Abstract
BackgroundYunnan province is located in south western China and is one of the poorest provinces of the country. This study examines the premature mortality burden from common causes of deaths among an urban region, suburban region and rural region of Kunming, the capital of Yunnan.MethodsYears of life lost (YLL) rate per 1,000 and mortality rate per 100,000 were calculated from medical death certificates in 2003 and broken down by cause of death, age and gender among urban, suburban and rural regions. YLL was calculated without age-weighting and discounting rate. Rates were age-adjusted to the combined population of three regions. However, 3% discounting rate and a standard age-weighting function were included in the sensitivity analysis.ResultsNon-communicable diseases contributed the most YLL in all three regions. The rural region had about 50% higher premature mortality burden compared to the other two regions. YLL from infectious diseases and perinatal problems was still a major problem in the rural region. Among non-communicable diseases, YLL from stroke was the highest in the urban/suburban regions; COPD followed as the second and was the highest in the rural region. Mortality burden from injuries was however higher in the rural region than the other two regions, especially for men. Self-inflicted injuries were between 2–8 times more serious among women. The use of either mortality rate or YLL gives a similar conclusion regarding the order of priority. Reanalysis with age-weighting and 3% discounting rate gave similar results.ConclusionUrban south western China has already engaged in epidemiological pattern of developed countries. The rural region is additionally burdened by diseases of poverty and injury on top of the non-communicable diseases.
Highlights
Yunnan province is located in south western China and is one of the poorest provinces of the country
All death reports were grouped by underlying cause of death as defined in the Global Burden of Disease (GBD) study [7] and coded using the International Classification of Diseases, 9th revision (ICD-9) coding system
Group I accounted for the highest Years of life lost (YLL)/1,000 population in the 0–4 age group
Summary
Yunnan province is located in south western China and is one of the poorest provinces of the country. This study examines the premature mortality burden from common causes of deaths among an urban region, suburban region and rural region of Kunming, the capital of Yunnan. China is a developing country where health resources are very scarce and inequality in health resource allocation between rural and urban regions is apparent [2,3]. International Journal for Equity in Health 2006, 5:13 http://www.equityhealthj.com/content/5/1/13 resources, whereas rural populations, which account for 70% of total populations, only use 20% of total health resources [4]. Yunnan province is located in the south-west of China, and is one of the poorest provinces in the country. The capital, contains two urban, two suburban and eight rural regions, and in 2000 had a population of approximately 5.8 million
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