2016年天津市滨海新区塘沽居民死亡现况及去死因期望寿命分析

目的:了解2016年天津市滨海新区塘沽居民死亡水平、死亡原因构成及主要死因在不同性别、不同年龄人群中的分布情况,并分析去除主要死因后期望寿命的增加情况。方法:收集2016年滨海新区塘沽居民全死因登记资料,按照国际疾病分类ICD-10确定根本死因及分类编码,利用SAS统计软件包、中国疾病预防控制中心开发的DeathReg 2005软件及预期寿命管理系统完成数据的统计分析。结果:2016年滨海新区塘沽居民粗死亡率为664.43/10万,男性粗死亡率为730.05/10万,女性粗死亡率为593.91/10万。慢性非传染性疾病是滨海新区塘沽居民的主要死因,占91.47%。多数疾病的男性死亡率显著高于女性死亡率。心脏病、脑血管病、呼吸系统疾病所导致的死亡80%以上都发生在65岁以上。肿瘤所导致的死亡约2/3发生在65岁以上,约1/3发生在15~64岁。去死因期望寿命增长最多的前3位疾病分别是心脏病、肿瘤、脑血管病,分别增加5.52岁、4.04岁、2.72岁。结论:慢性非传染性疾病严重威胁滨海新区塘沽居民健康,迫切需要采取有效措施遏制其发展。     

Death, disease and diversity in Australia, 1951 to 2000

There has been a substantial decline in mortality in Australia during the 20th century, with a major improvement in life expectancy. There has been a broad "health transition", from a pattern of high mortality from infectious diseases to one of lower overall mortality from non-communicable diseases and injury. From 1951, trends in death rates from major causes were evident, with the rise and partial fall of two epidemics (coronary heart disease and stroke, and lung cancer). This overall picture masks significant inequalities in health for Indigenous people and the socioeconomically disadvantaged.     

Delay times and management of acute myocardial infarction in indigenous and non-indigenous people in the Northern Territory

OBJECTIVES: To investigate differences in presentation and management of Indigenous and non-Indigenous patients hospitalised with acute myocardial infarction (AMI). DESIGN: Retrospective review of hospital medical records. PARTICIPANTS AND SETTING: 122 patients with definite or possible AMI admitted to hospitals in the Top End of the Northern Territory (NT) in 1996. MAIN OUTCOME MEASURES: Percentage receiving thrombolytic therapy; delays from symptom onset to primary and emergency department presentations, first and diagnostic electrocardiograms, thrombolytic therapy and aspirin; drugs prescribed during hospitalisation. RESULTS: Thrombolytic therapy was given to 12/41 Indigenous patients (29%) and 38/81 non-Indigenous patients (47%) (P = 0.06). Presentation delay over 12 hours was the reason for not giving thrombolytic therapy for 14/29 Indigenous patients (48%) and 8/43 non-Indigenous patients (19%) (P < 0.01). Median delay times were longer for Indigenous patients for all six categories of delay, although the difference was significant only for delay to emergency department presentation (10:00 versus 3:26 hours; P < 0.01) and to diagnostic electrocardiogram (8:10 versus 3:50 hours; P < 0.01). Delays were also longer for patients from rural compared with urban areas. Once diagnosed, Indigenous patients were as likely as non-Indigenous patients to receive aspirin (93% versus 96%) and beta-blockers (70% versus 69%) and more likely to receive angiotensin-converting enzyme inhibitors (60% versus 40%; P = 0.03). CONCLUSIONS: Delays in presentation affect Indigenous people living in rural and urban areas as well as non-Indigenous people living in rural areas. Concerted efforts are needed to improve health service access in rural areas and to encourage Indigenous people with persistent chest pain to present earlier.     

