| ObjectiveIn this study,a descriptive epidemiological analysis was carried out on the monitoring data of death causes in 21 national death surveillance sites in Guangxi in 2016.The purpose of this study is to understand the current status and distribution characteristics of the causes of death,the condition of probability of premature death and burden of disease caused by the main chronic disease in death surveillance points in Guangxi in 2016.Provide a scientific basis for targeted preventing and controlling major disease and formulating of local health policies according to local conditions.MethodsThe subject of this study was collected from the“Death Information Registration Management System”of the“China's Disease Prevention and Control Information System”business subsystem,the monitoring data of death cause of residents including 21 national death surveillance sites in Guangxi in2016,the demographic data of checkpoints were also derived from this system.The judgment,coding and classification of the underlying cause of death are in accordance with the International Statistical Classification of Disease and Related Health Issues(10~thh revised edition)(ICD-10).Data was card by Excel2016 and analyzed by SPSS 22.0.The mortality,composition ratio and the sequence of causes of death of residents in different sexes,ages,and regions were calculated respectively.At the same time,the probability of early death and the indicators related of burden of disease of major chronic disease were calculated.Then a descriptive analysis was conducted on the status quo,distribution characteristics caused by all causes of death of residents and the condition of premature of death and burden of disease caused by chronic diseases in Guangxi in 2016.Result1.Analysis of the population data of Monitoring point:There were 21state-level monitoring points of the cause of death of the monitoring system in Guangxi in 2016.The population of monitoring in total of 9370091 that covered21 counties(districts)in 14 cities and accounting for 20.4%in the total population of Guangxi;including 4939444 males and 4430647 females,the ratios of men and women was 52.72%and 47.28%respectively,and the gender ratio of the population of monitoring was 1.115.There were 2915754 people in urban and 6454337in rural,the proportion of urban and rural areas was 31.12%and 68.88%respectively,and the urban-rural ratio was 0.452.The number and constituent ratio of this population of monitoring at each age group showed a trend of decreasing with age.The composition ratio of gender and urban-rural is no difference between the population of monitoring and the composition of the2010 national census.2.Analysis of the population of death in Monitoring point:In 2016,21national death surveillance sites in Guangxi reported a total of 59874 deaths,including 36888 males and 22986 females,the composition ratio of men and women was 61.61%and 38.39%,and the sex ratio of the death toll was 1.605.There were 16761 Deaths in urban and 43113 in rural areas,the proportion of urban and rural was 27.99%and 72.01%respectively,and the ratio for urban-rural was 0.389.In addition to the 0-4 year old group,the number and constituent ratio of death were increased with the age,and the deaths above the age of 60 exceeded more than 75%of the total deaths.3.Analysis of total mortality:In 2016,the gross mortality of Guangxi residents was 638.99/100000,and the age-standardized mortality was563.37/100000.Among which the mortality,age-standardized mortality was746.80/100000 and 686.33/100000 in males,respectively;then it was518.8/100000 and 427.93/100000 in females;the mortality is higher for males than that of females.The gross mortality and age-standardized mortality of urban was 574.84/100000 and 506.17/100000,respectively;then it was667.97/100000 and 588.85/100000 in rural;the mortality in the countryside was higher than that of the city.The results of this study also showed that regardless of urban and rural,the residents'mortality in men was higher than that in women,and regardless of gender,the mortality in rural areas was higher than that in urban;the age-standardized mortality rate increases with age.According to analysis of different monitoring points in Guangxi found that the age-standardized mortality was highest(605.41/100000)in Xingning District and lowest(402.05/100000)in Fangcheng District,analysis of the cause of death in monitoring points in different regions showed that the age-standardized mortality in Western Guangxi was highest(501.48/100000)and the lowest(445.65/100000)was in Northern Guangxi.4.Analysis of the mortality and constituent ratio of three major diseases:The mortality of the first major category of disease(including infectious disease,maternal and infant disease,and nutritional deficiency disease),the second largest category of disease(chronic non-communicable disease)and the third major category of disease(injury)were 