Objective  To understand the death level in residents in Daishan county, Zhejiang province from 2014 to 2021, analyze the rank of causes of death and provide scientific evidence for the development of comprehensive disease prevention and treatment strategies or intervention measures and the evaluation of the effectiveness of prevention and treatment of disease in the future.

  Methods  Death cause surveillance data in residents in Daishan from 2014 to 2021 were collected and coded by the “International Statistical Classification of Diseases and Related Health Problems”. The crude mortality rate, standardized mortality rate, death cause rank, and potential years of life lost rate (PYLLR) were calculated. The comparison of rates were conducted by χ² test and trend χ² test, and the test level was 0.05.

  Results  From 2014 to 2021, a total of 12 968 deaths occurred in residents in Daishan, including 7 084 deaths in men and 5 884 deaths in women, and the crude mortality rate was 894.27/100 000 and the standardized mortality rate was 416.15/100 000. The mortality rate was higher in men than in women (χ²=142.156, P<0.001). The mortality rate in residents aged ＞45 years increased significantly, reaching a peak at age of 65 years. The top five causes of death were malignant tumor, heart disease, cerebrovascular disease, respiratory system disease, injury, and poisoning, with the deaths accounting for 88.06% of the total. The top five causes of life lost were malignant tumor, injury and poisoning, cerebrovascular disease, heart disease and respiratory system disease with the PYLLR of 23.93‰, 8.39‰, 3.63‰, 3.12‰ and 1.11‰, respectively. The rank of death causes varied in different age groups.

  Conclusion  Chronic and non-communicable diseases, such as malignant tumor, cardio/cerebrovascular diseases and injury, have become the main causes of death in Daishan. It is necessary to strengthen the health education about healthy lifestyles, conduct targeted health interventions in different populations and further improve disease prevention and control system.