2010-2012年江门市居民慢性非传染性疾病死因分析

目的了解江门市居民慢性非传染性疾病(以下简称慢性病)的死亡状况及变化趋势,为制定慢性病防治规划提供依据。方法应用DeathReg2005软件和Excel对2010-2012年江门市户籍居民死亡资料进行统计分析。结果 2010-2012年江门市居民因慢性病死亡71 466人,占全死因86.53%,慢性病死亡率为604.78/10万,3年间慢性病死亡率呈上升趋势。男性慢性病死亡率(664.00/10万)明显高于女性(544.44/10万),差异有统计学意义(χ2=727.71,P0.01)。慢性病死因顺位前5位依次为心血管疾病、脑血管疾病、恶性肿瘤、慢性呼吸系统疾病、消化系统疾病,占慢性病死因的93.40%。男性脑血管疾病、恶性肿瘤、慢性呼吸系统疾病、消化系统疾病、泌尿系统疾病的死亡率明显高于女性,而女性内分泌及代谢疾病、先天异常的死亡率明显高于男性,差异均有统计学意义(P0.01)。不同年龄组慢性病死因顺位不相同。结论慢性病已成为江门市居民的主要死因,为降低居民死亡率,须加强慢性病的三级预防工作。     

Long-term trends in cancer mortality for Indigenous Australians in the Northern Territory

OBJECTIVE: To examine long-term trends in cancer mortality in the Indigenous people of the Northern Territory (NT) of Australia. DESIGN: Comparison of cancer mortality rates of the NT Indigenous population with those of the total Australian population for 1991-2000, and examination of time trends in cancer mortality rates in the NT Indigenous population, 1977-2000. PARTICIPANTS: NT Indigenous and total Australian populations, 1977-2000. MAIN OUTCOME MEASURES: Cancer mortality rate ratios and percentage change in annual mortality rates. RESULTS: The NT Indigenous cancer mortality rate was higher than the total Australian rate for cancers of the liver, lungs, uterus, cervix and thyroid, and, in younger people only, for cancers of the oropharynx, oesophagus and pancreas. NT Indigenous mortality rates were lower than the total Australian rates for renal cancers and melanoma and, in older people only, for cancers of the prostate and bowel. Differences between Indigenous and total Australian cancer mortality rates were more pronounced among those aged under 64 years for most cancers. NT Indigenous cancer mortality rates increased over the 24-year period for cancers of the oropharynx, pancreas and lung, all of which are smoking-related cancers. CONCLUSIONS: Cancer is an important and increasing health problem for Indigenous Australians. Cancers that affect Indigenous Australians to a greater extent than other Australians are largely preventable (eg, through smoking cessation, Pap smear programs and hepatitis B vaccination).     

Long-term trends in Indigenous deaths from chronic diseases in the Northern Territory: a foot on the brake, a foot on the accelerator

OBJECTIVE: To examine trends in Northern Territory Indigenous mortality from chronic diseases other than cancer. DESIGN: A comparison of trends in rates of mortality from six chronic diseases (ischaemic heart disease [IHD], chronic obstructive pulmonary disease [COPD], cerebrovascular disease [CVD], diabetes mellitus [DM], renal failure [RF] and rheumatic heart disease [RHD]) in the NT Indigenous population with those of the total Australian population. PARTICIPANTS: NT Indigenous and total Australian populations, 1977-2001. MAIN OUTCOME MEASURES: Estimated average annual change in chronic disease mortality rates and in mortality rate ratios. RESULTS: Death rates from IHD and DM among NT Indigenous peoples increased between 1977 and 2001, but this increase slowed after 1990. Death rates from COPD rose before 1990, but fell thereafter. There were non-significant declines in death rates from CVD and RHD. Mortality rates from RF rose in those aged > or = 50 years. The ratios of mortality rates for NT Indigenous to total Australian populations from these chronic diseases increased throughout the period. CONCLUSIONS: Mortality rates from IHD and DM in the NT Indigenous population have been increasing since 1977, but there is evidence of a slower rise (or even a fall) in death rates in the 1990s. These early small changes give reason to hope that some improvements (possibly in medical care) have been putting the brakes on chronic disease mortality among Aboriginal and Torres Strait Islander peoples.     

