| ObjectivesAccording to the outline of"healthy Jiangsu 2030"proposed by the government,the death information of the entire population in Nanjing Gulou District from 2014 to 2018 is described and analyzed,and the deaths,causes of death,and trends of death causes in the residents of Gulou District in Nanjing are understood.The study further explores the causes of major fatal diseases and analyzes the life expectancy of residents and cause eliminated life expectancy from major diseases.The study,on the one hand,understands the main causes of death and changes in the spectrum of death causes of the population in Nanjing Gulou District,on the other hand,finds the gap between the health status of residents and the specific requirements set out in the planning outline.This study provides a scientific basis for the government to make"healthy Jiangsu"decisions and makes scientific suggestions for promoting residents’health.Materials and MethodsThe information of the death report of the whole population in the region from 2014 to2018 was from the Disease Prevention and Control Center of the Gulou District,Nanjing City.Nanjing Public Security Bureau has obtained the data of the resident population of the Gulou District,Nanjing City,2014-2018.Combined with the public data of the National Bureau of Statistics of the 6th Population Census in 2010,the cause of death was classified using the international standard icd-10 encoding.The data were analyzed using EXCEL 2019,SPSS22.0,and SAS 9.4.The main research indicators are:（1）Demographic indicators:population and dependency ratios.（2）Death level indicator:crude death rate,death rate of different genders and ages,and cause-specific death rate.（3）Index of rank of death cause:the proportion and rank of death cause of residents of different genders and age groups in each year.（4）Tendency of main causes of death:trend chi-square test was used for analysis.（5）Indicators of life expectancy and years of life lost:life expectancy,cause eliminated life expectancy,potential years of life lost and potential years of life lost rate.Results1.Demographic characteristics of residentsFrom 2014 to 2018,there were 4,639,386.5 people monitored in Gulou District,Nanjing,including 2,315,420 men and 2,323,966.5 women,with a gender ratio of 1:1.In the monitoring,there are 543,207.5 children under 15 years old,accounting for 11.71%of the total population,3,376,075 working people between 15 and 64 years old,accounting for 72.77%of the total population,and 720,104 elderly people over 65 years old,accounting for 15.52%of the total population.2.The death of residents（1）From 2014 to 2018,there were 28,044 deaths due to all causes in Gulou District of Nanjing with 15,789 males and 12,255 females.The average crude mortality rate was604.48/100,000.The total crude mortality rate,crude male mortality and crude female mortality showed an slow upward trend.After standardization,the total standardized mortality rate,standardized male mortality and standardized female mortality showed a slow downward trend(x2trend test P<0.05).The crude and standardized mortality rate of males was higher than that of females（P<0.05）.By age groups,in the age group of 40-80 in five years,the mortality rate of men was higher than that of women（P<0.05）.（2）From 2014-2018,the proportion of under-1-year-old deaths is the lowest（<1%）.Although the age span from 1 to 44 years old is large,the overall proportion of deaths is very low with<2%for men and women,respectively.The proportion of deaths of men and women aged 45-64 years old is higher than before.The proportion of deaths in the age group over 65years old is the highest,and the total proportion of men and women accounts for about 80%of total deaths.（3）From 2014 to 2018,the infant mortality rate in Gulou District of Nanjing City was the lowest at 2.67‰and the highest at 5.59‰,and the mortality rate for children under 5years old was the lowest at 3.31‰and the highest at 6.74‰.With reference to the health Jiangsu planning goals,in addition to exceeding the planning indicators in 2015,the other four years have reached the standards.（4）From 2014 to 2018,the number of maternal deaths in Gulou District of Nanjing City was zero,and no maternal deaths occurred.（5）From 2014 to 2018,the premature mortality rate of major chronic diseases of residents in Gulou District of Nanjing City remained at 9%-9.5%,which was relatively stable and lower than the target of less than 10%in 2030 proposed in the outline goal.3.Changes in the spectrum of death causes in residents（1）From 2014 to 2018,the leading causes of death among residents of Gulou District in Nanjing were circulating diseases,tumors,respiratory diseases and external causes,in which the death of circulatory disease accounted for 45.19%,tumor accounted for 31.10%,respiratory disease accounted for 8.97%and external causes accounted for 3.16%.These four causes of death accounted for 88.42%,showing a highly concentrated state.In the five years of the study,the mortality of circulatory diseases,tumors,respiratory diseases,external diseases,internal diseases,infectious diseases and other diseases increased year by year(x2trend test P<0.05).The cause of death in five years had little change.The major causes of death in different age groups are manifested in the neonatal group.The top five causes of death in the neonatal group are perinatal disease,congenital disease,infectious disease,respiratory disease and external cause disease.After one-year old,perinatal disease will no longer appear in the top five causes of death.In the age group after one-year old and before the age of 65,the main causes of death are tumor,circulatory disease,external cause disease and respiratory disease.After 65 years old,circulatory diseases rose to the first place,and accounted for about 50%of deaths,while external diseases dropped out of the top 