Analysis On The Death Causes And Its Burden Of Disease For Residents From 2008 To 2014 In A District Of Tang Shan City

Objectives To explore the main causes and disease burden of death in the monitoring points by analyzing the monitoring data of the certain district of Tangshan city from 2008 to 2014, and to find out priority diseases affecting residents’ health. To determine the characteristics of deaths unreported through registration system, and to provide a reference basis for the establishment of improvement measures.Methods All the death cases collected through death registration system and statistical bureau in the certain district of Tangshan city from January l, 2008 to December 31,2014 were treated as objects in the study. Stratified random cluster sampling method was applied to select objects for analyzing deaths unreported. Information of death was collected by questionnaires among seven years. SPSS17.0 software was used for statistical analysis.Results 1 A total of 34161 inhabitants died from the year 2008 to 2014, which the annual crude death rate(CDR) was 654.9/100 000 and standardized mortality ratio(SMR)was 628.7/100 000, with a gender ratio of 1.37(705.9/100 000 males and 546.5/100 000females). 2 Disease of the circulatory system made up most of all death cases accounting for 58.0%, and the second most was neoplasms accounting for 15.0%, followed by injury,nervous system diseases, respiratory system disease, all of above accounting for92.0%.Diseases of newborn babies was the major death cause in age group 0-15 years and injury was the major death cause in age group 15-45 years and chronic diseases was the major death cause in age group≥45 years. 3 The top fifth causes of death among disease of the circulatory system were cerebral infarction, cerebral hemorrhage, acute myocardial infarction and chronic ischemic heart disease and cor pulmonale. The top fifth causes of death among neoplasms were lung cancer, liver cancer, gastric cancer,esophageal cancer and colorectal cancer, all of above accounting for 74.4%.Leukemia was the first cause of death of malignancy in age group 0-15 years, and lung cancer was the first cause of death of malignancy among the people above 15 years old. Mortality of malignant tumor(except for brain cancer, breast cancer, leukemia) of males was higher than that of females. Traffic accident was the first injury death causes accounting for42.7%,followed by suicide,accidental poisoning. Drowning, traffic accident, suicide respectively was the first injury death causes in the people aged 0-15 years, 15-75 years,above 75 years. 4 The average life expectancy of the residents was 75.6 years old(males73.4 years old, females 78.1 years old). The main factor affecting the health of people were disease of the circulatory system, if that risk was eliminated, the life expectancy of residents would prolong 9.1 years(males 7.6 years, females 10.5 years). 5 The leading PYLL were injuries(76256.8 years) from the year 2008 to 2014,followed by circulatory system disease, malignant tumor, newborn disease, endocrine, nutritional and metabolic disease, all of which accounting for 91.6%.There were significant differences betweenmale and female in the sequence of PYLL of the main diseases of residents. There were874 deaths unreported during 2008 to 2014 in the survey area though death registration system and the rate of under-reporting was 12.66%, while there was143 deaths unreported by comprehensive collection method and the rate of under-reporting was3.39%. The rate of under-reporting was declining with years, which 21.05% in 2008 dropped to 2.16% in 2014(χ2=354.12,P<0.001). 6 The rate of under-reporting of group aged 5~15 years old was the lowest(0%), and the highest was group aged 0~5 years old(26.51%) in group of death registration system, while the rate of under-reporting of group aged 0~5 years old was the highest(7.23%), and next was group aged 60~74years old(4.47%) in group of comprehensive collection, which were significant differences of rate of under-reporting between different ages in two groups(P<0.05).It showed the rate of under-reporting of group in low mortality rates was the highest and they were significant differences between different groups(P<0.05). 7 Under-reporting rate of injury was the highest(23.22%), the next was chronic diseases(17.87%) in group of death registration system, while the highest and the lowest were chronic diseases(3.73%) and injury(1.12%) in group of comprehensive collection. It indicated the rate of under-reporting of group in low mortality rates was the highest and they were significant differences between different groups(P<0.05). 8 The cases of under-reporting in rural and urban were 701 and 173, and under-reporting rate were 14.51% and 8.35% respectively,which showed it was significant higher in rural area than that in urban area(χ2=16.23,P=0.003). The main place of deaths unreported through registration system was home,accounting for 87.5%, and the rate of under-reporting was14.03%, followed by death from nonlocal(13.82%) and hospital(4.01%),which were significant differences between different places(χ2 =16.23,P =0.003).Conclusions 1 In a district of Tangshan residents overall mortality rates are high er than the national average(2012), where the average life expectancy is up to 75.6 years, higher than the national average(2012).2 circulation system is the area residents die of the disease first disease, malignant tumor is second, injury ranked third; Injury is the sequence of the whole crowd reduce the first disease, apart fr om other areas.3 The area death reporting system non-response rates below the na tional average, among them injury is the highest in death reporting system, 7 year s total non-response rates declining trend year by year, still need to take correspo nding measures to further improve the quality of the cause of death report.