Age, Sex, and Disease-Specific Mortality Contributions to Life Expectancy in Urban and Rural — China, 1987–2021
Over the past 35 years, marked improvements in life expectancy (LE) in China reflect substantial progress in public health. This study aimed to quantify the contributions of mortality changes from different diseases and age groups to LE gains in China between 1987 and 2021. Using the Arriaga decomposition method, we analyzed the contribution of age- and disease-specific mortality to changes in LE for urban and rural areas, by sex.  Between 1987 and 2021, LE increased steadily for both males and females in both urban and rural areas. However, the contribution of different disease categories to LE gains varied. Reductions in mortality from circulatory and respiratory diseases contributed most to LE gains in urban areas, while respiratory diseases had a larger impact in rural areas.  Mortality reductions across all age groups contributed to LE gains, with the largest contributions from reductions in mortality among those aged 60-79 years.  While LE in China has increased significantly in recent decades, the contributions of different factors to these gains vary by region and sex.
城乡特定年龄、性别、疾病死亡率对预期寿命的贡献 — 中国，1987年–2021年
近几十年来，中国居民的寿命取得了显著进步，标志着我国卫生健康事业所取得的卓越成就。本研究旨在深入探讨不同疾病和年龄组死亡率的变化对中国过去35年预期寿命增长的贡献，为了解影响人口健康的关键因素提供见解。采用Arriaga方法分析了过去35年中国各疾病和年龄特定死亡率对人均寿命增长的影响。分别针对城市和农村地区，以及男性和女性进行分析。1987年至2021年期间，中国城市和农村地区男性和女性预期寿命均呈稳步增长。不同疾病类别对人均寿命增长的贡献存在差异。城市地区以循环系统疾病和呼吸系统疾病对于预期寿命增长贡献最大，而农村地区呼吸系统疾病的贡献相对更大。不同年龄组的减少死亡率对人均寿命增长起到了重要作用，其中60-79岁人口死亡率的下降对于预期寿命的提升贡献最大。过去几十年中国人口预期寿命显著增长，但各因素在不同地区、不同性别群体预期寿命增长的贡献有所差异。未来，需要针对不同人群的特定健康挑战制定相应的公共卫生政策和干预措施，以改善整体人口健康状况并延长人均寿命。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.154


Trends and Distribution of Infertility — Asia Pacific Region, 1990–2021
Infertility is a global public health priority, but little is known about its prevalence in the demographically challenging Asia-Pacific region. This study highlights the trends and distribution of infertility in the Asia-Pacific region from 1990 to 2021 based on data from the 2021 GBD Study. It found that the prevalence of female infertility has increased more rapidly compared to male infertility, and the rise in the prevalence of PCOS may be a key contributor. Geographical variations in the prevalence and trends of infertility across different countries were found in the Asia-Pacific region, with the highest prevalence rate and largest increase observed in the Philippines. Our findings underscore the importance of sexual and reproductive health services and reproductive rights in protecting fertility.
不孕不育症的变化趋势及地区分布 — 亚太地区，1990–2021年
不孕不育症是全球公共卫生的优先事项，但在人口结构具有挑战性的亚太地区，其流行情况知之甚少。本文基于2021年全球疾病负担数据（GBD），总结分析了1990年至2021年间亚太地区不孕不育症的时间变化趋势和地区分布变化情况。研究发现，相比于男性不育症的患病率，女性不孕症的患病率增速更快。而多囊卵巢综合症（PCOS）患病率的上升可能是女性不孕症增速快的关键因素。在亚太地区，不同国家的不孕不育症患病率和变化趋势存在较大地理差异，其中菲律宾的患病率最高且增长幅度最大。研究结果强调了性健康和生育保健服务以及生殖权利在保护生育能力方面的重要性。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.155


A Multi-State Model Study of the Disability-Free Life Expectancy Among Older Adults with Chronic Multimorbidity Based on CHARLS — China, 2011–2020
This study investigated the impact of chronic multimorbidity on functional status among adults aged 60 years and older in China. Using data from the CHARLS, a multi-state Markov model was employed to estimate transition probabilities between self-care, disability, and death states. Microsimulation techniques were then applied to simulate health and survival trajectories, estimating disability-free life expectancy (DFLE) and its proportion of life expectancy (LE). Chronic multimorbidity significantly increased the risk of transitioning from self-care to disability (HR=1.49, 95% CI: 1.25, 1.77).  Multimorbidity negatively impacted both LE and DFLE, with greater effects observed in older individuals and males. Chronic multimorbidity significantly affects both the length and quality of life among older adults in China, particularly in males and those aged 75 years and older.  A shift from single-disease management to a multimorbidity management model is urgently needed to promote healthy aging.
基于CHARLS模型的老年人慢性多病无残疾预期寿命模型研究 — 中国，2011–2020年
人口老龄化加剧背景下，老年人慢性病共病与失能的关联性亟待进一步探究。本研究旨在评估慢性病共病对我国60岁以上老年人功能状况的影响，为老年健康政策的制定提供科学依据。本研究使用多状态Markov模型估计慢性病共病影响下老年人自理、失能与死亡三种健康状态间的转换概率，并用微观仿真法模拟老年人健康与生存轨迹，估算无残疾预期寿命（disability-free life expectancy，DFLE）及其占预期寿命（life expectancy，LE）的比例。慢性病共病显著增加老年人从自理转为失能的风险（HR=1.49，95% CI: 1.25, 1.77），但对其余健康状态转换途径无显著影响。共病对LE和DFLE的负面影响随年龄增长不断扩大，男性以及75岁及以上老年共病患者的余寿中会有明显更少的年份可以自理。我国老年人的生命长度和生命质量受慢性病共病影响显著，且在男性和75岁以上老人中更为明显，应当加快从单一慢性病管理向慢性病共病管理的理念、政策和体系转变，促进健康老龄化的实施与实现。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.156