The impact of the major causes of death on life expectancy in China: a 60-year longitudinal study

Abstract

BackgroundIn the 12th Five-Year Plan, the Chinese government set the goal of increasing life expectancy by one year. The purpose of this study is to examine the impact of major causes of death on the life expectancy of the Chinese people between 1950 and 2010 and predict changing trends to identify major issues requiring future attention.MethodsA continuous database organised by population and death data on diseases by age group between 1950 and 2010 were created from A Province in Eastern China. The diseases were classified into four categories by the International Classification of Diseases-10 (ICD-10): infectious and parasitic diseases, chronic diseases, accidental injuries, and maternal diseases. Potential gains in life expectancy (PGLEs) were applied to reflect the impact on life expectancy caused by deaths from various diseases, by using the cause-eliminated life table.ResultsThe PGLEs of infectious and parasitic diseases decreased from 15.59 years in 1950, to 0.07 year in 2010, and have remained low since 2000. However, the PGLEs of chronic diseases increased from 8.70 years in 1950, to 13.36 years in 2010, and indicated an increasing future trend. The two opposite trends exhibited a ‘scissors-like difference’. The proportion of accidental injuries and maternal diseases in the death spectrum was low. The PGLEs of accidental injuries decreased from 2.95 years in 1950, to 0.86 year in 2010, maintaining a low level, while the PGLEs of maternal diseases dropped from 0.56 to 0.002 year during the same period, approaching zero.ConclusionsThe findings of this study provide useful information, which could contribute to a more effective allocation of public health programmes. In recent years, chronic diseases and accidental injuries have emerged as major factors influencing life expectancy. Primary and secondary prevention actions, such as public education, modification of behaviours, and introduction of safety measures should be emphasised in efforts to promote life expectancy. The morbidity and mortality rates of infectious, parasitic, and maternal diseases should be maintained at low levels.

Impact of injury-related mortality on life expectancy in Zhejiang, China based on death and population surveillance data

“…Meanwhile, few studies have focused on the impact of removing causes of death on life expectancy in China [1, 8, 18, 24–27], especially at the national or provincial level. Injury-related death is a significant public health issue in our country.…”

Patterns and changes in life expectancy in China, 1990-2016

“…Previous studies [7,8] usually used cause-eliminated life tables with potential gains in life expectancy as a research method to determine the impact of cause-specific death on life expectancy. However, this approach is only focused on a single population and the development of single decrement, while the decomposition method is more comparative and can assign responsibility for mortality variation to particular age groups or causes of death [9].…”

Impact of Pregnancy-Related Deaths on Female Life Expectancy in Zambia: Application of Life Table Techniques to Census Data

“…A study in China using health facility based data and covering the period 1950–2010 estimated PGLE at birth from eliminating maternal diseases (complications of pregnancy, childbirth and puerperium) of between 0.56 to 0.002 years over the same period [38]. The highest PGLE of 0.56 years was estimated for the period 1950, when the MMRatio for China was about 1,500 deaths per 100,000 live births [38]. …”