1994～2000年宁夏居民预期寿命分析

目的：了解近些年来宁夏居民病、伤死因谱及主要死因对人群寿命的影响程度。方法：采用1994～2000年我区疾病监测网的26万疾病监测人口报告的出生、死亡资料，应用寿命表计算宁夏居民全死因预期寿命、去主要死因预期寿命。结幂：1994～2000年宁夏居民男、女、全人口平均预期寿命分别为69．48、71．40和70．40岁，女性高于男性。目前影响宁夏居民的前四位主要死因为循环系统疾病、肿瘤、呼吸系统疾病及损伤与中毒。若去除以上死因，宁夏居民预期寿命有不同程度的提高。结论：循环系统疾病、肿瘤、呼吸系统疾病及损伤与中毒目前依次成为影响人民健康的主要死因，也是造成寿命损失的主要原因，损伤与中毒造成青壮年寿命损失严重，应加强对主要死因防治工作的投入和管理力度。     

2015年重庆市綦江区居民死因分析

目的  分析綦江区2015年居民死亡率、主要死因及人均期望寿命,为制定和调整卫生策略提供科学依据。方法  收集綦江区2015年网络直报的全死因资料,用死亡率、构成比及死因顺位等指标进行分析。 结果  2015年綦江区居民总粗死亡率为760.50/10万,标化死亡率为600.48/10万,男性居民的粗死亡率高于女性。2015年綦江区居民人均期望寿命为77.30岁,其中男性为74.52岁,女性为80.52岁,女性人均期望寿命高于男性。循环系统疾病、肿瘤、呼吸系统疾病、损伤和中毒外部原因及内分泌、营养和代谢的其他疾病分别位于死因前5位,占总死亡数的93.44%。3大类死因构成中,慢性非传染性疾病居首位,占死亡总数的90.44%,其中慢性非传染性疾病和伤害的男性粗死亡率高于女性。结论  慢性病仍将是今后卫生工作的防控重点,应该加强健康教育,提高居民自我防护意识,加强对高危人群干预等措施以降低死亡率和发病率,提高居民生活质量。

     

Racial disparities in infection-related mortality at Alice Springs Hospital, Central Australia, 2000--2005

OBJECTIVE: To compare infection-related mortality rates and pathogens isolated for Indigenous and non-Indigenous adult patients at Alice Springs Hospital (ASH). DESIGN, PARTICIPANTS AND SETTING: Retrospective study of inhospital deaths of adults (patients aged > or = 15 years) associated with an infection during a medical or renal admission to ASH between 1 January 2000 and 31 December 2005. MAIN OUTCOME MEASURES: Admission- and population-based infection-related mortality rates and mortality rate ratios (MRRs) for Indigenous versus non-Indigenous adults. RESULTS: There were 513 deaths, of 351 Indigenous and 162 non-Indigenous patients. For Indigenous patients, 60% of deaths were infection-related, compared with 25% for non-Indigenous patients (P < 0.001). The admission-based infection-related MRR for Indigenous versus non-Indigenous adults was 2.2 (95% CI, 1.6-3.1) (15.3 v 6.8 deaths per 1000 admissions; P < 0.001). After adjusting for age and year of death, the population-based infection-related MRR was 11.3 (95% CI, 8.0-15.8) overall (351 v 35 deaths per 100,000 population; P < 0.001) and 31.5 (95% CI, 16.1-61.8) for patients aged < 60 years. The median age of patients who died with an infection was 49 (interquartile range [IQR], 38-67) years for Indigenous and 73 (IQR, 58-80) years for non-Indigenous patients (P < 0.001). For Indigenous patients, 56% of infection-related deaths were associated with bacterial sepsis, with half of these due to enteric organisms. Other deaths followed chronic hepatitis B infection, invasive fungal infections and complications of strongyloidiasis. CONCLUSION: Indigenous patients at ASH are 11 times more likely than non-Indigenous patients to die with an infectious disease. This racial disparity reflects the ongoing socioeconomic disadvantage experienced by Indigenous Australians.     

Treatment patterns for cancer in Western Australia: does being Indigenous make a difference?

