基于期望寿命分析的上海市浦东新区慢性病示范区效果评价

Evaluation on the effectiveness of national demonstration areas for comprehensive prevention and control of non-communicable diseases in Shanghai Pudong New Area based on decomposition method of life expectancy

目的分析慢性病综合防控示范区(简称慢性病示范区)建设不同时期期望寿命的变化以及不同慢性病的防控成效。方法基于2006―2021年上海市浦东新区全死因登记资料,采用期望寿命分解方法分析不同时期4类主要慢性病防控成效对期望寿命增长的性别和年龄别归因贡献。结果2006―2012年、2012―2018年、2018―2021年上海市浦东新区恶性肿瘤与慢性呼吸系统疾病防治对期望寿命(岁)增长的贡献分别为0.17、0.51、0.25和0.25、0.32、0.16,高于同期心脑血管疾病(0.08、0.28、-0.13)和糖尿病(0.03、-0.06、-0.05)。期望寿命的增长贡献主要来自中老年人群。男性恶性肿瘤与慢性呼吸系统疾病防治对期望寿命增长的贡献始终高于女性,2012―2018年男性心脑血管疾病防治对期望寿命增长的贡献低于女性;男性糖尿病在上述3个时期对期望寿命增长均呈负向贡献,女性由示范区创建前的正向贡献转为创建后(2012―2021年)的负向贡献。结论自上海市浦东新区慢性病示范区创建以来,4类主要慢性病防治对期望寿命增长的贡献各有差异。运用期望寿命分解方法为评价慢性病示范区建设成效提供了新思路。

Objective To investigate change in life expectancy before and after the construction of National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases(referred to as"Demonstration Area"),as well as the effectiveness of control on main chronic diseases.Methods Data of all-cause of death in Pudong New Area from 2006 to 2021 were used.Gender-and age-specific contributions of four major chronic diseases were analyzed using decomposition method of life expectancy.Results The contributions of prevention and control on cancer and chronic respiratory diseases to the increase of life expectancy were 0.17,0.51 and 0.25 years as well as 0.25,0.32 and 0.16 years,during 2006-2012(before the establishment of Demonstration Area),2012-2018(the initial construction period)and 2018-2021(the consolidation period),respectively.The contributions were higher than cardiovascular diseases(0.08、0.28、-0.13 years)and diabetes(0.03、-0.06、-0.05 years)at the same period.The middle-aged and elderly population made the most contribution.The contributions of prevention and control on cancer and chronic respiratory diseases among males had always been higher than those among females.Male contributed lower than female in 2012-2018 in terms of cardiovascular diseases.On the aspect of diabetes,male contributed negatively in all three periods and female turned to contribute negatively from 2012 to 2021.Conclusions Since the establishment of Demonstration Area in Shanghai Pudong New Area,the prevention and control on four major categories of chronic diseases contributed to the growth of life expectancy in varying ways.The decomposition method of life expectancy provides a new perspective of evaluation on the effectiveness of Demonstration Area in future.