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

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.