.(3)Population aging has a negative effect on the decline in asthma mortality and YLL rates,slowing the degree of improvement in the burden of asthma deaths.(4)The decline in asthma mortality in China from 1990 to 2019 can be attributed mainly to period and cohort effects,with age effects not favoring the decline in asthma mortality.(5)From 2020 to 2025,it is predicted that the mortality and YLL rate of asthma in the Chinese population will continuously decrease,and the burden of asthma death will be further reduced. |
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