云南省四类慢性病早死概率实现2030年可持续发展目标预测分析

Predictions for premature mortalities of four major non-communicable diseases and Sustainable Development Goals-based achievement in mortality reductions by 2030 among residents in Yunnan province of China

目的通过云南省1990—2015年心脑血管疾病、糖尿病、慢性呼吸系统疾病和肿瘤四类慢性病的早死概率预测分析实现2030年可持续发展目标(SDGs)的情况。方法收集2016全球疾病负担研究(GBD 2016)云南省不同性别心脑血管疾病、糖尿病、慢性呼吸系统疾病和肿瘤四类慢性病1990—2015年疾病负担数据,根据世界卫生组织(WHO)推荐的早死概率计算方法计算此四类慢性病的早死概率值,并采用趋势外推法预测2030年此四类慢性病早死概率值及实现SDGs目标的情况。结果2015年云南省心脑血管疾病、糖尿病、慢性呼吸系统疾病和肿瘤四类慢性病合计早死概率值为20.89%,男性为26.92%,女性为14.48%。四类慢性病早死概率值从高到低依次为心脑血管疾病(10.99%)、肿瘤(7.39%)、慢性呼吸系统疾病(3.48%)和糖尿病(0.57%),男性除糖尿病外的其他三类慢性病早死概率值均高于女性;云南省1990—2015年四类慢性病合计早死概率值呈下降趋势,年均下降速度为1.44%。云南省2030年四类慢性病合计早死概率预测值为16.60%,高于SDGs目标值的13.93%,四类慢性病早死概率合计预测值到2030年难以实现SDGs目标;按疾病分类看,除慢性呼吸系统疾病可达到SDGs目标外,其他三类慢性病早死概率预测值均不能达到SDGs目标值,心脑血管疾病离SDGs目标值差距最大,糖尿病离SDGs目标值差距最小;按性别分类看,男性和女性除慢性呼吸系统疾病可达到SDGs目标外,其他三类慢性病早死概率预测值均不能达到SDGs目标值;男性四类慢性病合计早死概率预测值不能达到SDGs目标值,女性四类慢性病合计早死概率预测值能达到SDGs目标值。结论虽然云南省1990—2015年心脑血管疾病、糖尿病、慢性呼吸系统疾病和肿瘤四类慢性病早死概率均呈下降趋势,但按目前的下降速度到2030年仍难以实现SDGs目标。

Objective To predicate premature mortalities of four major non-communicable diseases(NCDs)and estimate mortality reductions of the NCDs to meet the United Nations Sustainable Development Goals(SDGs)by 2030 among residents in Yunnan province based on mortality data of 1990–2015 in the same population.Methods We collected the data on disease burden of cardiovascular and cerebrovascular diseases,diabetes,chronic respiratory diseases,and malignant tumors among residents in Yunnan province between 1990 to 2015 from the Global Disease Burden Study 2016(GBD 2016)and calculated gender-specific premature mortalities due to the four NCDs using the method recommended by World Health Organization(WHO).Then,we estimated the premature mortalities caused by the NCDs among the population in the province by the year of 2030 using trend extrapolation method and compared the estimated premature mortalities to those of SDGs.Results The total premature mortality of the four NCDs was 20.89%for the population in Yunnan province in 2015 and the premature mortality was 26.92%for the male and 14.48%for the female population.Cardiovascular and cerebrovascular diseases contributed the most(10.99%)to the total premature mortality,followed by malignant tumor(7.39%),chronic respiratory disease(3.48%),and diabetes(0.57%).The premature mortalities of the NCDs were all higher among the male population than among the female population,except for that of diabetes.The total premature mortality of the four NCDs showed a downward trend for the population in Yunnan during the period from 1990 to 2015,with an average annual declining rate of 1.44%.The predicted total premature mortality of the four NCDs was 16.60%for the population in Yunnan province by the year of 2030 and was higher than the target value of 13.93%according with the SDGs.Among the predicted premature mortalities for the four NCDs among the population in the province by the year of 2030,only the premature mortality of chronic respiratory diseases could meet the target value according with the SDGs and the situation is the same for both the male and the female population;the largest gap between the predicted premature mortality and the SDGs based target value is for cardiovascular and cerebrovascular diseases and the smallest is for diabetes.The predicted total premature mortality of the four NCDs in the male population by the year of 2030 would not reach the target value according with the SDGs but that in the female population might reach the target value.Conclusion Although the premature mortalities of cardiovascular and cerebrovascular diseases,diabetes,chronic respiratory diseases,and malignant tumor had been declined among residents in Yunnan province from 1990 to 2015,the predicted mortalities by the year of 2030 would be hard to reach target values according the target values of SDGs based on current declining rate for the mortalities.