Abstract
楚洁,鹿子龙,刘丹茹,徐晓慧,任杰,董静,付振涛,陈先献,郭晓雷,徐爱强.山东省1970-2021年居民死亡水平及死亡谱变动趋势[J].Chinese journal of Epidemiology,2024,45(5):679-686
山东省1970-2021年居民死亡水平及死亡谱变动趋势
Variation tendency of mortality and death spectrum in Shandong Province, 1970-2021
Received:October 10, 2023  
DOI:10.3760/cma.j.cn112338-20231010-00214
KeyWord: 死亡率  死因  差别分解  趋势分析
English Key Word: Mortality  Cause of death  Differential decomposition  Trend analysis
FundProject:泰山学者工程专项(TS201511105);山东省重点研发计划(2016GSF201231)
Author NameAffiliationE-mail
Chu Jie Department of Chronic and Non-communicable Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China  
Lu Zilong Department of Chronic and Non-communicable Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China  
Liu Danru Department of Chronic and Non-communicable Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China  
Xu Xiaohui Department of Chronic and Non-communicable Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China  
Ren Jie Department of Chronic and Non-communicable Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China  
Dong Jing Department of Chronic and Non-communicable Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China  
Fu Zhentao Department of Chronic and Non-communicable Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China  
Chen Xianxian Department of Chronic and Non-communicable Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China  
Guo Xiaolei Department of Chronic and Non-communicable Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China guoxiaolei@126.com 
Xu Aiqiang Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
Institute of Preventive Medicine of Shandong University, Jinan 250014, China 
aqxuepi@163.com 
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Abstract:
      目的 描述1970-2021年山东省居民死亡水平及死亡谱变动趋势,为采取有针对性的疾病防控措施提供依据。方法 分析资料来自山东省死因登记报告系统数据和3次山东省死因回顾性调查。采用死亡率、年龄标化死亡率、死亡构成比等观察指标描述山东省不同年份总死亡和主要死因死亡水平的变化,使用差别分解法定量测量死亡率变化中人口因素和非人口因素贡献值的大小。结果 1970-2021年山东省居民粗死亡率基本平稳,2020-2021年(732.73/10万)较1970-1974年(671.98/10万)略有上升。标化死亡率持续且明显下降,2020-2021年(183.39/10万)较1970-1974年(568.00/10万)下降了67.71%。人口因素对死亡率的负性增长和非人口因素的正性降低作用相互抵消使死亡率处于相对平稳阶段。心脑血管疾病始终为首位死因,但死亡构成比从1970-1974年的19.70%上升至2020-2021年的54.72%。恶性肿瘤从第4位(11.46%)上升至第2位(25.70%),伤害从第7位(5.85%)上升至第3位(5.59%);慢性呼吸系统疾病从第2位(12.87%)下降至第4位(4.99%),传染病从第3位(12.27%)下降至第10位(0.42%)。主要死因标化死亡率不同程度下降,其中产科疾病、传染病、消化系统疾病、慢性呼吸系统疾病等降幅均超过50.00%。死亡人群的年龄分布、不同年龄人群以及城乡死亡谱均发生显著变化。2020-2021年0~14岁人群死亡占0.54%,较1970-1974年下降了97.05%,≥75岁人群死亡占55.14%,上升了55.75%;所有年龄段人群感染性疾病的位次显著下降,儿童青少年人群伤害、神经精神系统疾病、恶性肿瘤位次显著上升,中老年人群中内分泌/营养/代谢性疾病位次上升。城乡死亡谱差别明显缩小,2020-2021年城乡主要死因位次基本一致。结论 山东省居民死亡谱发生了显著变化,以心脑血管疾病和恶性肿瘤为主的慢性非传染性疾病应成为当前疾病防控工作的重点。1970-2021年山东省的疾病防治工作取得了明显效果,但由于人口老龄化效应仍不断显现,应大力发展与老年人健康相关疾病与伤害的救治、预防、保健等服务。
English Abstract:
      Objective To describe the trend of mortality and death spectrum in Shandong Province from 1970 to 2021 and provide basis for the targeted disease prevention and control. Methods The data were collected from the death registration reports of Shandong and 3 national retrospective surveys of death causes in Shandong. The change in levels of overall and specific deaths in Shandong in different years were analyzed based on mortality rate, age-standardized mortality rate and constituent ratio of cause of death, differential decomposition was used to quantify the contribution of demographic and non-demographic factors to changes of mortality.Results The crude mortality rate in residents in Shandong was basically stable from 1970 to 2021, and the mortality rate during 2020-2021 (732.73/100 000) was slightly higher than that during 1970-1974 (671.98/100 000). While the standardized mortality rate decreased significantly, and the mortality during 2020-2021 (183.39/100 000) decreased by 67.71% compared with that during 1970-1974 (568.00/100 000). The negative increase of population factors and the positive decrease of non-population factors reacted each other, so the mortality was relatively stable. Cardiac-cerebrovascular disease was always the leading cause of death, but the constituent ratio of death increased rapidly from 19.70% during 1970-1974 to 54.72% during 2020-2021. The rank in the causes of death changed from the fourth (11.46%) to the second (25.70%) for malignant tumor, from the seventh (5.85%) to the third (5.59%) for injury, from the second (12.87%) to the fourth (4.99%) for chronic respiratory diseases, from the third (12.27%) to the tenth (0.42%) for infectious diseases. The standardized mortality rates of the main causes of death decreased at different degrees, the standardized mortality rates of obstetrical disease, infectious disease, gastrointestinal disease and chronic respiratory disease decreased by more than 50.00%. The age distribution of deaths and the death spectrum in different age groups and in urban-rural populations changed significantly. During 2020-2021, the proportion of deaths in young people aged 0-14 years was 0.54%, which was 97.05% lower than that during 1970-1974, while the proportion of deaths in the elderly aged ≥75 years was 55.14%, which was 55.75% higher than that during 1970-1974. The rank of infectious diseases in the causes of death descended significantly in all age groups, but the ranks of injury, neuropsychiatric disease and malignant tumor rose significantly in adolescents, and the ranks of endocrine nutrition and metabolic disease rose in middle-aged and elderly people. The difference of death spectrum between urban area and rural area became less obvious and the main death causes in urban and rural residents were basically the same during 2020-2021. Conclusions The death spectrum of residents in Shandong changed significantly. Chronic and non-communicable diseases, especially cardiac-cerebrovascular disease and malignant tumor, should be the focus in disease control and prevention. The prevention and control of diseases in Shandong made remarkable achievement during 1970-2021. However, in the context of population ageing, it is suggested to strengthen the treatment, prevention of diseases and injuries related to the health of the elderly and elderly health care in the future.
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