OBJECTIVE: To examine whether hospital patients with cancer who were identified as Indigenous were as likely to receive surgery for the cancer as non-Indigenous patients. DESIGN, SETTING AND PATIENTS: Epidemiological survey of all Western Australian (WA) patients who had a cancer registration in the state-based WA Record Linkage Project that mentioned cancer of the breast (1982-2000) or cancer of the lung or prostate (1982-2001). MAIN OUTCOME MEASURES: The likelihoods of receiving breast-conserving surgery or mastectomy for breast cancer, lung surgery for lung cancer, or radical or non-radical prostatectomy for prostate cancer were compared between the Indigenous and non-Indigenous populations using adjusted logistic regression analyses. RESULTS: Indigenous people were less likely to receive surgery for their lung cancer (odds ratio [OR], 0.64; 95% CI, 0.41-0.98). Indigenous men were as likely as non-Indigenous men to receive non-radical prostatectomy (OR, 0.69; 95% CI, 0.40-1.17); only one Indigenous man out of 64 received radical prostatectomy. Indigenous women were as likely as non-Indigenous women to undergo breast-conserving surgery (OR, 0.86; 95% CI, 0.60-1.21). CONCLUSIONS: These results indicate a different pattern of surgical care for Indigenous patients in relation to lung and prostate, but not breast, cancer. Reasons for these disparities, such as treatment choice and barriers to care, require further investigation.     

Perinatal and postneonatal mortality among Indigenous and non-Indigenous infants born in Western Australia, 1980-1998

OBJECTIVE: To describe cause-specific perinatal and postneonatal mortality for Indigenous and non-Indigenous infants using a new classification system. DESIGN: Total population retrospective cohort study. PARTICIPANTS AND SETTING: All registered births in Western Australia of birthweight greater than 399 g from 1980 to 1998, inclusive. MAIN OUTCOME MEASURES: Rates and time trends for all births 1980-1998, and cause-specific rates for births 1980-1993 of fetal, neonatal and postneonatal mortality among Indigenous and non-indigenous infants, using a classification system designed for use in perinatal, postneonatal and childhood deaths. RESULTS: For Indigenous infants born 1980-1998, the mortality rate before the first birthday was 2.7 times (95% CI, 2.5-2.9 times) that for non-Indigenous infants. Indigenous infants born 1980-1993 had a higher mortality rate in all cause-of-death categories. The highest relative risk was for deaths attributable to infection (8.1; 95% CI, 6.5-10.0) which occurred primarily in the postneonatal period; the source of the infection was less likely to be identified in Indigenous deaths. From 1980-1998, the rate of neonatal deaths decreased at a greater rate for Indigenous than for non-Indigenous infants. However, while stillbirth and sudden infant death syndrome rates for non-Indigenous births fell, they remained static for Indigenous births. CONCLUSIONS: The new classification system, which considers the underlying rather than immediate cause of death, enables investigation of the causes of all deaths, from stillbirths to childhood. This system has highlighted the comparative importance of infection as a cause of death for Indigenous infants, particularly in the postneonatal period.     

2005-2010年中国城市居民期望寿命趋势分析

 目的 了解中国城市男女期望寿命的现状,分析期望寿命受年龄和死因影响的不同变化,探讨哪个年龄组、何种死因是导致我国近5年期望寿命变化的主要因素。方法利用2005-2010年《中国卫生统计年鉴》中中国城市居民年龄别死亡率及死因别死亡率等数据,采用绘制寿命表法、期望寿命上升下降增减差异的年龄分解和死因分解法,进行城市居民期望寿命差异的分析比较。结果 2005-2010年中国城市的期望寿命不断上升,2005年为76.57岁,2008年达到峰值,为80.03岁。2005-2010年中国城市的居民死亡主要是循环系统疾病、恶性肿瘤及呼吸系统疾病造成的。在所有年龄组中,2005-2006年期望寿命的快速提高主要由55~85岁居民期望寿命的提高所引起;2008-2009年,期望寿命下降0.49岁,主要是因80岁以上、尤其是85岁以上老人期望寿命下降所致。从病因别分析,2005-2008年,期望寿命3年内增加3.46岁,主要是循环系统疾病对于期望寿命作用的快速增加(2.15岁,62.14%),其次为呼吸系统疾病和损伤中毒等外部原因,分别导致期望寿命上升0.75岁(21.68%)和0.64岁(18.50%)。肿瘤对期望寿命增长的作用为0.28岁(8.09%),传染病为0.06岁(1.73%)。2008-2010年,期望寿命在2年内下降了1.94岁,主要是循环系统疾病的作用(1.22岁,62.89%)。结论 针对循环系统疾病的危险因素,尽早采取干预措施,大力宣传戒烟、减少肥胖、提倡健康生活方式、预防糖尿病和高血压,将有助于期望寿命的进一步提高。呼吸系统疾病是影响期望寿命的第二大因素,肺炎对于期望寿命的影响始终为负作用,建议在5岁内的婴幼儿和儿童以及65岁以上的老年人等发病高危人群中接种肺炎疫苗,可有效提高机体的免疫力,减少肺炎发病,降低影响期望寿命的负面因素。     

