| Objective(s):To analyze the death characteristics of residents in Wuhua District of Kunming City during the seven-year period from 2014 to 2020,explore the level of death and the composition of causes of death of residents,and use potential years of life lost(PYLL)and other indicators to study life loss.The Arriaga factor decomposition method was used to investigate the contribution of different death levels at different ages and causes of death to the improvement or reduction of life expectancy.The Joinpoint model was applied to analyze the time trend of death data.To objectively reflect the health status and health care level of Wuhua District residents,determine the key diseases affecting the health of residents and disease prevention and control areas,and provide scientific basis for the formulation of public health strategies and evaluation of the effect of disease intervention.Methods:Data of registered population death cases in Wuhua District of Kunming City from January 1,2014 to December 31,2020 were collected from"Population Death Information Registration and Management System",subsystem of"Chinese Disease Control and Prevention Information System".The registered population data of Kunming Wuhua District from 2014 to 2020 were collected from the Bureau of Statistics.Mortality surveillance data were coded and classified according to ICD-10.The crude mortality rate of the population was described,and the composition of the cause of death of the population was described by the component ratio.The comparison between the count data groups was χ~2 tested,and the test level wasα=0.05.Life expectancy,PYLL,PYLLR and AYLL were calculated by using population summary life table.The standard population of the 6th National Census in 2010 was used to standardize the mortality rate.PYLL took 70 years as the target age for survival.The Arriaga factor decomposition method was used to analyze the contribution of different age and cause-specific mortality rates to the increase or decrease of life expectancy.The Joinpoint model was applied to analyze the time trend of death data.Results:1.From 2014 to 2020,the total registered population of Kunming Wuhua District is 4,285,432,including 2,136,898 males and 2,148,534 females,with a sex ratio of 0.99:1.The burden coefficient of children was 19.39%,the burden coefficient of the elderly was 22.94%,and the total burden coefficient was 42.33%.2.From 2014 to 2020,a total of 29,006 people died in Wuhua District of Kunming,with a crude mortality rate of 676.85/100,000 and a standardized mortality rate of 379.95/100,000;The mortality rate of male was higher than that of female(P<0.05).During the seven years,the mortality rate of the 10～group gradually increased with the increase of age,the mortality rate of the 65～group increased sharply,and the mortality rate of the 85～group reached the peak,and the death rate of the older people in the 65～group accounted for the highest proportion of the total number of deaths.3.From 2014 to 2020,the top five causes of death in Wuhua District of Kunming were circulatory system diseases,tumor,respiratory system diseases,endocrine nutrition and metabolic diseases,and digestive system diseases.The top five causes of death accounted for the highest proportion of the total number of deaths,accounting for 90.20%.Injuries and poisoning ranked sixth among all causes of death,and traffic accidents had the highest mortality rate(8.59 per 100,000).The top five causes of death of male and female were consistent with the causes of death of the whole population.The order of the top five causes of death was different in all age groups,and the crude death rate of cause of death was different(P<0.05).The first death of group 0 was due to perinatal origin,the first death of group 1 to 14 was due to injury and poisoning,and the first death of group 15 to 64 and 65 to 65 was due to circulatory diseases.4.During 2014-2020,there were differences in the mortality rates of the three major categories of diseases in the whole population,males and females in Kunming Wuhua District(P<0.05),among which the mortality rates of chronic non-communicable diseases were the highest.Groups 0 to 14 had the highest proportion of deaths due to infectious diseases,maternal and child diseases and nutritional deficiencies,while groups 15 to 64 and 65 to 65 had the highest proportion of deaths due to chronic non-communicable diseases.5.From 2014 to 2020,the PYLL,PYLLR and AYLL of all deaths in Wuhua District of Kunming were 285,088 person-years,66.52‰and 9.83 years respectively.PYLL,PYLLR and AYLL were higher in male than in female.The top six causes of premature death in the seven years were circulatory diseases,tumors,respiratory diseases,injuries and poisonings,digestive diseases,endocrine nutrition and metabolic diseases.PYLL and PYLLR caused by circulatory diseases were the highest in the whole population,male and female,and AYLL caused by injury and poisoning was the highest.6.The life expectancy of Kunming Wuhua District increased from 82.76 years in2014 to 84.00 years in 2020,an increase of 1.24 years in seven years.Compared with2014,the increase of life expectancy by age group in 2020 showed a double peak trend.The first peak was for the group of 0～years old,and the contribution rate was14.94%(0.19 years);the second peak was from 60～years old to 80～years old,and the 80～group reached the peak of 51.26%(0.64 years).In terms of the increase of life expectancy causes of death,respiratory diseases ranked first,with a contribution rate of 80.79%(1 year),followed by circulatory diseases with a contribution rate of38.03%(0.47 years)and malignant tumors with a contribution rate of 20.86%(0.26years).There are also many diseases with negative contribution rates:benign tumors-19.36%(-0.24 years old);endocrine,nutritional and metabolic diseases-18.96%(-0.23 years old);digestive diseases-10.86%(-0.13 years old);and mental and behavioral disorders-6.81%(-0.08 years old).7.The all-cause mortality rate of women in Wuhua District,Kunming City decreased by 2.4%per year during 2014-2020,APC2014-2020=-2.4(95%CI:-4.3～-0.3,P=0.031).The mortality rate of respiratory diseases decreased by 7.6%per year,APC2014-2020=-7.6(95%CI:-10.6～-4.5,P=0.002),and that of males decreased by7.4%per year,APC2014-2020=-7.4(95%CI:-11.1～-3.5,P=0.005).Women a year fell by 7.9%,APC2014-2020=7.9(95%CI:10.7～5.1,P=0.001).Circulatory diseases,cancer mortality APC,AAPC were statistically significant,and the mortality trend was not obvious.Conclusion(s):1.Male mortality rate was higher than female mortality rate in Wuhua District of Kunming during 2014-2020;People aged 65 and above have the highest mortality rate and the highest proportion of deaths.2.From 2014 to 2020,the top five causes of death in the whole population,male and female in Kunming Wuhua District were circulatory system diseases,tumor,respiratory system diseases,endocrine nutrition and metabolic diseases,and digestive system diseases.Injury and poisoning ranked the sixth place among all causes of death,and the death rate of traffic accidents was the highest.The order of the top five causes of death varies by age group.3.Chronic non-communicable diseases have become the main cause of death in Kunming’s Wuhua District.4.PYLL,PYLLR and AYLL caused by all causes of death were higher in male than female in Wuhua District of Kunming from 2014 to 2020;PYLL and PYLLR caused by circulatory system diseases were the highest in the whole population,men and women,and AYLL caused by injury and poisoning was the highest.5.Life expectancy in Kunming Wuhua District increased steadily from 2014 to2020;Respiratory and circulatory diseases have made positive contributions to the increase of life expectancy.However,attention should be paid to the negative effects of cancer,endocrine,nutritional and metabolic diseases,digestive diseases,and mental and behavioral disorders on life expectancy.Future public health strategies should be appropriately tilted.6.From 2014 to 2020,the female mortality rate in Wuhua District of Kunming gradually decreased,and the mortality rate of respiratory diseases in the whole population was effectively controlled.Prevention and control measures such as air control and tobacco control played an important role,but it is still necessary to strengthen the comprehensive prevention and control of circulatory diseases and tumors. |
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