Contributions of mortality changes by age group and selected causes of death to the increase in Japanese life expectancy at birth from 1950 to 2000

The purpose of this study is to analyze contributions of mortality change by age group and selected causes of death to the increase in life expectancy at birth from 1950 to 2000 in Japan, which has the longest longevity in the world. Using mortality data from Japanese vital statistics from 1950 to 2000, we analyzed contributions of mortality change by age group and selected causes of death to the increase in life expectancy at birth by the method of decomposition of changes and calculated age-adjusted death rates for selected causes of death. Gastroenteritis, tuberculosis and pneumonia largely contributed to an increase in life expectancy in childhood and in the young in the 1950s and 1960s. The largest contributing disease changed from tuberculosis and pneumonia in earlier decades to cerebrovascular diseases in the 1970s. The largest contributing age group also shifted to older age groups. Age-adjusted death rate for cerebrovascular diseases in 2000 was one fifth of the 1965 level. Cerebrovascular diseases contributed to an increase in life expectancy at birth of 2.9years in males and 3.1 years in females from 1970 to 2000. In the 1990s, the largest contributing age group, both among males and among females, was the 75–84 age group. Of the selected causes of death, heart diseases other than ischemic heart disease became the largest contributor to the increase in life expectancy at birth. Unlike cerebrovascular diseases, cancer and ischemic heart disease contributed little to change in life expectancy at birth over the past 50years. In conclusion, although mortality from ischemic heart disease has not increased since 1970 and remained low compared with levels in western countries, mortality from cerebrovascular diseases has dramatically decreased since the mid-1960s in Japan. This gave Japan the longest life expectancy at birth in the world. It is necessary to study future trends in life expectancy at birth in Japan.     

Influence of death from circulatory diseases on life expectancy at birth in Japan

This study aims to evaluate the contribution of the change in circulatory diseases mortality to the life expectancy at birth observed during the years 1955-1995 in Japan. We used data on the population and the number of deaths by cause, age, and sex in 1955, 1965, 1975, 1985, and 1995. The contribution of different ages and causes of death to the change in life expectancy were examined with the method developed by Pollard. We found that the reduction in circulatory diseases mortality contributed to the improvements in life expectancy for both sexes during the decade 1975-1985. Much of this was due to the decrease in cerebrovascular disease. In the years 1985-1995, however, the contribution of cerebrovascular disease decreased in both sexes, while that of heart disease grew to become the largest of any single condition. By age, the contribution of all circulatory diseases increased among the elderly in recent years. The contribution of the change in circulatory diseases mortality to the life expectancy at birth has increased in recent years but seems to have reached a plateau. The weight against improvements in life expectancy in middle-aged people has shown little change, so that reducing the mortality rate in middle-aged people is now a major issue.     

2005--2010年中国城市居民期望寿命性别差异的分析

目的了解2005--2010年中国城市居民期望寿命的性别差异及其受年龄和死因的影响, 并探讨影响期望寿命年龄差异变化的主要因素。方法利用2005--2010年《中国卫生统计年鉴》中城市居民年龄别死亡率及死因等死亡数据, 采用绘制寿命表法、期望寿命性别差异及其年龄分解和死因分解法, 进行城市居民期望寿命性别差异的分析比较。结果自2005年中国城市人群期望寿命开始呈上升趋势, 女性期望寿命始终高于男性; 2007年期望寿命性别差异显著增加(相差5．3岁)并呈现-个尖峰, 其中以60～79岁年龄组男女性别死亡率的差异最为显著, 是导致性别期望寿命差异的主要因素(42%～47%)。2005-2007年期望寿命性别差异增大, 主要为0～1岁婴幼儿和>75岁老年组; 2007-2008年该差异缩小, 仅表现为1-15岁和50～55岁年龄组; 2009--2010年差异增大, 主要为60-70岁年龄组。影响期望寿命性别差异的主要死因为肿瘤(1．638-2.019岁)、循环系统疾病(1.271～1.606岁)、呼吸系统疾病(0．551～0.800岁)。肿瘤中以肺癌对期望寿命的影响最大, 每年有约0．6岁的差异; 而肝癌导致男女性死亡差异不断缩小。损伤和中毒等原因也影响期望寿命的性别差异(10．60% 15.78%)。结论缩小中国城市居民健康的性别差距, 重点应关注男性>/60岁老年人; 肿瘤、循环系统疾病和呼吸系统疾病是导致中国城市人群期望寿命性别差异的主要疾病, 同时不可忽视外伤、自杀等对期望寿命差异的影响。     

