| SignificancesLife expectancy (LE) is a representative and comprehensive index which reflects a country’s development level of social economy and medical and health level. The LE of Chinese residents has increased from 35 years to 73.5 years in 2010 since the founding of new China, and population health has been greatly improved during this stretch. With the progress of society and economy, Chinese government is paying close attention to people’s health. China’s 12th Five-Year Plan has set up a goal for population health to increase LE at birth by 1 year in Chinese population from 2011 to 2015, which has also been put forward by the East-China Province we study.With the accelerated process of industrialization, environmental pollution and the aging of the population, chronic disease has become the main cause of death for the East-China province residents (deaths caused by malignant tumors, cerebrovascular disease, heart disease and other major chronic diseases accounted for 82.4% of all deaths). Its impact on residents’ health and life expectancy should not be neglected. Therefore, making a clear quantitative analysis of the effect of chronic diseases on the life expectation and putting forward priorities and strategies forchronic disease prevention and controlare necessary to ensure that the goal can be successfully achieved in 2015.Domestic and foreign studies on the impact of the disease on life expectancy show a multi-focus single or partial impact on life expectancy disease deaths from the content perspective and use just single evaluation dimension from the indicator perspective, especially focus little on the quantitative impact of disease Control and Prevention. From the time span perspective, most studies focus on a short period of one year, which is difficult to grasp the extent of the impact of disease on life expectancy from a long period of time.In terms of content and indicator, most of domestic and foreign studies focuse on the impact of deaths caused by only one disease or several diseases on life expectancy and used case-eliminated life expectancy as the key indicator. Their evaluation dimension was single and they focus little on the quantitative impact of disease control and prevention on life expectancy. From the perspective of time span, most studies focus on one year or a short period, which is difficult to know the impact of disease on life expectancy for a long period of time.Therefore, by using three indicesthree indices that is case-eliminated life expectancy, death attribution and the contribution of chronic disease prevention and control to life expectancy, this study will quantitatively analyze the impact of chronic diseases on life expectancy from 1900 to 2010 and try to predict the change trend of these indicators during the next 10 years in the East-China province. Then this study will propose management strategies for chronic disease prevention and control by making sure the priorities in the future work.Materials and MethodsFirst of all, this study analyzed the change trend of chronic disease mortality and life expectancy from 1990 to 2010 through collection of health statistics yearbook, census data and other data, initially making clear the major chronic diseases.Secondly, based on the population data by age group, chronic illness, chronic diseases death data, quantitatively analyze the degree of chronic disease affecting life expectancy from the following three perspectives:(1) Use life table to measure the effect of various types of chronic disease deaths on life expectancy in a single year impact; Further use Fulfillment Index to analyze the impact of different diseases in specific age groups; (2) Through attribution analysis ideas, explore and analyze the impact of various types of chronic disease death rates between different years in life expectancy. Further apply Arriaga decomposition method to make clear disease-specific analysis of the impact of changes in mortality in different age groups; (3) Explore and establish the quantitative relationship of "lower prevalence of chronic diseases and prolong survival-reduce or delay death-life expectancy improving" between chronic diseases prevention and control measure to improve the life expectancy. Use the method of time series analysis to predict the degree of influence of next 10-year in the future.Again, predict whether the life expectancy goal can be achieved successfully and propose feasible ways to focus on achieving that goal.Finally, in the quantitative analysis of the impact of chronic disease on life expectancy levels, based on targeted prevention and control of chronic diseases propose future priorities and management strategies.1990-2010 age group population groups, chronic illness, death and other basic data are mainly from the "Statistical Yearbook," "Health statistics compilation, "census data", "health services survey" and so on. Use time series analysis to make up the lacking data.Residents injury death disease classification and data in this study is consistent classification of chronic diseases, including cancer, blood-forming organs diseases, endocrine and metabolic immune diseases, mental disorders, neurological disorders, circulatory diseases, respiratory diseases, digestive diseases, musculoskeletal and connective tissue diseases, diseases of the genitourinary system diseases, totally 10 categories.Main Results(A) Trend of life expectancy and disease mortality in the East-China province The life expectancy increases from 71.9 years in 1990 to 80.28 years old in 2020. Total chronic disease also increases from 489.09 per 100000 in 1990 to 629.87 per 100000 in 2020.Among chronic diseases, cancer mortality rose from 170.40 in 1990 to 211.19 per 100000 in 2020, circulatory diseases mortality rose from 139.84 in 1990 to 316.47 per 100000 in 2020, metabolic immune disorders mortality rose from 4.87 in 1990 to 20.04 per 100000 in 2020. The mortality of four main common chronic diseases (these are cerebrovascular disease, heart disease, hypertension and diabetes) are rising fast.