| Objective:This paper was to explore the changes of mortality rates for mental disorders by gender in urban and rural areas in China(2006-2020),understand the temporal trends in mortality rates of mental disorders and estimate the independent effects of age,period,and cohort on the mortality of mental disorders,so as to evaluate the effect of prevention and control measures,and to provide scientific basis for further taking corresponding prevention and control strategies and measures.Methods:This study employs data from the China Health Statistical Yearbook(2006-2011),China Health and Family Planning Statistical Yearbook(2012-2016)and China Health Care Statistical Yearbook(2017-2020).The standardized mortality rate was calculated using the 2020 national census data as the standard;the data were analyzed using joinpoint regression analysis as well as age-period-cohort analysis;the joinpoint regression analysis was conducted to analyze the temporal trends in mortality rates for mental disorders;the age-period-cohort model combined with the intrinsic estimator method was used to estimate the values of age effects,period effects and birth cohort effects.Results:1.Changes in standardized mortality rates for mental disorders among men and women in urban and rural China:From 2006 to 2020,the age-standardized mortality rates for mental disorders in China showed a downward trend by gender in urban and rural areas.With the passage of time,the standardized mortality rates of male mental disorders were gradually stable.the standardized mortality rates for men were consistently higher than that for women.2.Analysis of the time trend of the standardized mortality rates and age-specific mortality rates for mental disorders by gender in urban and rural areas in China:Among different age groups,mortality rates for mental disorders among urban males aged 3034,35-39,40-44,45-49,50-54,55-59,70-74 and 75-79 years declined at an average annual rate of-6.8%,-4.9%,-6.6%,-6.2%,-4.6%,-5.6%,-4.6%and-4.2%respectively(P<0.05);the mortality rates for mental disorders among urban females aged 20-24,30-34,35-39,40-44,45-49,55-59,60-64,70-74 and 75-79 years declined at an average annual rate of-10.4%,-5.1%,-6.6%,-7.6%,-5.4%,-6.8%,-4.4%,-5.2%and-7.2%respectively(P<0.05);the mortality rates for mental disorders among rural males aged 35-39,40-44,45-49,50-54,55-59,60-64,65-69,70-74,and 75-79 years decreased at an average annual rate of-3.9%,-3.1%,-3.3%,-3.0%,-6.4%,-5.9%,-2.5%,-3.7%and-6.2%respectively(P<0.05);the mortality rates for mental disorders among rural females aged 25-29,35-39,40-44,45-49,55-59,60-64,65-69,70-74,and 75-79 years decreased at an average annual rate of-7.5%,-6.7%,-8.6%,-3.8%,-11.8%,-3.9%,3.9%,-4.9%,and-7.3%respectively(P<0.05).3.Analysis of age,period,and cohort effects of mortality for mental disorders:The risk of death from mental disorders showed an upward trend with age;the age effects were greater than 0 for urban men,urban women and rural women after 60 years old,and greater than 0 for rural men after 50 years old.The age effects of mental disorder mortality were the smallest in 20-24 years old and the largest in 75-79 years old;the risk of death for mental disorders was higher in 2006-2010 than in the two periods 20112015 and 2016-2020,and the risk of death for mental disorders was greater than 0 for both men and women in urban and rural areas from 2006 to 2010,the risk of death for mental disorders was less than 0 from 2011 to 2015(except for rural males)and from 2016 to 2020;for those born after 1960,the birth cohort effects showed a steady downward trend over time,and the rural mental disorders birth cohort effects were higher than the urban ones overall.Conclusions:1.The standardized mortality rates of mental disorders in China showed a decreasing trend,indicating that mental health policies and measures had a certain effect,but the decline rates of standardized mortality rate of male mental disorders were slower than that of female.2.Age,period,and birth cohort effects were statistically significant in the trend analysis of mental disorder mortality,and compared with period and cohort effects,age effects were the leading correlate of mental disorder mortality.Early measures can be taken to protect the lives of people with mental disorders. |
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