| BackgroundThe change of mortality rate and cause of death is one of the most important indicator which reflects the health condition, is the scientific basis for establishing health policies, evaluating the quality and effect of health service and is one of important content of studying dynamic of natural population activities. Therefore, the statistical and analytical works about death and its causes have been payed more attention by all the countries in the world. China has a vast territory and a large population. There is a different natural ecologic environment and uneven distribution of land resources and significant difference between Social and Economic Development and the lives of the people level. Dynamical collection and system analysis about the cause of death and the law of its change in different regions in China make a significant contribution to setting down the program on disease control, allocating health resources rationally, protecting the people health and promoting sustainable socioeconomic development.In recent years, with the rapid development of economy in Yantai, there are substantial changes of the environmental condition, living standards of the residents and Nutritional Status. Meanwhile, the health conduct mode and disease pattern have consequently changed. The burden and damages of diseases can not only affect the national economy, but increasingly become hot issues in china. Because perfect vital statistic system is lacked, there is not real-time, dynamic and accurate reflection of the change of mortality rate and cause of death, but only cross sectional survey in different periods has been compared to understand the trend of changes of death.On this basis, it is imperative to conduct sampling survey into the death causes focusing on cancer within the city and build complete data of survey. retrospective survey into the death causes especially cancer has been accomplished from September in 2009 to June in 2010 in Yantai, which found out the sequence of death causes and the death level of residents in Yantai. The trend of changes about the sequence of death causes and death level of main causes could be found by comparing the survey result from 2007 to 2009.ObjectiveTo find out mortality and constitution of all causes of death of the leading chronic diseases, and to grasp the characteristics as place and persons status of mortality of the leading chronic diseases in order to provide a scientific basis for taking preventive measures and to lay the good foundations for establishing and improving the cause of death registration system, tumor registered system, stroke registration system and developing correlative studies. The burden of death, diseases and the indirect financial burden on the residents in Yantai were comprehensively analyzed.MethodsWith the principle that the mortality and all causes of death of residents in regions of different types in Yantai can be reflected, all the residents in six regions were selected as the subjects for this survey. According to the program on this survey, the cause-of-death information can be collected and the death database can be built.The data was analyzed by EXCEL, ACCESS and SPSS to describe the pattern of death, mortality level and disease burden.ResultsThe surveyed people from 6 investigation points were respectively 21698,21902 and 21602 from 2007 to 2009. About the crude mortality rate, it was 695.39/100,000 in 2007, among which it was 785.20/100,000 for male and 603.99/100,000 for female; it was 709.78/100,000 in 2008, among which it was 811.76/100,000 for male and 606.78/100,000 for female; it was 699.87/100,000 in 2009, among which it was 798.28/100,000 for male and 600.21/100,000 for female. The infant mortality rate was respectively 475.08/100,000,332.12/100,000 and 354.50/100,000 from 2007 to 2009 in Yantai; the dead cases in each group from 1 to 29 years old accounted for 2.46%,2.13% and 2.06%, respectively of the total. Most dead cases focused on the people above 65 years of age, which accounted for 65.80%,66.30 and 66.72% from 2007 to 2009. The average life expectancy was 75.95,76.04 and 76.40 years old from 2007 to 2009 in Yantai, among which it was 73.45 years old for male and 78.64 years old for female in 2007, it was 73.38 years old for male and 78.91 years old for female in 2008 and it was 73.89 years old for male and 79.10 years old for female in 2009.The top ten causes of death in both 2007 and 2008 in Yantai were respectively tumor, cerebrovascular diseases, cardiovascular disease, injury, chronic respiratory disease, diabetes, digestive system diseases, infectious diseases, neuropsychiatric disease and respiratory infection. Compared with the top ten causes of death in both 2007 and 2008, cardiovascular disease rose from No.3 to No.2; infectious diseases dropped from No.8 to No.9 and respiratory infection was absent from the top ten list. Besides, cardiovascular disease, tumor, injury and chronic respiratory disease were the main causes of death to have an impact on the average life expectancy.The number of people at the investigation points who died from tumor from 2007 to 2009 were respectively 5204,5336 and 5447 which accounted for 23.98%,24.36% and 25.22%, respectively of all the causes of death.The crude mortality rate of tumor was respectively 166.78/100,000, 172.92/100,000 and 176.47/100,000 from 2007 to 2009(among which, it was 208.49/100,000 for male and 124.17/100,000 for female in 2007; it was 223.59/100,000 for male and 121.68/100,000 for female in 2008; it was 223.57/100,000 for male and 128.78/100,000 for female in 2009). The people dying from tumor focused in 55-74 age group accounting for 46.60%,48.53% and 49.95% respectively of total number of people dying from tumor from 2007 to 2009, among which, more male person tend to die from tumor, especially focused in 55-74 age group accounting for 50.05%,51.60% and 53.63% respectively of total number of male person dying from tumor in these 3 years and it accounted for 40.71%,42.83% and 43.49% for female in the same age group. During the 3 years, the constitution of death cause spectrum about malignant tumor is stable. The lung cancer, gastric cancer and liver cancer had remained in the top three for three years. The rank of leukemia, Nasopharyngeal Carcinoma, lymph cancer, skin cancer and cervical cancer in the death cause spectrum showed tendency to drop; the rank of pancreatic cancer, esophageal carcinoma, laryngeal carcinoma, bladder cancer, prostate cancer, breast cancer and ovarian cancer showed tendency to ascend.The disability adjusted life years (DALYs) per 1000 people caused by all kinds of disease were respectively 144.26,143.97 and 141.97 every year from 2007 to 2009 in Yantai. The important disease which had serious effect on health of residents in Yantai during the 3 years were malignant tumor, cerebrovascular diseases, injury, cardiovascular disease and chronic respiratory disease. Total DALYs of these five kinds of disease accounted for 59.39%,60.58% and 60.65% respectively of all DALYs from 2007 to 2009 and the constitution of them showed tendency to ascend annually. Indirect economic cost per person caused by all kinds of disease was 3155.49 yuan and the total indirect economic cost was 20.557 billion yuan in 2007; indirect economic cost per person caused by all kinds of disease was 3712.65 yuan and the total indirect economic cost was 24.195 billion yuan in 2008; indirect economic cost per person caused by all kinds of disease was 3964.08 yuan and the total indirect economic cost was 25.846 billion yuan in 2009. The indirect economic cost caused by all kinds of disease showed tendency to ascend annually with time.Conclusion and suggestionThe average life expectancy of residents in Yantai showed tendency to ascend with time from 2007 to 2009, which indicated the economy, the level of health and medical care and the living environment state had been developing and improving constantly. Meanwhile, with the development of economy and medicare cause, the living standards of the residents in Yantai had been increasing constantly and the pattern of death had been changing all the time. The proportion of infectious disease which used to damage badly the health of residents in Yantai was decreasing annually and it's rank in the sequence of death causes was declining gradually and the mortality rate showed a obvious tendency to decrease with time changing. However, non-communicable chronic diseases (NCD) has been the main cause of death in Yantai. It was indicated that the prevention and control of the Category 1 disease has achieved remarkable effect, including infectious disease, respiratory infection, perinatal disease, reproduction disease and nutritional disease. But adverse effects of NCD on residents'health has been increasing with every passing day, which has been the main disease threatening the health and safety of residents in Yantai. Therefore, emphasis should be put on the health education. Residents should be promoted a healthy lifestyle and all measures shoule be taken to remove risk factors causing the NCD. |
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