Analysis of sex,age and disease factors contributing to prolonged life expectancy at birth,in cases of malignant neoplasms in Japan

BACKGROUND: This study aimed to examine the contribution made by the change in mortality from malignant neoplasms to the life expectancy at birth, observed during the years 1965-1995 in Japan. METHODS: We used data on the population and number of deaths by cause, age and sex in 1965, 1975, 1985 and 1995. The contribution of different ages and causes of death to the change in life expectancy were examined with the method developed by Pollard. RESULTS: We found that, among all causes, the decrease of mortality from stomach cancer led to the greatest improvement in life expectancy for both sexes. On the other hand, negative contributions were seen with cancers of many sites, such as cancer of the intestine, liver and lung for males, and cancer of the intestine, gallbladder, lung and breast for females. Recently, the contributing years of all cancers have been negative because of the increase in mortality from malignant neoplasms. In addition, increase of death from malignant neoplasms in middle-aged and elderly people negatively influenced the life expectancy at birth. CONCLUSIONS: Female cancer influenced the improvement in life expectancy at birth. Cancer for males, however, contributed little to improvement of life expectancy at birth except for a little prolongation of life expectancy at birth during the years 1965-1975. To develop a public health policy, the contributing years to life expectancy at birth can be a useful indication in evaluating the impact of death from various diseases. It is necessary to analyze the contribution made by various causes of death to the changes of life expectancy at birth.     

2015-2020年四类重点慢性病对济南市户籍人口期望寿命的影响分析

目的 分析2015-2020年恶性肿瘤、心脑血管疾病、慢性呼吸系统疾病和糖尿病（四类重点慢性病）对济南市户籍人口期望寿命增长的影响。方法 利用济南市2015-2020年死因监测资料和人口数据,应用简略寿命表和Arriaga分解法,分析2015-2020年四类重点慢性病及其具体病种的死亡率对期望寿命增长的贡献,不同性别、不同年龄段死亡率对期望寿命增长的贡献。结果 2015-2020年济南市户籍人口期望寿命增长了1.59岁。四类重点慢性病死亡率下降贡献了1.25岁,贡献比例为78.62%,男性期望寿命增长了1.66岁,四类重点慢性病死亡率下降贡献了1.18岁;女性期望寿命增长了1.52岁,四类重点慢性病死亡率下降贡献了1.35岁。恶性肿瘤、心脑血管疾病、慢性呼吸系统疾病和糖尿病的死亡水平下降对期望寿命的贡献分别为0.42、0.62、0.20和0.01岁。胃癌死亡率下降对期望寿命的贡献大于肺癌,高血压性心脏病死亡率增加导致了负贡献,哮喘和糖尿病对期望寿命的贡献微乎其微。结论 2015-2020年济南市户籍人口期望寿命增长主要由四类重点慢性病死亡率下降贡献。肺癌、糖尿病、高血压性心脏病等对期望寿命贡献较小,甚至为负贡献,应重点关注。     

Life expectancy at birth: impact of variation in mortality by age group and cause of death in Campinas, São Paulo State, Brazil

This study investigated the impact of variation in mortality by age group and cause of death on gains in life expectancy at birth in the city of Campinas, S?o Paulo State, Brazil, in 1991, 2000, and 2005. Life tables were constructed. Pollard's method was used to estimate the contributions by age group and cause of death on gains in life expectancy. In 1991-2000, the age group that most contributed was 0-1 year (31.1% for males and 22.9% for females). In 2000-2005, 79% of the gain for males was the result of mortality improvements in the 15-44-year bracket. Cardiovascular diseases made the largest contribution in 1991-2000 (66.1% for males and 43.5% for females). A loss in longevity was seen in men (1.1 year) resulting from increased mortality from external causes. In 2000-2005, the substantial gain (2.3 year) in male life expectancy was due to a reduction in mortality from external causes. Neoplasms had a negative effect on the gain (0.11 year for males and 0.15 for females). These findings should help support public health policies to reduce mortality risks and increase life expectancy.     

