2018－2022年海南省居民期望寿命与死亡疾病谱变化的关系

陈赛苦; 孙定炜; 王康麟; 王兴任; 周雪; 王小焕; 江娟; 何滨; 殷大鹏; 陈礼英; 苏美颜; 刘莹

doi:10.3784/jbjc.202405070291

2018－2022年海南省居民期望寿命与死亡疾病谱变化的关系

Analysis on relationship between life expectancy and change of diseases spectrum of death in Hainan, 2018−2022

摘要

摘要:
目的了解2018—2022年海南省居民期望寿命、死亡疾病谱的变化情况，分析主要疾病死亡对期望寿命的影响，为制定疾病防控相关政策提供科学依据。
方法收集2018—2022年海南省死因监测数据，结合漏报情况对死亡数据进行漏报调整。分别采用简略寿命表、去死因期望寿命表、Joinpoint回归模型和Arriaga差异分解法对2018—2022年海南省居民死亡疾病谱的变化趋势进行分析，并对不同年龄组死亡率和不同死因对期望寿命的影响进行比较。
结果 2018—2022年海南省居民期望寿命年均增长0.20岁；对期望寿命增长贡献最大的是60～岁组人群，占全年龄组的36.73%，其次为35～59岁年龄组，占27.52%。按系统分类，循环系统疾病、恶性肿瘤、呼吸系统疾病、伤害始终位于海南省前4位死因，其中循环系统疾病造成居民期望寿命损失最多，且粗死亡率呈上升趋势平均年度变化百分比（AAPC）=9.78%，t=46.910，P<0.001；伤害粗死亡率下降（AAPC=−8.18%，t=−3.609，P=0.037）则是居民期望寿命增长的最主要原因。按单病种分类，2018—2022年前5位死因减寿损失顺位依次为心脏病、脑血管疾病、慢性下呼吸道疾病、肝癌、胃癌。
结论慢性病是导致海南省居民死亡及寿命损失的主要原因，要进一步提高居民健康水平和期望寿命，应积极普及健康知识、推进慢性病综合防控体系建设，对60～岁年龄组人群进行重点干预，促进健康老龄化。

Abstract:
Objective To investigate the changes of life expectancy and diseases spectrum of death in residents in Hainan province from 2018 to 2022, analyze the impact of death from major diseases on life expectancy and provide evidence for the development of disease prevention and control policies.
Methods The surveillance data of death causes in Hainan from 2018 to 2022 were collected and the death data were adjusted according to the under-reporting status. Brief life table, cause eliminated life expectancy table, Joinpoint regression model and Arriaga differential decomposition method were used to analyze the changing trend of diseases spectrum of death in residents in Hainan from 2018 to 2022, and compare the effects of mortality in different age groups and different death causes on life expectancy.
Results The average life expectancy increased by 0.20 years in residents in Hainan from 2018 to 2022. Age group ＞60 years had largest contribution to the increase of life expectancy, accounting for 36.73% of the contribution in all age groups, followed by age group 35～59 years, accounting for 27.52%. Classified by disease type, circulatory system disease, malignant tumor, respiratory system disease and injury were the top 4 causes of death in Hainan, in which circulatory system disease caused the largest life expectancy loss, with crude mortality rate showing an increasing trend average annual percent change (AAPC)=9.78%, t=46.910, P<0.001. The decrease in crude mortality of injury (AAPC=−8.18%, t=−3.609, P=0.037) was the most important reason for the increase in life expectancy. Classified by specific disease, the top 5 causes of death were heart disease, cerebrovascular disease, chronic lower respiratory disease, liver cancer, and gastric cancer.
Conclusion Chronic disease was the main cause of death and life loss in residents in Hainan. In order to further improve the health status and life expectancy of residents, it is necessary to strengthen the health education and the construction of comprehensive prevention and control system of chronic diseases, and carry out targeted interventions in population aged ＞60 years to promote healthy aging.

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