(B) Make out the impact of chronic diseases on life expectancy1. case-eliminated life expectancy increased year by yearCase-eliminated life expectancy of chronic disease increases from 13.081 years in 1990 to 17.037 years in 2020.old, which shows an accelerated trend. Circulatory system diseases roses from 3.491 years in 1990 to 10.868 years in 2020, while cancer roses from 3.861 to 4.098 years and endocrine and metabolic immune disorders rose from 0.110 to 0.522 years.F Index results show that during 2010 to 2020, young people (18-40 years old) and middle-aged (41-65 years old) died of chronic diseases were the main tumor and circulatory system diseases, the elderly (66 years and older) in the main chronic disease deaths are followed by circulatory system diseases and tumors.2. Changes in mortality due to chronic disease:gradually from "active attribution" to "negative attribution"With 2010 as the base year, the attribution of chronic diseases switches from "positive" to "negative":decrease from 72.85% of 1990-2010 to -81.76% of 2010-2020. Cancer will be-21.1% and circulatory disease will be -26.1% in next ten years. The main diseases as diabetes, hypertension, heart disease and cerebrovascular disease, are also both "negative" attribution, the ratio was -2.72%,-6.25%,-19.31% and -14.51%.Arriaga decomposition results show that during 2010-2020, increased mortality of 65+ age group of hypertension and heart disease have greater impact on the life expectancy, which is 70 for diabetes and 75 for Cerebrovascular diseases.3. Contribution of chronic disease prevention and control on life expectancy:"negative contribution" to be intensifiedLife expectancy of the East-China province increased by 6.58 years old from 1990 to 2010,and prevention and control of chronic diseases contributed-18.1%(-1.19 years) 2010-2020, chronic disease prevention and control for life expectancy will continue "negative contribution".Only a single year in 2020 will reach -0.377 years old and 10 years accumulation will reach -3.007 years old. Such finding suggests that even if the contribution of chronic disease to the life expectancy being switched from negative to zero can also enhance the life expectancy of future work.(C) Analyze the feasibility of the East-China province to achieve the life expectancy objectiveIn accordance with the existing disease prevalence, life expectancy in East China province will increase by 0.86 years old from 2011 to 2015, which is still 0.14 goals-year-old gap from the life expectancy goal. The results show:the circulation system or tumor mortality decreasing by 3% or 6% will increase the life expectancy by 0.146 or 0.159 years old, which can reach the goal. Heart disease or cerebrovascular disease mortality decreasing by 8% or 6% will increase life expectancy by 0.153 years or 0.150 years, which can also achieve the goal.(D) Propose management strategy for prevention and control of chronic disease1. Chronic disease is the most important disease affecting life expectancy in the next 10 years. Therefore, it is imperative to strengthen the prevention and control of chronic diseases, especially the primary prevention strategy, such as carrying out a comprehensive national health lifestyle, strengthen the monitoring of chronic disease risk factors. The department in charge of disease prevention and control should also develop more effective intervention strategies and measures.2. The major chronic diseases for young and middle-aged will be tumor and circulatory system disease. For elderly, the diseases are the same, while the rank changes. This finding will contribute to find out the major diseases and develop appropriate prevention and control measures.3. For high blood pressure, heart disease, cerebrovascular disease, diabetes mortality increased life expectancy and thus a greater impact on the main age group, the core of the strategy should be to strengthen the prevention and control of third preventive measures and delay death. Through community survey, a comprehensive grasp of the community for patients with these "high-risk age group" were "group management" to strengthen the follow-up and treatment of complications, so as to delay the patient’s death. Meanwhile, disease prevention and control department is also based on the average duration of specific chronic diseases, in advance for effective primary prevention interventions targeted populations.ExplorationsUsing abridged life table, the cause of death to the life table method, attribution analysis, time series analysis, Fulfillment index and Arriaga decomposition method and other methods, the three dimensions such as increased longevity age, changes in the degree of death from diseases attributed to changes in life expectancy for death, chronic diseases prevention and control of the level of life expectancy to enhance the contribution were figured out, which showed that chronic diseases would be the most important desease in the future, especially circulatory diseases, cancer, respiratory diseases and endocrine diseases; youth, middle-aged and older people needed to focus on prevention and control of different diseases; major diseases needed to take action against its "high-risk age group" and slow its death. |
PDF Full Text Request