Positive Effects of Declining Age-Standardized All-Cause Mortality Rates in China During 2005-2015

Abstract

Background: It is important to understand which factors can substantially decrease mortality rates, as multiple strategies have been implemented to improve economic development and national health in China. We aimed to describe the geographic variations and changes in the all-cause mortality rates in 2005-2015, and to investigate the positive effects of declining age-standardized all-cause mortality rates. Methods: The data used came from China’s National Census Survey in 2005, 2010 and 2015 and China National Statistical Yearbooks. We conducted provincial-level thematic mapping of age-standardized all-cause mortality rate trajectory groups in 2005-2015 by using ArcGIS. Generalized estimating equation (GEE) models were used to clarify the possible long-term effects of declining age-standardized all-cause mortality rates. We compared the characteristics of the three provinces with the lowest mortality rates and the three provinces with the highest mortality rates to further understand the associated health disparities. Results: The age-standardized mortality rates declined from 2000 to 2006 and from 2008 to 2019. Provinces in the low-trajectory tended to be located in the Northeast and Southeast China. The GEE results revealed that the greater the proportion of the population with senior high school education or above, the more families with flushing or pumping toilets that are not shared with other households, the more nurses per 1000 people and a stable economic growth rate can substantially decrease age-standardized all-cause mortality rates (p < 0·05). Interpretation: Regional disparities in population health still exist. Thus, it is critical to improve equality in economic and educational development, the distribution of healthcare professionals, and sanitation facilities, as well as people’s policy literacy, to ensure the equality of opportunities in terms of healthy lives and well-being for all. Furthermore, for developing countries, the improvement of national health urgently needs to prevent the health risks caused by rapid industrialization and urbanization. Funding: Natural Science Foundation of Fujian Province of China (No. 2018J01129). Conflict of Interest: We declare no competing interests.