Objective To analyze the change trend of life expectancy of registered residents in Xuhui district, Shanghai, from 1995 to 2024, evaluate the impact of changes in the cause-and-death spectrum on life expectancy, and provide evidence for the allocation of health resources and the development of public health service policies.

Methods Based on the population data and death data from the Xuhui Branch of the Shanghai Public Security Bureau and the Shanghai Disease Control and Prevention Information Management Platform, software Joinpoint was used to calculate the annual percentage change (APC) of life expectancy of local residents for the analysis on the dynamic change trend of time series data. The period from 1995 to 2024 was divided into two periods: 1995-2009 and 2009-2024. The simplified life expectancy method, life expectancy decomposition method (Arriaga's), and causal-cause decomposition method were used to analyze the age and disease (death cause) specific influences on the life expectancy of local residents.

Results From 1995 to 2024, the life expectancy of the entire population, men and women with household registration in Xuhui increased by 8.61 years, 7.83 years and 9.45 years, respectively, and the APCs all showed an upward trends (P<0.05). During the two periods, the contributions of the entire population, men and women to life expectancy were 6.57 years, 5.91 years, 7.28 years and 2.04 years, 1.92 years, 2.17 years, respectively. The upward trend of APC from 1995 to 2009 was higher than that from 2009 to 2024, and the increase in life expectancy was greater in women than in men. In all the age groups, age group 65-<85 years made the greatest contributes to the increase of life expectancy, followed by age group 45−<65 years. Among the 17 major diseases, the first three diseases that made "positive contribution" to the life expectancy of the entire population were circulatory system disease (2.86 years), tumor (1.91 years), and respiratory system disease (1.74 years). The first three diseases that made "positive contribution" to the life expectancy of men were tumor, circulatory system disease, and respiratory system disease. The first three diseases that made “positive contribution” to the life expectancy of women were similar to those in the entire population. While the diseases having "negative contribution" the life expectancy of the entire population, men and women were endocrine nutritional and metabolic diseases (−0.64 years, −0.76 years and −0.48 years). The first three diseases having "positive contribution" to the life expectancy of the entire population and women were circulatory system disease, respiratory system disease and tumor during 1995−2009, and similar result was found in men from 1995 to 2024. During 2009−2024, the first three diseases having "positive contribution" to life expectancy of the entire population and men were respiratory disease, tumor and circulatory system disease, while they were circulatory system disease, respiratory system disease and tumor in women.

Conclusion It is necessary to strengthen the population based prevention and control of chronic diseases and the health management focusing on high-risk groups aged 65−<85 and 45−<65, especially on men, and establish a full-cycle chronic disease prevention and control system to effectively increase people’s life expectancy.