Age-period-cohort analysis of infectious disease mortality in urban-rural China, 1990-2010.

Zhi Li,Xinguang Chen,Chunling Xu,Peigang Wang,Ge Gao

doi:10.1186/s12939-016-0343-7

Abstract

BackgroundAlthough a number of studies on infectious disease trends in China exist, these studies have not distinguished the age, period, and cohort effects simultaneously. Here, we analyze infectious disease mortality trends among urban and rural residents in China and distinguish the age, period, and cohort effects simultaneously.MethodsInfectious disease mortality rates (1990–2010) of urban and rural residents (5–84 years old) were obtained from the China Health Statistical Yearbook and analyzed with an age-period-cohort (APC) model based on Intrinsic Estimator (IE).ResultsInfectious disease mortality is relatively high at age group 5–9, reaches a minimum in adolescence (age group 10–19), then rises with age, with the growth rate gradually slowing down from approximately age 75. From 1990 to 2010, except for a slight rise among urban residents from 2000 to 2005, the mortality of Chinese residents experienced a substantial decline, though at a slower pace from 2005 to 2010. In contrast to the urban residents, rural residents experienced a rapid decline in mortality during 2000 to 2005. The mortality gap between urban and rural residents substantially narrowed during this period. Overall, later birth cohorts experienced lower infectious disease mortality risk. From the 1906–1910 to the 1941–1945 birth cohorts, the decrease of mortality among urban residents was significantly faster than that of subsequent birth cohorts and rural counterparts.ConclusionsWith the rapid aging of the Chinese population, the prevention and control of infectious disease in elderly people will present greater challenges. From 1990 to 2010, the infectious disease mortality of Chinese residents and the urban-rural disparity have experienced substantial declines. However, the re-emergence of previously prevalent diseases and the emergence of new infectious diseases created new challenges. It is necessary to further strengthen screening, immunization, and treatment for the elderly and for older cohorts at high risk.

Highlights

A number of studies on infectious disease trends in China exist, these studies have not distinguished the age, period, and cohort effects simultaneously
When researching the development trend of infectious diseases in China, special attention should be paid to the unbalanced development between urban and rural areas
The fourth National Health Services Survey in 2008 showed that the proportions of urban and rural residents who were ill but did not take any therapeutic measures within the last two weeks were 6.4 % and 12.4 % respectively and the proportions of residents untreated for economic reasons were 23.2 % and 30.6 %. The values of both indicators were significantly lower among urban residents than rural residents [12]

Summary

Introduction

A number of studies on infectious disease trends in China exist, these studies have not distinguished the age, period, and cohort effects simultaneously. We analyze infectious disease mortality trends among urban and rural residents in China and distinguish the age, period, and cohort effects simultaneously. The fourth National Health Services Survey in 2008 showed that the proportions of urban and rural residents who were ill but did not take any therapeutic measures within the last two weeks were 6.4 % and 12.4 % respectively and the proportions of residents untreated for economic reasons were 23.2 % and 30.6 %. The values of both indicators were significantly lower among urban residents than rural residents [12]

Objectives

Methods

Results

Conclusion