Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, Hubei Province 430030, PR China.
BMC Public Health. 2013 Aug 2;13:713. doi: 10.1186/1471-2458-13-713.
Chronic non-communicable diseases have become the major cause of death in China. This study describes and compares chronic disease mortality between urban and rural residents in Hubei Province, central China.
Death records of all individuals aged 15 years and over who died from 2008 through 2010 in Hubei were obtained from the Disease Surveillance Points system maintained by the Hubei Province Centers for Disease Control and Prevention. Average annual mortality, standardized death rates, years of potential life lost (YLL), average years of potential life lost (AYLL) and rates of life lost were calculated for urban and rural residents. Standardized rate ratios (SRR) were calculated to compare the death rates between urban and rural areas.
A total of 86.2% of deaths were attributed to chronic non-communicable diseases in Hubei. Cerebrovascular diseases, ischemic heart disease and neoplasms were the main leading causes in both urban and rural areas, and the mortality rates were higher among rural residents. Lung cancer was the principal cause of mortality from cancer among urban and rural residents, and stomach cancer and liver cancer were more common in rural than urban areas. Breast cancer mortality among women in rural areas was lower than in urban areas (SRR=0.73, 95% CI=0.63-0.85). The standardized mortality for chronic lower respiratory disease among men in rural areas was higher than in urban areas (SRR=4.05, 95% CI=3.82-4.29). Among men, total AYLL from liver cancer and other diseases of liver were remarkably higher than other causes in urban and rural areas. Among women the highest AYLL were due to breast cancer in both urban and rural areas.
Chronic diseases were the major cause of death in Hubei Province. While circulatory system diseases were the leading causes in both urban and rural areas, our study highlights that attention should also be paid to breast cancer among women and chronic lower respiratory disease among rural residents. It is important that governments focus on this public health issue and develop preventive strategies to reduce morbidity and premature mortality from chronic non-communicable diseases.
慢性非传染性疾病已成为中国主要的死亡原因。本研究描述并比较了中国中部湖北省城乡居民的慢性病死亡率。
从湖北省疾病预防控制中心维护的疾病监测点系统中获取了 2008 年至 2010 年期间湖北省所有 15 岁及以上人群的死亡记录。计算了城乡居民的平均年死亡率、标准化死亡率、潜在生命损失年数（YLL）、平均潜在生命损失年数（AYLL）和生命损失率。计算了标准化率比（SRR）以比较城乡地区的死亡率。
湖北省 86.2%的死亡归因于慢性非传染性疾病。脑血管病、缺血性心脏病和恶性肿瘤是城乡地区的主要死因，农村居民的死亡率更高。肺癌是城乡居民癌症死亡的主要原因，农村地区胃癌和肝癌更为常见。农村地区女性乳腺癌死亡率低于城市地区（SRR=0.73，95%CI=0.63-0.85）。农村地区男性慢性下呼吸道疾病的标准化死亡率高于城市地区（SRR=4.05，95%CI=3.82-4.29）。在男性中，肝癌和其他肝病的总 AYLL 明显高于城乡地区的其他原因。在女性中，城乡地区乳腺癌的 AYLL 最高。
慢性病是湖北省的主要死亡原因。虽然循环系统疾病是城乡地区的主要死因，但我们的研究强调，还应关注城乡妇女的乳腺癌和农村居民的慢性下呼吸道疾病。政府应重视这一公共卫生问题，制定预防策略，以降低慢性非传染性疾病的发病率和过早死亡率。
