Shuo Wang1, Xiaoyu Du1, Xue Han1, Fan Yang1, Jia Zhao1, Hui Li1, Mi Li1, Hongwei Zhang1, Wenbin Liu1, Jiahui Song1, Guangwen Cao2. 1. Department of Epidemiology (Wang, Du, Yang, M. Li, Zhang, Liu, Song, Cao), Second Military Medical University; Department of Chronic Diseases (Han, Zhao, H. Li), Center for Disease Control and Prevention of Yangpu District, Shanghai, China. 2. Department of Epidemiology (Wang, Du, Yang, M. Li, Zhang, Liu, Song, Cao), Second Military Medical University; Department of Chronic Diseases (Han, Zhao, H. Li), Center for Disease Control and Prevention of Yangpu District, Shanghai, China gcao@smmu.edu.cn.
Abstract
BACKGROUND: Understanding how socioeconomic events influence cause-specific mortality is essential for optimizing disease-control strategies. We characterized long-term trends in cause-specific mortality in a stable population from a very large urban centre. METHODS: We derived population data from 1974 to 2015 on vital status, demographics and causes of death from the death registration system in Yangpu District, Shanghai, China. We examined temporal trends in mortality and assessed the effects of age, period and birth cohort. RESULTS: Over 41 879 864 person-years of follow-up, we analyzed 290 332 deaths: 3.80% from communicable conditions (group 1), 86.50% from noncommunicable diseases (group 2), and 5.56% from injuries (group 3). Age-standardized mortality decreased after 1988 for group 1 (average annual percentage change [AAPC] -6.7, 95% confidence interval [CI] -9.3 to -4.1), after 1995 for group 2 (AAPC -2.9, 95% CI -3.5 to -2.3), and after 1994 for group 3 (AAPC -5.4, 95% CI -6.3 to -4.5), after improvements in public health and clinical service infrastructure and the removal of polluting industries during the 1980s. We observed increased mortality from group 2 and group 3 causes in those born between 1955 and 1965, a period that included the Great Chinese Famine. Cause-specific mortality risks increased in those born after 1949 for cancer and diabetes only. INTERPRETATION: Birth cohorts exposed to extreme starvation in early life had increased premature cause-specific mortality in later life. Decreased cause-specific mortality followed improvements in public health, medical infrastructure and pollution control, but not for cancer or diabetes, likely because of exposure to new risk factors.
BACKGROUND: Understanding how socioeconomic events influence cause-specific mortality is essential for optimizing disease-control strategies. We characterized long-term trends in cause-specific mortality in a stable population from a very large urban centre. METHODS: We derived population data from 1974 to 2015 on vital status, demographics and causes of death from the death registration system in Yangpu District, Shanghai, China. We examined temporal trends in mortality and assessed the effects of age, period and birth cohort. RESULTS: Over 41 879 864 person-years of follow-up, we analyzed 290 332 deaths: 3.80% from communicable conditions (group 1), 86.50% from noncommunicable diseases (group 2), and 5.56% from injuries (group 3). Age-standardized mortality decreased after 1988 for group 1 (average annual percentage change [AAPC] -6.7, 95% confidence interval [CI] -9.3 to -4.1), after 1995 for group 2 (AAPC -2.9, 95% CI -3.5 to -2.3), and after 1994 for group 3 (AAPC -5.4, 95% CI -6.3 to -4.5), after improvements in public health and clinical service infrastructure and the removal of polluting industries during the 1980s. We observed increased mortality from group 2 and group 3 causes in those born between 1955 and 1965, a period that included the Great Chinese Famine. Cause-specific mortality risks increased in those born after 1949 for cancer and diabetes only. INTERPRETATION: Birth cohorts exposed to extreme starvation in early life had increased premature cause-specific mortality in later life. Decreased cause-specific mortality followed improvements in public health, medical infrastructure and pollution control, but not for cancer or diabetes, likely because of exposure to new risk factors.
Authors: Steven S Coughlin; Eugenia E Calle; Lauren R Teras; Jennifer Petrelli; Michael J Thun Journal: Am J Epidemiol Date: 2004-06-15 Impact factor: 4.897
Authors: Kelly J Hunt; Miran A Jaffa; Sara M Garrett; Deirdre K Luttrell; Kenneth E Lipson; Maria F Lopes-Virella; Louis M Luttrell; Ayad A Jaffa Journal: Diabetes Care Date: 2018-01-30 Impact factor: 19.112
Authors: Chunhua He; Li Liu; Yue Chu; Jamie Perin; Li Dai; Xiaohong Li; Lei Miao; Leni Kang; Qi Li; Robert Scherpbier; Sufang Guo; Igor Rudan; Peige Song; Kit Yee Chan; Yan Guo; Robert E Black; Yanping Wang; Jun Zhu Journal: Lancet Glob Health Date: 2016-12-20 Impact factor: 26.763
Authors: Qing Da Li; Hao Li; Fu Ji Li; Mei Shu Wang; Zhuo Jian Li; Jing Han; Qing Hui Li; Xiang Ji Ma; Da Nan Wang Journal: BMC Cancer Date: 2012-07-28 Impact factor: 4.430
Authors: Lei Chen; Tian Xia; Zheng-An Yuan; Rasika Rampatige; Jun Chen; Hang Li; Timothy Adair; Hui-Ting Yu; Martin Bratschi; Philip Setel; Megha Rajasekhar; H R Chowdhury; Saman Hattotuwa Gamage; Bo Fang; Omair Azam; Romain Santon; Zhen Gu; Ziwen Tan; Chunfang Wang; Alan D Lopez; Fan Wu Journal: BMJ Open Date: 2022-02-15 Impact factor: 2.692