安徽省2014-2018年4类重大慢性病早死概率变化趋势及健康指标达标分析

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目的:分析安徽省2014-2018年心脑血管疾病、癌症、糖尿病和慢性呼吸系统疾病的早死概率、变化趋势,探讨实现“健康中国2030”重大慢性病早死概率目标的可能性。方法:死亡资料来源于国家“人口死亡信息登记管理系统”中安徽省2014-2018年24个全国死因监测点数据。计算死亡率、标化死亡率、早死概率、年度变化百分比(APC)等指标。以“健康中国2030”和“健康安徽2030”重大慢性病早死概率目标(分别下降30%和25%)为基准,评价实现4类慢性病早死概率目标的难度。结果:2014-2018年安徽省4类慢性病死亡数占总死亡数的比例从82.76%升高至84.77%,呈上升趋势(APC=0.50%)。30~69岁人群4类慢性病标化死亡率呈下降趋势(APC=-1.78%)。4类慢性病合计的早死概率分析结果显示,合计早死概率由2014年的15.53%下降到2018年的14.43%;男性和女性均呈下降趋势,男性下降速度(APC=-1.80%)略低于女性(APC=-2.00%);城市(APC=-1.57%)和农村(APC=-1.99%)、皖北(APC=-2.32%)和皖中(APC=-1.81%)地区均呈下降趋势;同一年份早死概率比较,男性约为女性的2倍、农村>城市、皖北>皖中>皖南。分病种看早死概率,慢性呼吸系统疾病下降最明显(APC=-9.19%),其次为癌症(APC=-1.77%),男性糖尿病呈上升趋势(APC=-2.90%)。按2014-2018年早死概率平均增长速度,预计2030年可实现健康安徽目标;但实现健康中国目标需将下降速度在既往基础上提高26.40%;比较不同性别、城乡和地区下降速度需提高的比例,男性>女性、城市>农村、皖南>皖中>皖北。结论:安徽省4类慢性病早死概率呈持续下降趋势,男性、农村、皖北地区居民为重点人群,应开展针对主要慢性病危险因素的干预工作,降低慢性病早死概率,努力实现“健康中国2030”目标。“,”Objective:To investigate the current status and temporal trend of probability of premature death, caused by four major non-communicable diseases (NCDs) in Anhui province, from 2014 to 2018, and to explore the possibility of achieving the goal of “Healthy China 2030”.Methods:Data of death were collected from the “Information System for Death Cause Register and Management”. The mortality, standardized mortality, premature mortality rate and annual percentage change (APC) were calculated. Based on the reduction target of “Healthy China 2030”(-30%) and “Healthy Anhui 2030”(-25%) for premature death probability of four major NCDs, the possibility of achieving the target was evaluated.Results:From 2014 to 2018, the proportion of four major NCDs deaths to total deaths increased from 82.76% to 84.77%, showing an upward trend(APC=0.50%). The standardized mortality rate of four major NCDs in the population aged 30-69 years was decreasing annually (APC=-1.78%). The premature death probability of four major NCDs decreased from 15.53% to 14.43% with a downward trend. The decline rate of men (APC=-1.80%) was slightly lower than that of women (APCn =-2.00%). The decline rate of urban (APC=-1.57%) and rural (APC=-1.99%), Northern Anhui (APC=-2.32%) and Central Anhui (APC=-1.81%) areas were all showed a downward trend. The premature death probability in the same year was higher in men, rural areas and northern Anhui areas. The decrease of chronic respiratory diseases was the greatest (APC=-9.19%), followed by cancer (APC=-1.77%), but increased in diabetes for men (APC=-2.90%). According to the average growth rate of premature death probability from 2014 to 2018, it was predicted that the goal of healthy Anhui would be achieved by 2030. However, to achieve the goal of healthy China, the rate of decline needs to be increased by 26.40% on the existing basis. Comparing to the proportion, the descent speed needs to be increased between different genders, urban and rural areas and regions.n Conclusions:The premature death probability of four major NCDs in Anhui province has a continuous downward trend. Men, rural residents and residents in northern Anhui province are the key population. We should carry out intervention against the main risk factors of NCDs, reduce the premature mortality rate of NCDs, and strive to achieve the goal of “Healthy China 2030”.
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