Changing life expectancy in Romania after the transition

BACKGROUND: While Poland, Hungary, and the Czech Republic have seen impressive gains in life expectancy in the 1990s, Romania has not. In contrast with the other countries, there has been very little research on the causes of the pattern of mortality seen in Romania. OBJECTIVES: To describe the trends in life expectancy at birth in Romania after the political transition in 1989 and to evaluate the contribution of deaths from different causes and different ages to these changes. METHODS: Decomposition of life expectancy by age and cause of death using routine data on mortality for the years 1990, 1996, and 1998; comparison of death rates by age, sex, and cause of death. RESULTS: Romania has experienced an overall decline of 1.71 years of life expectancy at birth from 1990 to 1996 in men and 0.54 years in women. The major contribution to this decline was an increase in mortality from cardiovascular diseases and diseases of the digestive system, in particular cirrhosis, among the middle aged and elderly. The recovery observed in 1998, of 1.12 years in men and 0.89 years in women, was mainly caused by a reduction in deaths from cardiovascular disease in the middle aged and elderly. Infant and early childhood mortality fell throughout the period but there was an increase of approximately 40% in mortality at age 5-9 that was almost entirely attributable to AIDS. CONCLUSION: This is the first Romanian study that describes the evolution of life expectancy after transition. Romania may at last be beginning to follow the path of improving adult mortality seen in the early 1990s in some of its neighbours. It has, however, been unique in eastern Europe in experiencing increasing childhood mortality. This is attributable to an epidemic of paediatric AIDS, consequent on the tragically inappropriate policies adopted in the 1980s.     

成都市近20年户籍人口期望寿命变化

目的分析成都市户籍人口期望寿命的变化,探讨不同年龄和死因对期望寿命变化产生的影响。方法利用1990-2010年成都市死因监测户籍人群的死亡数据,和公安局公布的同期同范围人口数,采用寿命表法计算户籍人口期望寿命,采用期望寿命的年龄分解法、期望寿命的死因分解法计算年龄别死亡率和死因别死亡率的变化对期望寿命变化的影响。结果成都市户籍人口期望寿命在提高,男女性别差异扩大;低年龄组死亡率的变化对期望寿命变化的影响逐渐减小,高年龄组死亡率变化对期望寿命变化影响增大;对期望寿命变化影响较大的疾病主要是如呼吸系统疾病、恶性肿瘤、脑血管病、心脏病等。结论降低高年龄组死亡率,加强对呼吸系统疾病、恶性肿瘤、脑血管病、心脏病的控制,降低其死亡率,有助于提高期望寿命。     

不同民族女性主要死因的年龄分布特征及期望寿命比较分析

目的:分析延边地区不同民族女性主要死因的年龄分布及期望寿命。方法:采用死亡病例回顾分析方法,对延吉市不同民族中老年妇女死亡病例进行调查。死因分类依据国际疾病分类标准(ICD-9)进行编码及统计。结果:从主要死因的年龄分布看,汉族中年组以肿瘤(38.5%)为主,其次是意外伤害(15.4%)和心血管病(10.3%);老年组以脑血管病(21.6%)、心血管病(19.8%)以及呼吸系统病(19.8%)为主。朝鲜族中年组以脑血管病(28.7%)及肿瘤(27.7%)为主,其次是消化系统病(14.9%)和心血管病(8.9%);老年组以脑血管病(37.9%)、心血管病(26.6%)为主,其次是肿瘤(9.2%)。延吉市女性汉族和朝鲜族的平均期望寿命分别为82.29岁及79.40岁,汉族的期望寿命高于朝鲜族。朝鲜族女性的心脑血管疾病对期望寿命的影响大于汉族,而恶性肿瘤对期望寿命的影响汉族高于朝鲜族。结论:不同民族女性主要死因的年龄分布、平均期望寿命水平及主要死因对期望寿命的影响差异较大。     

Changing mortality patterns in East and West Germany and Poland. II: short-term trends during transition and in the 1990s