5.4.Cause analysis of major fatal diseases（1）In the past five years,12,673 people died of circulatory diseases,including 6,666males and 6,007 females.In the past five years,the crude mortality rate of males was slightly higher than that of females,and the ratio of males to females was 1.11:1.Among the causes of death of circulatory diseases,the highest death rate is cerebrovascular disease.The death rate of men is 77.53/100,000,and that of women is 73.48/100,000.The second is ischemic heart disease.The death rates of men and women are 47.31/100,000 and 40.22/100,000,respectively.There is no significant difference between men and women.The mortality of cerebrovascular disease and ischemic heart disease before the age of 45 is relatively low,no more than 3/100,000.After the age of 45,the mortality began to increase,and after the age of65,it increased significantly,and the mortality of men is higher than that of women.（2）Cancer is the second leading cause of death.In the past five years,8,721 people died of cancer,accounting for 31.10%of all deaths.The total crude mortality rate in the past five years was 187.98/100,000,which in males was 231.92/100,000 and in females was144.19/100,000.Men were significantly higher than women with 1.61 times,and the cancer mortality rate of men and women showed an upward trend.Among the tumors,the highest mortality rate is trachea,bronchus and lung cancer,followed by gastric cancer,colorectal cancer,other tumors,liver cancer and pancreatic cancer,and the mortality rate of men is significantly higher than that of women.Under 15 years old,the main causes of tumor death are leukemia,brain tumor,etc.The highest causes of tumor death in young adults aged 15-45years old are other tumors,with a mortality rate of 1.53/100,000.After 45 years old,the death rate of tumor begins to rise,the highest is still trachea,bronchus,lung cancer,followed by liver cancer.After 65 years old,the death rate of tumor is the highest,and the first is still trachea,bronchus,lung cancer,with a mortality rate of 229.69/100,000,followed by gastric cancer,with a mortality rate of 105.54/100,000,followed by colorectal cancer,with a mortality rate of 106.37/100,000.（3）The cause of death of respiratory diseases ranks the third in the mortality.In the past five years,in Gulou District,Nanjing,there are 2,515 people died of respiratory diseases including 1,552 men and 963 women.Men are 1.61 times more than women,accounting for8.97%of the total death population with 5.53%of men and 3.43%of women.Respiratory disease death occurred in the whole age group,with a high incidence after the age of 70,and men were significantly more than women in the whole process.Among them,the highest death causes are infection,emphysema and chronic obstructive pulmonary disease.（4）The most external causes of death were accidental falls,followed by traffic accidents.These two kinds of deaths accounted for 52.71%of the total number of injuries and deaths.The number of accidental falls was significantly higher in the population after 60 years old.The death rate of men in traffic accidents was higher than that of women,and the number of suicides after 25 years old was significantly increased.5.Analysis of life expectancy and life lossFrom 2014 to 2018,the average life expectancy of male and female residents in Gulou District of Nanjing was 82.33 and 86.42 years,respectively.The life expectancy of female residents was higher than that of male residents,both of which were higher than the provincial average.In the past five years,the life expectancy of men remained stable,while that of women increased.The most common causes of death were circulatory disease and tumor,which increased life by 10.69±2.23 years and 4.02±0.28 years,respectively.At the same time,tumors,circulatory diseases,and exogenous diseases are the top three causes in the order of life loss.Conclusion1.The total population of Gulou District remained stable during 2014 to 2018.However,the total burden factor,child burden factor,and elderly burden factor have increased year by year.2.From 2014 to 2018,the total standardized mortality rate of Gulou District in Nanjing showed a slow downward trend,which is consistent with the situation of the whole province.The mortality rate of males was higher than that of females.The infant mortality rate and the under-5-mortality rate have reached the targets of"healthy Jiangsu 2030"except 2015,while the maternal mortality rate and premature mortality of major chronic diseases have reached the standards.3.The main causes of death in Gulou District of Nanjing were circulatory system diseases,tumors,respiratory diseases and external causes,accounting for 88.42%of the entire population.Cerebrovascular disease and ischemic heart disease accounted for the largest proportion of circulatory diseases,and the crude death rate of these two diseases was significantly higher than other circulatory diseases;trachea,bronchus,and lung cancer accounted for the largest number of deaths among tumor deaths,followed by gastric and colorectal cancer;among the deaths due to respiratory diseases,50.14%died from infection,followed by emphysema and obstructive pulmonary disease,accounting for 31.30%;External cause mortality has increased year by year,of which accidental falls are the injuries that cause the most deaths,followed by traffic accidents.4.The average life expectancy of residents in Gulou District of Nanjing City was higher than the average level of the province.Among them,the life expectancy of men has remained basically stable,and that of women has increased.After the cause of death has been removed,the two diseases with the greatest number of life spans were circulatory disease and tumor.And tumors,circulatory diseases,and external causes were the top 3 in the order of life loss. |
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