Zeng X Y, Li Y C, Liu S W, Wang L J, Liu Y N, Liu J M, Zhou M G
National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Mar 6;51(3):209-214. doi: 10.3760/cma.j.issn.0253-9624.2017.03.004.
To investigate the current status, temporal trend and achieving Health China 2030 reduction target of probability of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases, tumour, diabetes, and chronic respiratory disease in China both at national and provincial level during 1990 to 2015. Using the results of Global Burden of Disease study 2015 (GBD 2015), according to the method of calculating premature mortality probability recommended by WHO, the current status and temporal trend by different gender from 1990 to 2015 were calculated, analyzed, and compared. Referring to " Health China 2030" target of reduction 30% of probability of premature mortality caused by major NCDs, we evaluated the difficulty of achieving the reduction target among provinces (not including Taiwan). From 1990 to 2015, the probabilities of premature mortality in cardiovascular and cerebrovascular diseases, tumour, and chronic respiratory disease were all declined consistently for both men and women in China, the total of four main NCDs decreased from 30.69% to 18.54% with higher decreasing in women (from 25.97% to 12.40%) than that in men (from 34.94% to 24.19%). In 2015, the top five provinces in terms of probability of premature mortality caused by four main NCDs were Qinghai (28.81%), Tibet (25.88%), Guizhou (24.67%), Guangxi (23.56%), and Xinjiang (23.21%) in turn, while the top five provinces with the lowest probability were Shanghai (8.40%), Beijing (9.39%), Hong Kong (10.10%), Macao (10.31%), and Zhejiang (11.70%). If achieving the " Health China 2030" target, the probabilities of premature mortality in Qinghai and Tibet with the highest probability should decline to about 20.17%, and 18.12%, respectively in 2030, while 5.88%, and 6.57% in Shanghai and Beijing, respectively. From 1990 to 2015, the probability of premature mortality of four main NCDs declined by 2.00% a year on average, the top five provinces with the fastest decline were Beijing (3.48%), Shanghai (3.24%), Zhejiang (2.81%), Fujian (2.75%), and Guangdong (2.67%), and 11 provinces including these five provinces could achieve the " Health China 2030" target by the usual rate of decline, while other 22 provinces could not achieve the target, they need greater rate of decline in order to achieve the target. From 1990 to 2015, the probabilities of premature mortality of four main NCDs were declined consistently in China both at national and provincial level, compared with women, the men had higher probabilities and declined slower, there were significant different in probabilities of premature mortality and their change speed among provinces. Based on the results from 1990 to 2015, there were about two thirds of the provinces, which the task of achieving the Health China 2030 target will be daunting.
调查1990年至2015年期间中国全国及省级层面心血管疾病、肿瘤、糖尿病和慢性呼吸系统疾病这四种主要非传染性疾病导致的过早死亡概率的现状、时间趋势以及实现《“健康中国2030”规划纲要》中提出的降低目标的情况。利用2015年全球疾病负担研究(GBD 2015)结果,按照世界卫生组织推荐的过早死亡概率计算方法,计算、分析和比较了1990年至2015年不同性别的现状和时间趋势。参照《“健康中国2030”规划纲要》中主要非传染性疾病过早死亡概率降低30%的目标,评估了各省(不包括台湾)实现降低目标的难度。1990年至2015年,中国心血管疾病、肿瘤和慢性呼吸系统疾病的过早死亡概率在男性和女性中均持续下降,四种主要非传染性疾病合计从30.69%降至18.54%,女性下降幅度(从25.97%降至12.40%)高于男性(从34.94%降至24.19%)。2015年,四种主要非传染性疾病过早死亡概率排名前五的省份依次为青海(28.81%)、西藏(25.88%)、贵州(24.67%)、广西(23.56%)和新疆(23.21%),概率最低的前五省份为上海(8.40%)、北京(9.39%)、香港(10.10%)、澳门(10.31%)和浙江(11.70%)。若实现《“健康中国2030”规划纲要》目标,2030年过早死亡概率最高的青海和西藏应分别降至约20.17%和18.12%,而上海和北京应分别降至5.88%和6.57%。1990年至2015年,四种主要非传染性疾病过早死亡概率平均每年下降2.00%,下降最快的前五省份为北京(3.48%)、上海(3.24%)、浙江(2.81%)、福建(2.75%)和广东(2.67%),包括这五个省份在内的11个省份按通常下降速度可实现《“健康中国2030”规划纲要》目标,而其他22个省份无法实现目标,它们需要更大幅度的下降才能实现目标。1990年至2015年,中国全国及省级层面四种主要非传染性疾病过早死亡概率均持续下降,与女性相比,男性概率更高且下降较慢,各省过早死亡概率及其变化速度存在显著差异。基于1990年至2015年的结果,约三分之二的省份实现《“健康中国2030”规划纲要》目标的任务艰巨。