OBJECTIVES: To examine trends in life expectancy at birth and age and cause specific patterns of mortality in the former German Democratic Republic (GDR) and Poland during political transition and throughout the 1990s in both parts of Germany and in Poland. METHODS: Decomposition of life expectancy by age and cause of death. Changes in life expectancy during transition by cause of death were examined using data for 1988/89 and 1990/91 for the former GDR and Poland; examination of life expectancy changes after transition were based on 1992-97 data for Germany and 1991-96 data for Poland. RESULTS: In both the former GDR and Poland male life expectancy at birth declined by almost one year during transition, mainly attributable to rising death rates from external causes and circulatory diseases. Female life expectancy in Poland deteriorated by 0.3 years, largely attributable to increasing circulatory mortality among the old, while in East German female rising death rates in children and young adults were nearly outbalanced by declining circulatory mortality among those over 70. Between 1991/92 and 1996/97, male life expectancy at birth increased by 2.4 years in the former GDR, 1.2 years in old Federal Republic, and 2.0 years in Poland (women: 2.3, 0.9, and 1.2 years). In East Germany and Poland, the overall improvement was largely attributable to falling mortality among men aged 40-64, while those over 65 contributed the largest proportion to life expectancy gains in women. The change in deaths among men aged 15-39 accounted for 0.4 of a year to life expectancy at birth in East Germany and Poland, attributable largely to greater decreases from external causes. Among those over 40, absolute contributions to changing life expectancy were greater in the former GDR than in the other two entities in both sexes, largely attributable to circulatory diseases. A persisting East-west life expectancy gap in Germany of 2.1 years in men in 1997 was largely attributable to external causes, diseases of the digestive system and circulatory diseases. Higher death rates from circulatory diseases among the elderly largely explain the female life expectancy gap of approximately one year. CONCLUSIONS: This study provides further insights into the health effects of political transition. Post-transition improvements in life expectancy and mortality have been much steeper in East Germany compared with Poland. Changes in dietary pattern and, in Germany, medical care may have been important factors in shaping post-transition mortality trends.     

The changing gender differences in life expectancy in Korea 1970-2005

Women live much longer than men in Korea, with remarkable gains in life expectancy at birth for the past decades. The gender differential has steadily increased over time, reaching a peak of more than 8 years in 1980s, and decreased thereafter to 6.7 years in 2005. Studies to investigate the pattern and contributing factors to changes in the life expectancy gender gap have been mostly from Western countries, and there has been no such study in Asian countries, except in Japan. We therefore aimed to examine age- and cause-specific contributions to the changing gender differentials in life expectancy in Korea, in particular the decline of the gap, using a decomposition method. Between 1970 and 1979 when the gender gap in life expectancy widened, faster mortality decline among women in ages 20-44 explained 66% of the total increase in the gender gap, which would be due to substantial improvements in reproductive health among women and excess male mortality in occupational injuries and transport accidents. Although greater survival advantage among elderly women over 70 contributed to further increase in the gender gap, the contributions from younger ages with the ages 15-64 contributing the most (-2 years) resulted in the overall reduction of the gender gap which began in 1992 and continued to 2005. Among causes of death, liver diseases (-0.5 years, 38% of the total decline), transport accidents (-0.4 years, 31%), hypertensive diseases (-0.3 years, 19%), stroke (-0.1 years, 11%), and tuberculosis (-0.1 years) contributed the most to the overall 1.4 years reduction in the gender gap. However, changes in mortality from lung cancer (+0.3 years), suicide (+0.3 years), chronic lower respiratory diseases (+0.2 years), and ischemic heart diseases (+0.1 years) contributed to widening the gap during the same period. In sum, while smoking-related causes of death have contributed most to the narrowing gap in most other industrialized countries, these causes contributed toward increasing the gender gap in Korea. Instead, liver disease, hypertension-related diseases, and transport accidents were major contributing causes of death to the narrowing of gender differentials in life expectancy in Korea.     

