Abstract
BackgroundThe Chinese population has aged significantly in the last few decades. Comprehensive health losses including both fatal and non-fatal health outcomes associated with ageing in China have not been detailed.MethodsBased on freely accessible disability adjusted life years (DALYs) estimated by the Global Burden of Diseases (GBD) 2017, we adopted a robust decomposition method that ascribes changes in DALYs in any given country across two time points to changes resulting from three sources: population size, age structure, and age-specific DALYs rate per 100,000 population. Using the method, we calculated DALYs associated with population ageing in China from 1990 to 2017 and examined the counteraction between the effects of DALYs rate change and population ageing. This method extends previous work through attributing the change in DALYs to the three sources.ResultsPopulation ageing was associated with 92.8 million DALYs between 1990 and 2017 in China, of which 65.8% (61.1 million) were years of life lost (YLLs). Males had comparatively more DALYs associated with population ageing than females in the study period. The five leading causes of DALYs associated with population ageing between 1990 and 2017 were stroke (23.6 million), chronic obstructive pulmonary disease (COPD) (18.3 million), ischemic heart disease (13.0 million), tracheal, bronchus, and lung cancer (6.1 million) and liver cancer (5.0 million). Between 1990 and 2017, changes in DALYs associated with age-specific DALY rate reductions far exceeded those related to population ageing (− 196.2 million versus 92.8 million); 57.5% (− 112.8 million) of DALYs were caused by decreases in rates attributed to 84 modifiable risk factors.ConclusionPopulation ageing was associated with growing health loss in China from 1990 to 2017. Despite the recent progress in alleviating health loss associated with population ageing, the government should encourage scientific research on effective and affordable prevention and control strategies and should consider investment in resources to implement strategies nationwide to address the future challenge of population ageing.
Highlights
As in many other countries, population ageing in China has emerged as an increasingly important social issue in the last few decades, driven especially by the combination of decreased birth rates and prolonged life expectancy [1]
Population ageing Global Burden of Diseases (GBD) 2017 population estimates suggest the number of people aged and older increased by 141.9% in China from million (30 million males and 36 million females) in 1990 to 160 million (76 million males and 84 million females) in 2017 (Additional e-file)
disability-adjusted life years (DALYs) associated with population ageing Using year 1990 as the reference, DALYs associated with population ageing first decreased continuously from 1991 to 1996 and began to increase gradually, reaching 92.8 million in 2017 (Fig. 1a)
Summary
As in many other countries, population ageing in China has emerged as an increasingly important social issue in the last few decades, driven especially by the combination of decreased birth rates and prolonged life expectancy [1]. Previous research has described changes in deaths, incidence, prevalence, and disability-adjusted life years (DALYs) associated with population ageing for specific diseases in particular countries and regions, including China [3,4,5,6,7,8,9,10,11,12,13,14,15,16,17]. Comprehensive health losses including both fatal and non-fatal health outcomes associated with ageing in China have not been detailed
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