The Trend And The Age-period-cohort Study In Diabetes Death Among People Aged 20-79 In Urban And Rural China Between 2003-2017

Purpose:Describe the trend of diabetes death in urban and rural populations aged 20-79 in China between 2003 and 2017.The time trend characteristics of standardized mortality and age-specific mortality in urban and rural diabetes in China were analyzed using JoinPoint regression.The age-period-queue model was used to estimate the extent of age,period,and cohort affecting diabetes death,and to explore possible risk factors for diabetes death.In order to provide a scientific reference for the prevention and control of diabetes in China.Methods:The diabetes mortality in urban and rural areas aged 20-79 years in the 2003-2017 data and population data was collected from“China Health and Family Planning Statistics Yearbook”and “China Population and Employment Statistics Yearbook”.The 2010 census data was used as the standard population to calculate the standardized mortality of 20-79 years old Chinese urban and rural population.Standardized mortality time trend and age-specific mortality in urban and rural diabetes in China was analyzed by JoinPoint regression.The APC model wascombined with IE algorithm to estimate the effect of age,period and birth cohort on diabetes mortality.Results:1.The standardized mortality rate of urban diabetes decreased by5.7% in the period of 2009-2013(P=0.000),but the average annual percentage change between 2003 and 2017 was no significant.The standardized mortality rate of diabetes in rural areas increased by the percentage change of annual and the average annual change rate of 2.2%between 2003 and 2017(P=0.000).2.Age-specific death rate in urban diabetes: the mortality rate of urban diabetes in ages of 25-29,35-39,40-44,45-49 and 55-59 years showed a rising and falling trend,and annual percentage change and annual average at the rates of 3.7%,-2.8%-2.5%,-3.2% and-1.5%(P=0.000)between 2003 to 2017;The 50-54 age group showed a rapid upward trend in the period of 2003-2017 with a mean annual change of 3.5%(P =0.000);The diabetes mortality rate of diabetes in the 70-74 age group showed an upward trend with an annual change percentage of 0.9%between 2003 and 2013(P=0.000);the annual change percentage of the75-79 age group was 5.7% between 2003 and 2007(P The speed of =0.000)shows a rapid upward trend.Age-specific death rate in rural diabetes: annual mortality percentage and annual average of rural diabetes mortality rates among the age groups35-39,60-64,65-69,70-74 and 75-79 years showed a decreasing and continuous upward trend,The percentage change at a rate of-3.2%,2.5%,4.2%,3%,2.8%(P=0.000)between 2003 to 2017.The annual percentage change in diabetes mortality rates between 30-34 and 50-54 years showed a rapid upward trend(P=0.000)between 2008-2017 and 2012-2017 at 9.5%and 12.8%.3.In general,the risk of diabetes death in urban and rural areas in China fluctuates with varying degrees of age.For the trend of urban diabetes death risk,The 30-34 age group contributed the most to the risk of diabetes death(0.6131),and the 55-59 age group had the least contribution to the risk of diabetes death(-0.2561),but rose to a positive value in the60-64 age group.And between the 50-79 age group,the maximum risk of diabetes death risk.For rural areas,the 40-44 age group contributed the most to the risk of diabetes death(0.3978),the 35-39 age group contributed the risk of diabetes death(0.3174),and the 30-34 age group had the risk of diabetes death.The contribution was minimal(-0.3295),and the contribution of different age groups to the risk of diabetes death in the60-74 age group gradually increased to a positive value.Controlling age and period effects,it can be concluded that the birth cohort between 1970-1974,1975-1979 and 1984 is a period in which the risk of death from diabetes in urban and rural areas is decreasing.The urban and rural birth cohort effect is roughly the same.The population born between 1990 and 1994 has theleast impact on the risk of diabetes death,that is,the later the population born later,the lower the risk of diabetes death.4.The age-period model and the age-period-queue model were selected to fit the trend of diabetes mortality in urban and rural areas in China,and the two models were well fitted.Conclusion:1.According to the regression analysis of JoinPoint and the effects of age,period and cohort,the risk of death in both urban and rural areas is gradually becoming younger.30-34,40-44 years old have the greatest impact on the risk of diabetes death in urban and rural areas,and the risk of diabetes death in different age groups over 60 years old has gradually increased.Therefore,it is necessary to strengthen the health education,prevention and control of diabetes in urban and rural high-risk groups over30 years old and over 60 years old.2.The risk of death in urban and rural diabetes in China has a period of decline in the birth cohort between 1970-1974,1975-1979 and 1984.As the cohort progresses,the mortality rate decreases,possibly with the education level,and the medical environment.Improvements are related to a variety of factors.3.The age-period model and the age-period-queue model were selected to fit the mortality data of urban and rural diabetes in China,and the model fitting effect was the best.