Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China
Objectives To measure the disease burden of ageing based on age-related diseases (ARDs), the sex and regional disparities and the impact of health resources allocation on the burden in China.Design A national comparative study based on Global Burden of Diseases Study estimates and China’s routine of...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/11/e064641.full |
| _version_ | 1798017193013673984 |
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| author | Yafei Si Shenglan Tang Chenkai Wu Shu Chen Xiaochen Dai Katja Hanewald Bingqin Li Hazel Bateman |
| author_facet | Yafei Si Shenglan Tang Chenkai Wu Shu Chen Xiaochen Dai Katja Hanewald Bingqin Li Hazel Bateman |
| author_sort | Yafei Si |
| collection | DOAJ |
| description | Objectives To measure the disease burden of ageing based on age-related diseases (ARDs), the sex and regional disparities and the impact of health resources allocation on the burden in China.Design A national comparative study based on Global Burden of Diseases Study estimates and China’s routine official statistics.Setting and participants Thirty-one provinces of Mainland China were included for analysis in the study. No individuals were involved.Methods We first identified the ARDs and calculated the disability-adjusted life years (DALYs) of ARDs in 2016. We assessed the ARD burden disparities by province and sex and calculated the provincial ARD burden-adjusted age. We assessed historical changes between 1990 and 2016. Fixed effects regression models were adopted to evaluate the impact of health expenditures and health workforce indicators on the ARD burden in 2010–2016.Results In 2016, China’s total burden of ARDs was 15 703.7 DALYs (95% uncertainty intervals: 12 628.5, 18 406.2) per 100 000 population. Non-communicable diseases accounted for 91.9% of the burden. There were significant regional disparities. The leading five youngest provinces were Beijing, Guangdong, Shanghai, Zhejiang and Fujian, located on the east coast of China with an ARD burden-adjusted age below 40 years. After standardising the age structure, western provinces, including Tibet, Qinghai, Guizhou and Xinjiang, had the highest burden of ARDs. Males were disproportionately affected by ARDs. China’s overall age-standardised ARD burden has decreased since 1990, and females and eastern provinces experienced the largest decline. Regression results showed that the urban–rural gap in health workforce density was positively associated with the ARD burdens.Conclusion Chronological age alone does not provide a strong enough basis for appropriate ageing resource planning or policymaking. In China, concerted efforts should be made to reduce the ARDs burden and its disparities. Health resources should be deliberately allocated to western provinces facing the greatest health challenges due to future ageing. |
| first_indexed | 2024-04-11T16:01:50Z |
| format | Article |
| id | doaj.art-bdae6355a7ed4765b399effce7cdbe48 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-11T16:01:50Z |
| publishDate | 2022-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-bdae6355a7ed4765b399effce7cdbe482022-12-22T04:14:56ZengBMJ Publishing GroupBMJ Open2044-60552022-11-01121110.1136/bmjopen-2022-064641Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland ChinaYafei Si0Shenglan Tang1Chenkai Wu2Shu Chen3Xiaochen Dai4Katja Hanewald5Bingqin Li6Hazel Bateman71 School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, ChinaDuke Global Health Institute, Duke University, Durham, North Carolina, USAGlobal Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, ChinaGlobal Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China1 Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USASchool of Risk and Actuarial Studies, UNSW, Sydney, New South Wales, AustraliaSocial Policy Research Center, University of New South Wales, Sydney, New South Wales, AustraliaSchool of Risk and Actuarial Studies, UNSW, Sydney, New South Wales, AustraliaObjectives To measure the disease burden of ageing based on age-related diseases (ARDs), the sex and regional disparities and the impact of health resources allocation on the burden in China.Design A national comparative study based on Global Burden of Diseases Study estimates and China’s routine official statistics.Setting and participants Thirty-one provinces of Mainland China were included for analysis in the study. No individuals were involved.Methods We first identified the ARDs and calculated the disability-adjusted life years (DALYs) of ARDs in 2016. We assessed the ARD burden disparities by province and sex and calculated the provincial ARD burden-adjusted age. We assessed historical changes between 1990 and 2016. Fixed effects regression models were adopted to evaluate the impact of health expenditures and health workforce indicators on the ARD burden in 2010–2016.Results In 2016, China’s total burden of ARDs was 15 703.7 DALYs (95% uncertainty intervals: 12 628.5, 18 406.2) per 100 000 population. Non-communicable diseases accounted for 91.9% of the burden. There were significant regional disparities. The leading five youngest provinces were Beijing, Guangdong, Shanghai, Zhejiang and Fujian, located on the east coast of China with an ARD burden-adjusted age below 40 years. After standardising the age structure, western provinces, including Tibet, Qinghai, Guizhou and Xinjiang, had the highest burden of ARDs. Males were disproportionately affected by ARDs. China’s overall age-standardised ARD burden has decreased since 1990, and females and eastern provinces experienced the largest decline. Regression results showed that the urban–rural gap in health workforce density was positively associated with the ARD burdens.Conclusion Chronological age alone does not provide a strong enough basis for appropriate ageing resource planning or policymaking. In China, concerted efforts should be made to reduce the ARDs burden and its disparities. Health resources should be deliberately allocated to western provinces facing the greatest health challenges due to future ageing.https://bmjopen.bmj.com/content/12/11/e064641.full |
| spellingShingle | Yafei Si Shenglan Tang Chenkai Wu Shu Chen Xiaochen Dai Katja Hanewald Bingqin Li Hazel Bateman Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China BMJ Open |
| title | Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China |
| title_full | Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China |
| title_fullStr | Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China |
| title_full_unstemmed | Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China |
| title_short | Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China |
| title_sort | disease burden of ageing sex and regional disparities and health resources allocation a longitudinal analysis of 31 provinces in mainland china |
| url | https://bmjopen.bmj.com/content/12/11/e064641.full |
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