基于全球视角的中国伤害负担现状及趋势分析
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摘要
目的从全球视角分析中国伤害负担现状与趋势,为我国伤害防控决策提供参考。方法采用GBD 2017数据,以死亡率、伤残调整寿命年(Disability-Adjusted Life Years,DALY)率等指标反映伤害负担,对比分析中国伤害情况。结果 2017年中国伤害的死亡率、YLL率、YLD率、DALY率以及YLL/YLD比值分别为51. 94/10万、1 916. 32/10万、718. 77/10万、2 635. 09/10万、2. 67,均低于全球平均水平。除女性的人际暴力伤害DALY率高于男性外,男性伤害负担其他各项指标均明显高于女性。儿童、老年人的意外伤害相对严重。1990—2017年伤害DALY率各项指标均呈下降趋势,意外伤害、自残和人际暴力伤害DALY率下降尤其明显,但运输伤害下降不明显。中国职业风险所致伤害的死亡率已有下降,但目前仍高于全球;中国低骨密度、饮酒等危险因素导致的伤害死亡率呈上升趋势。结论 28年来中国伤害防治工作进步明显,但道路伤害仍需进一步加大防控力度。对于儿童、老人等弱势群体,应进一步防止其意外伤害发生。
Objective From the global views to analyze the status and trends of injury burden in China,to provide reference for injury prevention and control decision-making in China. Methods Using the data of the GBD 2017,compared and analyzed the injury burden by mortality rate and Disability-Adjusted Life Years( DALY) rate. Results In 2017,China's injury mortality,YLL rate,YLD rate,DALY rate and YLL/YLD ratio were 51. 94/100 000,1916. 32/100 000,718. 77/100 000,2 635. 09/100 000 and 2. 67 respectively,which were lower than the global level. Except that the DALY rate of interpersonal violence injury in women was higher than that in men,the other indicators of injury burden in men were significantly higher than that in women. The unintentional injuries in children and the elderly were still serious. From 1990 to 2017,the DALY rate of injuries showed a downward trend. The DALY rates of unintentional injuries,self-harm and interpersonal violence injuries decreased significantly,but the decrease of transportation injuries was not obvious. The mortality rate of occupational hazards in China has declined,but it is still higher than that the global level. The mortality rate of injuries caused by low bone mineral density,drinking is on the rise in China. Conclusion Over the past 28 years,China has made remarkable progress in injury prevention and control,but road injuries still need to be further strengthened. For children,the elderly and other vulnerable groups,we should further prevent the occurrence of unintentional injuries.
Objective From the global views to analyze the status and trends of injury burden in China,to provide reference for injury prevention and control decision-making in China. Methods Using the data of the GBD 2017,compared and analyzed the injury burden by mortality rate and Disability-Adjusted Life Years( DALY) rate. Results In 2017,China's injury mortality,YLL rate,YLD rate,DALY rate and YLL/YLD ratio were 51. 94/100 000,1916. 32/100 000,718. 77/100 000,2 635. 09/100 000 and 2. 67 respectively,which were lower than the global level. Except that the DALY rate of interpersonal violence injury in women was higher than that in men,the other indicators of injury burden in men were significantly higher than that in women. The unintentional injuries in children and the elderly were still serious. From 1990 to 2017,the DALY rate of injuries showed a downward trend. The DALY rates of unintentional injuries,self-harm and interpersonal violence injuries decreased significantly,but the decrease of transportation injuries was not obvious. The mortality rate of occupational hazards in China has declined,but it is still higher than that the global level. The mortality rate of injuries caused by low bone mineral density,drinking is on the rise in China. Conclusion Over the past 28 years,China has made remarkable progress in injury prevention and control,but road injuries still need to be further strengthened. For children,the elderly and other vulnerable groups,we should further prevent the occurrence of unintentional injuries.
引文
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[14]符传东,何永华,廖哲安,等.职业伤害经济负担研究现状及展望[J].中国工业医学杂志,2013,26(4):312-315.
[15]程建鹏,饶克勤,严俊.我国居民伤害疾病负担研究[J].中国卫生经济,2010,29(8):45-46.
[2] GBD 2017 Causes of Death Collaborators. Global,regional,and national age-sex-specific mortality for 282 causes of death in 195countries and territories,1980-2017:a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet,2018,392(10159):1736-1788. DOI:10. 1016/S0140-6736(18)32203-7.
[3] GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence,prevalence,and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017:a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet,2018,392(10159):1789-1858. DOI:10. 1016/S0140-6736(18)32279-7.
[4] GBD 2017 DALYs and HALE Collaborators. Global,regional,and national disability-adjusted life-years(DALYs)for 359diseases and injuries and healthy life expectancy(HALE)for195 countries and territories,1990-2017:a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet,2018,392(10159):1859-1922. DOI:10. 1016/S0140-6736(18)32335-3.
[5] GBD 2017 Risk Factor Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural,environmental and occupational,and metabolic risks or clusters of risks for 195 countries and territories,1990-2017:a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet,2018,392(10159):1923-1994. DOI:10. 1016/S0140-6736(18)32225-6.
[6] Institute for Health Metrics and Evaluation. Global Health Data Exchange[EB/OL].[2018-11-06]. http://ghdx.healthdata. org/geography/china.
[7]秦国双,温昊于,宇传华.中国COPD的患病发病及YLD现状及趋势[J].公共卫生与预防医学,2019,30(2):4-8.
[8]段蕾蕾,吴春眉,邓晓,等. 2006—2008年中国道路交通伤害状况分析[J].公共卫生与预防医学,2010,21(3):10-13.
[9] WANG L,YU C H,ZHANG Y Q,et al. An Analysis of the characteristics of road traffic injuries and a prediction of fatalities in China from 1996 to 2015[J]. Traffic Injury Prevention,2018,15(11):E2508. DOI 10. 1080/15389588. 2018. 1487061.
[10] HAAGSMA J A,GRAETZ N,BOLLIGER I,et al. The global burden of injury:incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease Study2013[J]. Injury prevention,2016,22(1):3-18. DOI:10. 1136/injuryprev-2015-041616.
[11] WANG Z K,YU C H,HENRY X,et al. Age-period-cohort analysis of trends in mortality from drowning in China:data from the Global Burden of Disease Study 2015[J]. Scientific Reports,8(1):5829. December 2018 DOI:10. 1038/s41598-018-24281-7.
[12]张岚,戴馨,胡晓云.儿童伤害的类型、危险因素及预防措施[J].公共卫生与预防医学,2011,22(2):69-72.
[13]莫庆仪,黄东明,谢广清,等.儿童意外伤害924例分析[J].中国当代儿科杂志,2013,15(7):559-562.
[14]符传东,何永华,廖哲安,等.职业伤害经济负担研究现状及展望[J].中国工业医学杂志,2013,26(4):312-315.
[15]程建鹏,饶克勤,严俊.我国居民伤害疾病负担研究[J].中国卫生经济,2010,29(8):45-46.