[Changes of mortality and causes of death from 1970 to 2005 and decomposition analysis in Shandong province].
摘要
OBJECTIVE: To describe the trend of overall mortality and major causes of death in Shandong population from 1970 to 2005, and to quantitatively estimate the influential factors. METHODS: Trends of overall mortality and major causes of death were described using indicators such as mortality rates and age-adjusted death rates by comparing three large-scale mortality surveys in Shandong province. Difference decomposing method was applied to estimate the contribution of demographic and non-demographic factors for the change of mortality. RESULTS: The total mortality had had a slight change since 1970s, but had increased since 1990s. However, both the mortality rates of age-adjusted and age-specific decreased significantly. The mortality of Group I diseases including infectious diseases as well maternal and perinatal diseases decreased drastically. By contrast, the mortality of non-communicable chronic diseases (NCDs) including cardiovascular diseases (CVDs), cancer and injuries increased. The sustentation of recent overall mortality was caused by the interaction of demographic and non-demographic factors which worked oppositely. Non-demographic factors were responsible for the decrease of Group I disease and the increase of injuries. With respect to the increase of NCDs as a whole, demographic factors might take the full responsibility and the non-demographic factors were the opposite force to reduce the mortality. Nevertheless, for the increase of some leading NCD diseases as CVDs and cancer, the increase was mainly due to non-demographic rather than demographic factors. CONCLUSION: Through the interaction of the aggravation of ageing population and the enhancement of non-demographic effect, the overall mortality in Shandong would maintain a balance or slightly rise in the coming years. Group I diseases in Shandong had been effectively under control. Strategies focusing on disease control and prevention should be transferred to chronic diseases, especially leading NCDs