Lack of improvement of life expectancy at advanced ages in The Netherlands

BACKGROUND: Several countries have reported an increase in life expectancy at advanced ages. This paper analyses recent changes in life expectancy at age 60 and 85 in The Netherlands, a low mortality country with reliable mortality data. METHODS: We used data on the population and the number of deaths by age, sex and underlying cause of death for 1970-1994. Life expectancy at age 60 and 85 was estimated using standard life-table techniques. The contribution of different ages and causes of death to the change in life expectancy during the 1970s (1970/74-1980/84) and the 1980s (1980/84-1990/94) were estimated with a decomposition technique developed by Arriaga. RESULTS: Life expectancy at age 60 increased in the 1970s and 1980s, whereas life expectancy at age 85 decreased (men) and stagnated (women) in the 1980s, and has decreased in both sexes since 1985/89. The decomposition by age showed that constant mortality rates in women aged 85-89, and increasing mortality rates at ages 85+ (men) and 90+ (women) have caused this lack of increase in life expectancy. The decomposition by cause of death showed that smaller mortality reductions from other cardiovascular and cerebrovascular diseases, which contributed most to the increase in life expectancy at age 85 in the 1970s, and mortality increases from, amongst others, chronic obstructive pulmonary disease (COPD), mental disorders and diabetes mellitus produced the decrease (men) and plateau (women) in life expectancy at age 85. CONCLUSIONS: Life expectancy at advanced ages stopped increasing during the 1980s in The Netherlands due to mortality increases at ages 85+ (men) and 90+ (women). Cause-specific trends suggest that, in addition to (past) smoking behaviour in men, changes in the distribution of morbidity and frailty in the population might have contributed to this stagnation.     

2015-2018年乌海市市区居民死因分析

目的 了解2015-2018年乌海市市区居民主要死因及寿命损失，为提出有针对性的疾病预防控制策略提供依据。 方法 整理2015-2018年乌海市市区居民全死因数据，分析死亡率、死因顺位、期望寿命等指标。结果 2015-2018年乌海市市区居民粗死亡率为533.59/10万，标化死亡率为531.61/10万，男性高于女性，随年龄增长死亡率呈升高趋势（〖XC小五号.EPS;P〗=30785.35，P<0.001）。全人群死因前5位依次为循环系统疾病、肿瘤、呼吸系统疾病、损伤和中毒及其他，占全部死亡人数的90.34%；其中循环系统疾病和肿瘤占全部死亡人数的69.33%。2015-2018年乌海市市区居民期望寿命为77.20岁，去循环系统疾病和去肿瘤后期望寿命可分别增加5.44岁和3.33岁。结论 循环系统疾病和肿瘤是乌海市市区居民的两大死因，也是造成居民期望寿命损失最主要的两大疾病，尤其要重点关注肿瘤。     

1990—2010 年疾病谱变化对上海市居民期望寿命增长的影响

目的］ 比较上海市1990—2010 年不同时期人群期望寿命变化趋势,探讨疾病谱变化对期望寿命的影响,确定疾病干预的优先领域。 ［方法］ 利用1990—2010 年上海市居民死亡登记系统的死亡数据和上海市公安系统的人口数据,应用简略寿命表法、期望寿命分解法、死因分解法,比较年龄和不同死因对期望寿命的影响。 ［结果］1990—2010 年上海市男性和女性期望寿命分别增加了6.91 岁和6.94 岁,年均增寿均达0.35 岁。65 岁以上老年人口对期望寿命增长的贡献最大,男女分别占增寿总量的52.97%和51.44%。呼吸系统疾病、循环系统疾病和肿瘤死亡率的降低是期望寿命增加的主要原因,他们对男女性期望寿命的贡献分别为2.13 岁和1.98 岁、1.42 岁和1.89 岁、1.35 岁和0.67岁。 ［结论］ 上海市现阶段,居民的死亡大部分是疾病造成,提高人群期望寿命,重点是关注中老年人健康状况。近20年慢性病死亡率虽大幅下降,但仍是上海市主要死因,建立健全慢病防治体系,提高慢性病防治效果,是进一步提高上海市人口健康水平,增加上海市居民期望寿命的有效途径。     