41.40/100,000,539.67/100,000 and46.09/100,000 in the cause of death surveillance points in Guangxi in 2016.The constituent ratio of three major diseases was 6.48%,84.46%and 7.21%respectively.The mortality of three major types of disease was higher in males than that in females.The number of deaths caused by the second major categories disease(chronic non-communicable disease)accounts for more than80%of the total deaths.5.Analysis of the sequence of causes of death:The first five causes of death were cerebrovascular disease,malignant tumor,heart disease,respiratory system of disease and injury in Guangxi in 2016.The top of five causes of death in males were malignant neoplasm,cerebrovascular disease,heart disease,respiratory system of disease and injury,and the first five causes of death were heart disease,cerebrovascular disease,respiratory system of disease,malignant neoplasm and injury in females.No matter men and women,the total number of deaths caused by four chronic diseases(including cerebrovascular disease,malignant tumor,heart disease and respiratory system of disease)were accounted for more than 78%of total deaths.The top five causes of death in urban were malignant tumor,cerebrovascular disease,heart disease,respiratory system of disease and injury,while the first five causes of death were cerebrovascular disease,malignant tumor,heart disease,respiratory system of disease and injury in rural residents.Regardless of urban and rural,the composition ratio of the four chronic disease(including malignant tumor,cerebrovascular disease,heart disease and respiratory system of disease)was accounted for more than 77%of total deaths.6.Analysis of the probability of early death of the major chronic disease:The probability of premature death causes by all deaths was 21.86%in Guangxi in 2016,and the probability of premature death of the main chronic disease was17.19%;The probability of early death of this four major chronic disease accounted for 76.84%of the probability of premature death from all causes of death.Among them,the probability of premature death of malignant tumor,circulatory disease,chronic respiratory system disease and diabetes were 8.37%,8.19%,0.63%and 0.94%respectively.7.Analysis of the burden of disease caused by major chronic disease:revealed that the PYLL and YPLLR caused by all deaths were 540302person-years and 57.66‰,while the total PYLL and YPLLR caused by four major chronic diseases were 325372 person-years and 34.72‰of monitoring points in Guangxi in 2016.The total PYLL accounts for more than 60%of all deaths due to the deaths of major chronic diseases.Among the four main chronic diseases,the PYLL of malignant tumor was 177733 person-years and the YPLLR was 18.97‰,the PYLL of cardiovascular disease was 127514person-years and the YPLLR was 13.61‰,the PYLL of chronic respiratory disease was 11303 person-years and the YPLLR was 1.21‰,the PYLL of diabetes was 8823 person-years and the YPLLR was 0.94‰.Only the PYLL caused by the death of malignant tumor and cardiovascular disease accounted for 56.5%of the total causes of death and they was accounting for 93.84%of the four main chronic disease.Conclusions1.In general,the mortality of residents in Guangxi in 2016 reached the national average level,and equivalent of Shanxi,Anhui and other provinces,but lower than the average level of western region,and also lower than that the neighboring Yunnan Province.This shows that the total mortality of Guangxi residents is at a high level in the whole country,and people's life and health are facing a greater threat,but the mortality is better than the average level of the western provinces.The death rate of men is higher than that of women and the mortality of rural areas is higher than that of the city,which is in accordance with the vast majority of studies.There are regional differences in the mortality of residents of monitoring points in different regions in Guangxi,among which the mortality is highest in western Guangxi but lowest in northern Guangxi.Thus,in-depth exploration the main factors affecting the differences of mortalities in different gender,sexes and regions in Guangxi,to guide the construction of health city(county and district),to provide health care services and to formulate Guangxi's health policy according to local conditions are particularly important.2.In recent years,Guangxi is faced with the new challenges of health from changes of the spectrum of disease and death as in most regions at home and abroad.The mortality of infectious disease,maternal and child disease,nutritional deficiency disease in Guangxi is still higher than the national level,we need to more pay more attention to the health status of the related people of the first major category of disease,and we also need to increase the prevention and control of this disease.Meanwhile,the study showed that the number of deaths caused by chronic non-communicable