| Objectives：To understand the changes of death cause, to explore the differences of death causeby gender, rural/urban residency, and to explore the risk factors for life expectancy. Toprovide scientific evidence for formulating strategy of disease control and healthpromotion, by analyzing years of life lost attributable to each disease.Methods：Eight representative prefectures of Chongqing City, including2urban districts(Yuzhong district, Jiulongpo district) and6rural counties (Wanzhou district, Tongliangcounty, Zhong county, Nanchuan city, Dazu county, Xiushan county) were selected asdeath cause surveillance points. All deaths in the surveillance points were recorded withdeath certificates, and were classified and coded according to the ICD-10. After dataauditing, raking and summarizing, we estimated the life expectancy, cause eliminatedlife expectancy and the years of potential life lost (YPLL) etc., in order to explore thedeath composition and trend for life expectancy and YPLL by gender and geographicalresidency.Results：1. The death cause surveillance in Chongqing City was representative and covered31.81million population from2006-2010, namely6.36million yearly, accounting for20%of total population, which is representative. A total of190,565deaths werereported trough the surveillance system, and the yearly mortality increased over timewith average death rate of598.54/100,000. The efficacy and efficiency of thesurveillance system were enhanced during5years. Mortality for men (690.02/1000,000)was significantly higher than women (502.34/1000,000), and the mortality for bothgenders increased over time; rural residents had a higher mortality (615.36/1000,000) than their urban counterparts (538.91/1000,000).2. The top5causes of death and their yearly specific mortality in Chongqing Citywere207.30/1000,000for circulatory system diseases,139.55/1000,000for tumor,126.45/1000,000for respiratory diseases,53.28/1000,000for injury and poisoning, and17.18/1000,000for digestive diseases, all of which accounts for increasing percentagesof all death over time:89.46%in2006,90.26%in2007,90.63%in2008,91.64%in2009, and92.07%in2010. PYLL reflects the life lost attributable to specific diseases,and indicates the effect on health due to premature mortality. The top5disease-specificPYLL were tumor, injury and poisoning, circulatory system diseases, respiratorydiseases, and digestive diseases, the order of which was quite different from that ofdeath cause.3. Mortality bumped in0year, and then dropped obviously and bottomed at10-years, followed with a steady increase after25years. The main causes of death ofinfants were perinatal conditions and congenital anomalies; individuals aged1-44yearsmainly died from injury and poisoning which accounted for40%of all deaths. Thesecond cause of death for children aged1-4years was contagious disease, with96.55%of deaths from rural areas. Tumor was the second cause for the deaths of individualsaged5-44years, and it led to17.19%of all childhood deaths and27.71%of deaths ofyoung adults. The main tumor for children was leukemia, and liver cancer, lung cancer,leukemia, digestive tract cancer for the young adults. It could not be neglected thatmammary cancer was responsible for4.18%of all deaths for women aged15-44years.Tumor ranked first among the killers of individuals aged45-64years, followed bycirculatory system diseases, respiratory diseases, and injury and poisoning. For the elder(65+years), circulatory system diseases was their first killers which accounted for45.37%of deaths, and the respiratory diseases ranked second (COPD contribute91.25%of deaths from respiratory diseases).4. From2006to2010, mortality for circulatory system diseases and tumorincreased significantly, mortality for respiratory diseases and digestive diseasesremained, and injury and poisoning declined slowly. Mortality of circulatory systemdiseases for males and rural residents increased sharply, and that of tumor and respiratory diseases for males, tumor for females and rural residents increased steadilyas well, but injury and poisoning for females and urban residents declined slightly. Noobvious increase or decrease of mortality was observed in other diseases.5. The LE in Chongqing rose over time. By the year of2010, the LE was76.5yearsas a whole for Chongqing residents, and was74.19years for males and79.13years forfemales; LE for urban residents (78.74years) was higher than LE of their ruralcounterparts (75.96). Take2010, if we eliminated circulatory system diseases, tumor,respiratory diseases, injury and poisoning, and digestive diseases, the LE would increasefor4.22,2.48,2.01,1.26and0.27years, respectively. Except for circulatory systemdiseases, the cause-eliminated life expectancy for all kinds of disease was higher in menthan in women. Rural residents had a higher cause-eliminated life expectancy than theirurban counterparts for circulatory system diseases, respiratory diseases, injury andpoisoning, and urinary system disease, whereas urban residents’ cause-eliminated lifeexpectancy was higher than rural residents for tumor, digestive diseases, endocrinesystem diseases and contagious diseases.6. We used the YPLL to evaluate the effect from each kind of disease on health.Since2008, tumor had overtaken injury and poisoning to be the first killer of prematuredeath, which indicates that tumor was the biggest barrier for people’s health andsocio-economic development. And, it can’t be neglected that premature deaths due toinjury and poisoning also exerted great economic burden and lost on our aging society.The YPLL for respiratory diseases decreased over time. Further, YPLL for injury andpoisoning and tumor was higher in men than women; YPLL for tumor and injury andpoisoning was higher in rural residents than in urban residents.Conclusions：1. According to the characteristics of mortality, distributions of death causes,cause-eliminated life expectancy, and the changes of death causes over time, publichealth programs and strategy should be formulated base on locals conditions, and focuson cancer, cerebrovascular diseases, lower respiratory diseases, heart diseases and injuryand poisoning.2. Non-communicable diseases has been one of the factors that have great influences on health of Chongqing residents, as a result of which three-grade preventionstrategy should be focused. Health education, behaviors intervention, enhancement oflife quality and living environment, elevation for health concept and prevention of riskfactors should be reinforced according to local situations.3. Injury and Poisoning was not only an issue regarding health, but an increasinglyimportant social problem. We did not observe an increase for deaths due to injury andpoisoning, but the burden for it was still quite high, and hence we have to formulatestrategy of injury and poisoning prevention and control for population with priority.4. Contagious diseases were, to some extent, controlled, but still were importantpublic health problems we are facing. In recent years, TB, viral hepatitis and othercontagious diseases increased, and some emerging infectious diseases throw a threat onpopulation health social development. We should pay more attention to the control ofsource of infection, protecting susceptible people, in order to achieve the goal ofdecreasing incidence and detrimental effects of contagious diseases in a long time. |
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