山东省1970-2005年人群死亡率及死因 变化与差别分解分析

目的 描述1970-2005年山东省人群总死亡及主要死因死亡水平的变化趋势,定量分析死亡率变化的影响因素.方法 对山东省3次死因调查资料的比较分析,利用死亡率和年龄调整死亡率等指标描述不同年代总死亡和主要死因死亡水平的变化趋势,采用死亡率差别分解法计算死亡率变化中人口因素和非人口因素的贡献值和贡献率.结果 自1970年代以来,山东省人群总死亡率变化幅度不大,1990年代后略呈上升趋势,但调整死亡率和各年龄段死亡率均呈现显著下降趋势.包括感染性疾病和母婴疾病在内的第一大类疾病死亡率急剧下降,而以心脑血管疾病和恶性肿瘤为主的慢性非传染性疾病(慢性病)和伤害死亡率上升趋势明显.人口因素和非人口因素对总死亡率作用方向相反,二者交互作用使1990年代以来的总死亡率较为稳定.第一类疾病死亡率的下降和伤害死亡率的升高主要为非人口因素作用的结果,所有慢性病总死亡率的升高全部为人口因素所致,但对于心脑血管疾病和恶性肿瘤死亡率的升高,非人口因素起到主要作用.结论 随人口老龄化趋势的加重和非人口因素作用的增强,未来一段时间内山东省人群总死亡率将维持在目前水平或略有升高.第一类疾病已得到有效控制,以心脑血管疾病和恶性肿瘤为代表的主要慢性病应成为疾病控制工作的重点.     

2017年贵阳市常住居民主要死因对期望寿命的影响分析

目的 分析贵阳市4个死因监测点常住居民主要死因及对期望寿命的影响程度,为制定疾病预防控制的政策措施和方向提供科学依据。方法 采用描述统计学方法以及编制简略寿命表和去死因寿命表计算2017年贵阳市死因监测点常住居民的死亡率、死因顺位以及期望寿命和去主要死因期望寿命。结果 贵阳市2017年死因监测点常住居民报告死亡率564.14/10万,标化死亡率为578.25/10万,其中男性报告死亡率656.83/10万,标化死亡率为663.21/10万;女性报告死亡率为466.88/10万,标化死亡率为488.50/10万。男女性死亡率差异有统计学意义(χ2 = 366.25, P＜0.05)。2017年贵阳市死因监测点常住居民的前5位死因分别是恶性肿瘤（112.83/10万）、脑血管病（105.85/10万）、心脏病（101.11/10万）、呼吸系统疾病（83.82/10万）以及损伤和中毒（41.56/10万）。2017年贵阳市死因监测点常住居民人均期望寿命是77.96岁,其中男性期望寿命为75.38岁,女性期望寿命为80.88岁。男性在去除前5位死因后期望寿命可提高12.47岁,女性可提高8.41岁。结论 慢性非传染性疾病以及损伤和中毒是目前贵阳市常住居民的主要死因,对贵阳市常住居民期望寿命影响较大的5大疾病分别是脑血管疾病、心脏病、恶性肿瘤、呼吸系统疾病和损伤及中毒     

Mortality with Alzheimer's disease and dementia in France, 2006

BackgroundAlzheimer's and related diseases have become a major public health issue in all developed countries, particularly with the aging of the population. Given the potential burden of these pathologies, the French government launched a third National Alzheimer's Strategic Plan 2008–2012 in 2008. The aim of the study was to provide French data on the mortality statistics of Alzheimer's and related diseases by age, gender, and geographical area.MethodsAnalyses were based on the number of deaths from Alzheimer's disease (AD) and dementia, extracted from the 2000–2006 French National Mortality Registry (Inserm-Centre d’épidémiologie sur les causes médicales de décès [CépiDc]). Underlying and multiple causes of death were taken into account. Gender, age, area of residence, and place of death were noted for all subjects deceased with AD or dementia. Mortality rates were standardized on the truncated 60+ French 2006 population. Mortality rates were also estimated by 5-year age groups. Causes of death in demented and nondemented people were compared by estimating an age-adjusted relative-risk ratio.ResultsIn France, in 2006, AD or dementia was reported as the underlying cause or a multiple cause of death on 45,597 death certificates. Among these death certificates, 70% were women and the mean age at death was 85.9 years. Age-standardized mortality rates were 341/100,000 person-years for men and 333/100,000 person-years for women. Age-specific mortality rates increased with age and were higher in women than in men over 90 years of age. The analysis of the changes in mortality rates showed an overall increase of 11.3% between 2000 and 2006. The most frequent underlying cause when AD or dementia was mentioned as an associated cause were cardiovascular diseases (40.5%), neoplasms (11.9%), and endocrine diseases (8.5%).ConclusionThe analysis of mortality data on AD and dementia provides insight into the burden of these diseases in France. If carried out regularly, these analyses can provide trend analyses of mortality rates.     