diseases exceeds 80%,and the death of chronic diseases has become the most important cause of death among residents in Guangxi in 2016.Therefore,to establishing and improving the prevention and control system for chronic disease in Guangxi and strengthening the health education of resident is an effective measure to promote the construction of healthy Guangxi.3.The results show that cerebrovascular disease,malignancy,heart disease,respiratory disease and injury are the top five causes of death in Guangxi.Malignancy is the first cause of death for men and urban residents,and heart disease is the most important death cause for women,than the leading cause of death in rural areas is cerebrovascular disease.This indicates that the prevention and control,early diagnosis and treatment of malignant tumors in men and urban should be implemented as soon as possible;Targeting Cerebrovascular disease in rural areas and heart disease in women,the capacity for diagnosis and treatment needs to be strengthened;which also suggests that there are certain differences in the risk factors that affect the deaths of men,women,urban and rural residents.It is necessary to further strengthen epidemiological studies and crowd cohort study,implement targeted prevention and control measures at the right time.4.The probability of premature death caused by all deaths in Guangxi in2016 was higher than that in developed provinces and cities such as Jiangsu,Zhejiang and Beijing,and it was significantly higher than that of Japan.Among them,the probability of premature death caused by the four major chronic disease accounting for 76.84%of the probability of early death of the whole cause of death.The early death caused by malignant tumor is the most serious,followed by circulatory system of disease.We can see that the situation of premature death of the main chronic disease in urban and rural of residents in Guangxi is serious,and the ability and level to prevention and control the main chronic disease need to be improved.It is suggested that we should put forword effective health prevention measures in accordance with the local situation and take the problem as the guidance to achieve the goal put forward by the“Health China 2030 Plan”program outline.The goal is to reduce the probability of premature death in four major chronic diseases to 15.47%in 2020 and to12.03%in 2030.The PYLL caused by all deaths in Guangxi is higher than that of Yunnan Province and Shanxi Province,and the PYLL caused by main chronic disease of early of death is 60.22%of all the causes of death.At present,the burden of disease in our district is more serious,the burden of cancer and circulatory disease is much higher than that of the other diseases.Malignant tumor and circulatory disease are major diseases that threaten the health of Guangxi residents.How to reduce the death and epidemic of major chronic disease,especially how to reduce the probability of premature death and the burden of disease of main disease in Guangxi as soon as possible is a main problem of public health in Guangxi.SuggestionsThe first is to carry out the multi direction and crowd cohort epidemiological study to explore the main factors that affecting the differences in the mortality of different sexes,ages and regions,in order to provide health care services and scientific evidence for health policy according to local conditions in Guangxi.Second,to strengthen to prevention and control of chronic disease,actively to establish the comprehensive prevention and control demonstration zones for chronic disease,and make full use of the projects of basis public health to effectively promote the healthy life style,66 health literacy,development of dietary nutrition and health of both urban and rural residents.We must to strengthen health education and improve the quality,knowledge and ability of self-management in health of urban and rural residents.The third is to adjust the health policy,pay attention to the optimal allocation of rural medical resources,establish and improve the system of prevention and control chronic disease that covering rural villages in Guangxi,and evaluate the effect of prevention and control in a timely manner.The fourth is development the epidemiological studies on main causes of death such as malignant tumor,cerebrovascular disease and heart disease,etc of urban and rural residents.It will help to further explore the main diseases'epidemiological characteristics and the risk factors of death,also provide scientific basis for the effective and accurate prevention and treatment of disease.Fifth,increase financial input and actively develop personnel training,as soon as possible to cover the cause of death monitoring sites in whole Guangxi,in order to comprehensively and dynamically grasp the death status and the changes of the trend of cause of death in Guangxi. |
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