Impact of hepatitis A vaccination of Indigenous children on notifications of hepatitis A in north Queensland

OBJECTIVE: To describe the impact of a hepatitis A vaccination program for Indigenous children in north Queensland. DESIGN: Enhanced surveillance of all notified cases of hepatitis A in north Queensland from 1996 to 2003. SETTING: North Queensland; population, 596 500 people, including about 6900 Indigenous children aged under five years. INTERVENTIONS: Hepatitis A vaccine was provided to Indigenous children in north Queensland from February 1999; two doses were recommended (at 18 months and 2 years of age), as was catch-up vaccination up to the sixth birthday. RESULTS: In the 4 years 1996-1999, 787 cases of hepatitis A were notified in north Queensland, 237 (30%) of which were in Indigenous people. The average annual notification rates in Indigenous and non-Indigenous people during this period were 110 and 25 cases per 100 000 persons, respectively. In the first 4 years after introduction of the vaccination program (2000-2003), 66 cases of hepatitis A were notified. Only nine of the 66 (14%) were in Indigenous people. The average annual notification rates in Indigenous and non-Indigenous people in 2000-2003 were 4 and 2.5 cases per 100 000 persons, respectively. CONCLUSION: Hepatitis A seems to have been eradicated from Indigenous communities in north Queensland very soon after the vaccination program began. The rapid decline in notifications in non-Indigenous as well as Indigenous people suggests the program quickly interrupted chains of transmission from Indigenous children to the broader community. To our knowledge this is the first evidence that a hepatitis A vaccination program targeting a high-risk population within a community can reduce disease in the broader community. Hepatitis A vaccine should be provided to other high-risk Indigenous children elsewhere in Australia.     

赣州市章贡区2008～2010年居民全死因监测分析

目的:为掌握赣州市章贡区居民死因构成及其顺位,分析寿命损失情况,为政府制定有效的疾病预防控制策略提供科学依据。方法:通过死因监测系统收集2008～2010年居民死因资料,采用死亡率、构成比、潜在减寿损失年数(PYLL)、平均期望寿命等指标进行分析。结果:2008～2010年赣州市章贡区居民平均死亡率为634.85/10万,标化死亡率为448.22/10万;前5位死因为肿瘤、脑血管疾病、呼吸系统疾病、心脏病、损伤和中毒,占全死因的84.79%;对居民潜在寿命损失最大的是肿瘤,达到每千人13.52年;损伤和中毒造成平均减寿年数最高,达到30.97年。结论:肿瘤、脑血管病、呼吸系统疾病、心脏病等慢性非传染性疾病为影响居民健康的主要疾病;损伤和中毒是造成居民寿命损失较为严重的疾病,是居民"早死"的主要原因之一。今后疾病控制工作的重点应是加强慢性非传染性疾病及伤害和中毒的防治力度。     

Changing profile of disease contributing to mortality in a resettlement colony of Delhi

BACKGROUND: The past decade has seen a decline in the disability-adjusted life years (DALYs) contributed by communicable diseases while lifestyle changes and rapid urbanization have led to an increase in DALYs contributed by non-communicable diseases. We studied the causes of death in a low socioeconomic area over 11 years to help identify changes in the pattern of disease. METHODS: We did this study in Gokulpuri, a resettlement colony in East Delhi. All deaths occurring from 1994 to 2004 were analysed using a verbal autopsy questionnaire completed by trained health workers during their home visits in the area. RESULTS: A total of 515 deaths occurred during the period; 340 in men (66%) and 175 in women (34%). The six commonest causes of death were tuberculosis (24.8%), chronic obstructive pulmonary disease (11.6%), pneumonia (8.7%), accidents and poisoning (8.6 %), coronary heart disease (8.2%) and cancer (4.6%). The age-specific mortality rate was highest among people > 45 years of age. The cause-specific mortality rate due to communicable diseases showed a decline while that due to non-communicable diseases showed a rising trend in all age groups. CONCLUSION: Our study shows the coexistence of communicable and non-communicable diseases in a low socioeconomic area with a rising trend in non-communicable diseases. Surveillance for risk factors of non-communicable diseases should be done even in predominantly low socioeconomic areas. The coexistence of communicable and non-communicable diseases and the increase in non-communicable diseases among the economically deprived sections of our society suggest the need to re-prioritize components of healthcare among these sections.     

