Objective To analyze the mortality and life expectancy trends of residents in Changzhi, Shanxi province, from 2019 to 2021, provide reference for the formulation of relevant prevention and control strategies.

Methods Death cause surveillance data from 2019 to 2021 in Changzhi were collected and adjusted for underreporting. Life expectancy table and life expectancy decomposition method were used to analyze the death cause surveillance data in residents in Changzhi from 2019 to 2021, and the contribution rates of different age groups and diseases to life expectancy were calculated.

Results From 2019 to 2021, the life expectancy of residents in Changzhi was 75.11 years, 76.22 years and 76.25 years respectively. The life expectancy of men was 73.22 years, 74.34 years and 74.12 years, respectively, and the life expectancy of women was 77.30 years, 78.34 years and 78.74 years, respectively. Compared with 2019, the life expectancy increased by 1.14 years overall, 0.90 years in men, and 1.44 years in women in 2021. The major death causes affecting the life expectancy mostly were cardiovascular and cerebrovascular diseases and tumors, followed by injury and poisoning, and respiratory system disease. The age group ≥85 years had the biggest positive contribution to the life expectancy of local residents, with a contribution rate of 34.20% and an increase of 0.39 years of life expectancy. The age group 45- years had the biggest negative contribution to the life expectancy, with a contribution rate of –5.95% and a decrease of 0.07 years of life expectancy.

Conclusion Cardiovascular and cerebrovascular diseases, tumor, injury and poisoning, and respiratory disease were the main causes for the loss of life expectancy of residents in Changzhi, and the age group of 45- years was the main age group affecting life expectancy. Health interventions in middle-aged and elderly populations are the key measure to improve the health status of local population and reduce the burden of diseases in local population.