2015－2021年我国城乡居民死亡状况分析

凌鑫; 林秀文; 张莹; 肖瑶

doi:10.3784/jbjc.202305090206

摘要:

目的了解2015—2021年我国居民死亡率及死亡原因，为制定卫生政策和疾病防控提供依据。

方法利用《中国死因监测数据集》和《中国卫生健康统计年鉴》中2015—2021年城乡居民死亡数据，分析死亡率、平均年度变化百分比（AAPC）、构成比等指标。

结果 2015—2021年我国城市、农村、男性、女性年均粗死亡率分别为627.87/10万、693.31/10万、765.15/10万、574.01/10万，均呈上升趋势（AAPC=0.71%、1.54%、1.13%、1.42%，P=0.007、0.004、0.005、0.002）；标化死亡率分别为676.60/10万、748.67/10万、895.45/10万、565.41/10万，均呈现下降趋势（ AAPC=−4.16%、−1.95%、−2.37%、−2.89%，P<0.001、0.015、0.001、0.005）。农村居民年均粗死亡率（χ²=27188.022，P<0.001）和年均标化死亡率（χ²=30570.094，P<0.001）均高于城市居民，男性年均粗死亡率（χ²=258728.380，P<0.001）和年均标化死亡率（χ²=706679.858，P<0.001）均高于女性。城市新生儿、婴儿、5岁以下儿童、孕产妇死亡率均高于农村（χ²=30 241.791、48 081.135、86 265.732、101.718，均P<0.001），城乡合计死亡率均呈逐年下降趋势（AAPC=−9.02%、−7.71%、−6.89%、−3.67%, 均P<0.001）。心脏病、恶性肿瘤、脑血管病、呼吸系统疾病、损伤及中毒占据城乡居民死因顺位前五，至2021年共占城市和农村居民整体死亡人数的85.87%和87.35%。

结论我国农村居民死亡率明显高于城市，且孕产妇与儿童死亡率仍有较大差距；循环、呼吸系统疾病和恶性肿瘤等慢性非传染病是威胁居民身体健康的主要疾病；政府应在医疗公共资源分配上进行合理倾斜，加强重大死因的防治工作。

Abstract:

Objective To understand the mortality rate and causes of death in the population in China from 2015 to 2021, and provide evidence for health policy formulation and disease prevention and control.

Methods The mortality data in urban and rural residents in China from 2015 to 2021 were collected from China Cause of Death Surveillance Dataset and the China Health and Wellness Statistical Yearbook to analyze the mortality rates, average annual percentage change (AAPC), and composition ratios.

Results During 2015−2021, the average annual crude mortality rates in urban residents, rural residents, men, and women in China were 627.87/100 000, 693.31/100 000, 765.15/100 000, and 574.01/100 000, respectively, all showed increasing trends (AAPC=0.71%, 1.54%, 1.13%, 1.42%, P=0.007, 0.004, 0.005, 0.002), and the standardized mortality rates were 676.60/100 000, 748.67/100 000, 895.45/100 000, and 565.41/100 000, respectively. All showed decreasing trends (AAPC=−4.16%, −1.95%, −2.37%, −2.89%, P=<0.001, 0.015, 0.001, 0.005). The average annual crude mortality rate (χ²=27 188.022, P<0.001) and the average annual standardized mortality rate (χ²=30 570.094, P<0.001) were higher in rural residents than in urban residents, and the average annual crude mortality rate (χ²=258 728.380, P<0.001) and the average annual standardized mortality rate (χ²=706 679.858, P<0.001) were higher in men than in women. The mortality rates in neonates, infants, children under 5 years old, and pregnant and lying-in woman were higher in urban area than in rural area (χ²=302 41.791, 48 081.135, 86 265.732 and 101.718, respectively, all P<0.001), and the combined urban and rural mortality rate showed a decreasing trend from year to year (AAPC −9.02%, −7.71%, −6.89%, and −3.67%, respectively, all P<0.001). Heart disease, malignant neoplasm, cerebrovascular disease, respiratory disease, and injury and poisoning were the top five causes of death in urban and rural area, accounting for 85.87% and 87.35% of the overall urban and rural mortality by 2021.

Conclusion The mortality rate was significantly higher in rural residents than in urban residents in China, and there is still obvious difference between pregnant and lying-in woman and child mortalities. Chronic non-communicable diseases such as circulatory diseases, respiratory diseases and malignant neoplasms have become the main diseases threatening the health of residents. It is necessary to allocate medical public resources in a reasonable way to strengthen the prevention and treatment of the diseases.

2015－2021年我国城乡居民死亡状况分析

Analysis on incidence of death in urban and rural residents in China, 2015−2021