重庆市2010年城乡居民期望寿命及减寿情况分析

目的了解重庆地区男女及城乡不同人群的主要死因及其对期望寿命的疾病影响因素,分析各类疾病的危害程度,为制订疾病控制和健康促进策略提供科学依据。方法收集整理2010年重庆地区全死因监测点数据,计算死亡率、期望寿命、去死因期望寿命、潜在减寿损失年数、减寿率等指标,分析居民死亡和减寿的主要原因。结果 2010年重庆地区人口期望寿命值为76.5岁,在西部地区属于高寿命值地区,但低于其他直辖市及部分沿海发达省市;处于死因构成前5位的分别是循环系统疾病、肿瘤、呼吸系统疾病、损伤中毒和消化系统疾病;不同人群的死因顺位基本一致,但在不同性别、不同地区的病死率存在差异;去除前5位死因后,人均期望寿命可分别增加4.22、2.50、2.01、1.26、0.27岁,各类疾病对不同人群的寿命影响程度不同;对居民早死威胁最大的是恶性肿瘤,以肺癌为首,其次是以交通事故、意外死亡为主的损伤中毒类;自杀行为导致的早死是意外死亡的主要原因之一。结论重庆地区人口期望寿命值有待进一步提高;加强针对不同人群心脑血管疾病、恶性肿瘤以及意外伤害的防治策略研究是非常必要的。     

Stage at diagnosis and cancer survival for Indigenous Australians in the Northern Territory

OBJECTIVE: To investigate whether Indigenous Australians with cancer have more advanced disease at diagnosis than other Australians, and whether late diagnosis explains lower Indigenous cancer survival rates. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: Indigenous and non-Indigenous people diagnosed with cancers of the colon and rectum, lung, breast or cervix and non-Hodgkin lymphoma in the Northern Territory of Australia in 1991-2000. MAIN OUTCOME MEASURES: SEER summary stage of cancer at diagnosis (local, regional or distant spread), cause-specific cancer survival rates and relative risk of cancer death. RESULTS: Diagnosis with advanced disease (regional or distant spread) was more common for Indigenous people (70%; 95% CI, 62%-78%) than for non-Indigenous people (51%; 95% CI, 53%-59%) with cancers of the colon and rectum, breast, cervix and non-Hodgkin lymphoma, but for lung cancer the opposite was found (Indigenous, 56% [95% CI, 46%-65%] v non-Indigenous, 69% [95% CI, 64%-75%]). Stage-adjusted survival rates were lower for Indigenous people for each cancer site. With few exceptions, the relative risk of cancer death was higher for Indigenous people for each category of stage at diagnosis for each cancer site. CONCLUSIONS: Health services apparently could, and should, be performing better for Indigenous people with cancer in the Northern Territory, and probably elsewhere in Australia. This study has demonstrated that data from cancer registers, enhanced with data on stage at diagnosis, can be used to monitor health service performance for Indigenous Australians in the Northern Territory; similar data is available in other States, and could be used to monitor health service performance for Indigenous people throughout Australia.     

Effect of influenza epidemics on Australian mortality

The effect of influenza epidemics on all major causes of death has been examined. The results showed an increase in total mortality, and a fall in life expectancy, during epidemic years. Using the 1974 epidemic as an example, an increase in mortality was found in all age groups, with the greatest percentage in increases occurring in the very young and the very old. For all ages combined, the greatest percentage increases in mortality were for respiratory diseases, while the greatest absolute increases in mortality were for cardiovascular diseases, especially ischaemic heart disease. A thrombotic mechanism is suggested to explain the increase in mortality from cardiovascular diseases.