The impact of changes in age-related and cause-related mortality on life expectancy at birth in the State of Santa Catarina, Brazil, in the 1990s

This study aimed to analyze the impact of changes in age-related and cause-related mortality on life expectancy at birth in the State of Santa Catarina, Brazil, in the 1990s. Data were obtained from the Mortality Information System (SIM) for the three-year periods 1989/1990/1991 and 1998/1999/2000. Infant mortality rates and specific mortality rates for individuals > or = 1 year of age were calculated by gender and cause of death. The Pollard method was used to disaggregate the contributions by mortality from different causes and in different ages to life expectancy at birth. The age groups that contributed the most to the increase in life expectancy at birth were 0-1 year and > or = 70 years. The causes of death that most contributed to this increase were chronic non-communicable diseases, such as cardiovascular diseases, in the age brackets above 35 years, and neonatal diseases in the < 1-year bracket. Finally, there were a high proportion of deaths from ill-defined causes, indicating that the true cause-related mortality structure in the State is still unknown.     

Mortality from neglected tropical diseases in Brazil, 2000–2011

Objective

To describe mortality from neglected tropical diseases (NTDs) in Brazil, 2000–2011.

Methods

We extracted information on cause of death, age, sex, ethnicity and place of residence from the nationwide mortality information system at the Brazilian Ministry of Health. We selected deaths in which the underlying cause of death was a neglected tropical disease (NTD), as defined by the World Health Organization (WHO) and based on its International statistical classification of diseases and related health problems, 10th revision (ICD-10) codes. For specific NTDs, we estimated crude and age-adjusted mortality rates and 95% confidence intervals (CI). We calculated crude and age-adjusted mortality rates and mortality rate ratios by age, sex, ethnicity and geographic area.

Findings

Over the 12-year study period, 12 491 280 deaths were recorded; 76 847 deaths (0.62%) were caused by NTDs. Chagas disease was the most common cause of death (58 928 deaths; 76.7%), followed by schistosomiasis (6319 deaths; 8.2%) and leishmaniasis (3466 deaths; 4.5%). The average annual age-adjusted mortality from all NTDs combined was 4.30 deaths per 100 000 population (95% CI: 4.21–4.40). Rates were higher in males: 4.98 deaths per 100 000; people older than 69 years: 33.12 deaths per 100 000; Afro-Brazilians: 5.25 deaths per 100 000; and residents in the central-west region: 14.71 deaths per 100 000.

Conclusion

NTDs are important causes of death and are a significant public health problem in Brazil. There is a need for intensive integrated control measures in areas of high morbidity and mortality.     

中国2010-2015年呼吸系统疾病死亡的预期寿命差异分析

目的  分析我国2010年-2015年呼吸系统疾病死亡率变化对预期寿命影响的年龄、地区差异。 方法  本文数据来源于国家统计局2010年-2015年人口普查结果, 以及国家卫生健康委统计信息中心和中国疾病预防控制中心公布的《中国死因监测数据集》, 应用简略寿命表、Arriaga分解法计算不同年龄组和不同地区的呼吸系统疾病死亡率变化对预期寿命增量的贡献值和百分比。 结果  2010年-2015年, 我国呼吸系统疾病死亡率有所下降。2010和2015年因呼吸系统疾病减少的寿命分别为2.0岁和1.6岁, 呼吸系统疾病死亡率降低对预期寿命增量的贡献分别为, 东部地区15.4%, 中部12.5%, 西部55.6%。从年龄维度分析, 0~5岁、70岁以上年龄组死亡率的下降对提升预期寿命贡献最大。 结论  2010年-2015年全国因呼吸系统疾病减少的寿命降幅为20.0%, 具有明显的区域差异; 从疾病别维度分析, 慢性下呼吸道疾病对预期寿命的影响最大, 但对预期寿命的增加贡献较小; 肺炎对预期寿命的增加有贡献, 其中0~10岁人群肺炎的改善促进预期寿命增长。