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Changes and trends in mortality, disability-adjusted life years, life expectancy, and healthy life expectancy in China from 1990 to 2021: a secondary analysis of the global burden of disease 2021

Xue‐ming Cheng, Wenchang Jia, Jing Zhou, Ya-Xin Xu, Jian Zou, Ming Liu, Sun-Fang Jiang, Xiao-Pan Li

Archives of Public Health, 2025

7 citations

Abstract

The aging population in China is increasingly evident, leading to a shift in the patterns of disease burden. This study aims to investigate changes and trends in mortality, disability-adjusted life years (DALYs), life expectancy (LE), and health-adjusted life expectancy (HALE) in China from 1990 to 2021. This study presents a secondary analysis of data from the Global Burden of Disease Study 2021, with a focus on mortality, DALYs, LE, and HALE. We examined changes in these indicators in China from 1990 to 2021, comparing them with global averages and across five SDI regions. Using Joinpoint Regression Software, we analyzed trends in the top ten cause-specific DALY rates in 2021. Furthermore, we employed the Bayesian Age-Period-Cohort model to forecast age-standardized rates (ASR) of mortality for the next decade. China witnessed a decrease in the ASRs of mortality (1198.16/100,000 [1098.61–1294.10] to 644.68/100,000 [555.12–735.51]) and DALYs (43085.42/100,000 [39330.62–47273.39] to 22717.19/100,000 [19748.18–25903.34]) from 1990 to 2021. During the COVID-19 pandemic, the ASRs of mortality and DALY declined in China (23009.47/100,000 [19661.21–26495.58] in 2019), but global rates and those across the five SDI (Socio-demographic Index) regions increased. Projections indicate a continued decline in the ASRs of mortality over the next decade, from 2019 to 2035 and 2021 to 2035. Notably, DALY rates for the top 10 level 2 causes in 2021 decreased over the past three decades,…

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Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.

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