Population Research ›› 2020, Vol. 44 ›› Issue (1): 26-38.

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Decomposition of Changes in Health-adjusted Life Expectancy in China, 1990-2013

Chen He1   

  1. Chen He1, School of Public Administration and Policy, Renmin University of China.
  • Online:2020-01-29 Published:2020-02-23
  • About author:Chen He is Associate Professor, School of Public Administration and Policy, Renmin University of China.

1990~2013年中国健康调整预期寿命变化的分解研究

陈鹤1   

  1. 陈鹤1,中国人民大学公共管理学院。
  • 作者简介:陈鹤,中国人民大学公共管理学院副教授。
  • 基金资助:
    本文得到教育部人文社会科学研究青年基金项目“长期照护保险筹资机制的可持续性评估及政策优化研究”(18YJC840003)、国家自然科学基金北京大学管理科学数据中心项目“试点市长期护理保险的筹资机制评估与政策优化研究”(2018KEY05)和国家社会科学基金重大项目“健康预期寿命与人口群体健康水平测量”(17ZDA124)的资助。感谢全球疾病负担2013项目提供的死亡和伤残数。

Abstract: Using data from GBD 2013, this study estimates the changes in health-adjusted life expectancy at birth (HALE0) between 1990 and 2013 in China, analyzes its influencing factors, and, for the first time, decomposes these changes into the contribution of 302 diseases and injuries. During this period, HALE0 increased by 7.39 years, ranging from 2.48 years in Hebei to 10.81 years in Tibet.Provinces with low HALE0 at base year (1990)and high human development index values were more likely to witness rapid increase in HALE0.Communicable diseases, non-communicable diseases, and injuries have contributed 3.17 years, 3.13 years and 1.10 years, respectively, to the growth of HALE0. The five top and positive causes to HALE0 changes include COPD, lower respiratory infections, stroke, preterm birth complications, and diarrheal diseases; and the five top and negative causes to HALE0 changes include diabetes mellitus, low back and neck pain, chronic kidney disease, interstitial lung disease and medication overuse headache. Mortality reduction was the predominant driver for population health improvement, accounting for 95.26% of HALE0 changes. This has resulted in a prolonged life expectancy with disability.

Keywords: Health-adjusted Life Expectancy at Birth, Changes, Decomposition, Diseases and Injuries, Inter-province Variation

摘要: 基于GBD2013数据,分析了1990~2013年我国及各省出生时健康调整预期寿命(HALE0)的变化和影响因素,首次分解了302种疾病或伤害对HALE0变化的贡献。24年间,我国人口健康显著改善,HALE0增长7.39年;河北HALE0增幅最低(2.48年),西藏最高(10.81年)。基线健康水平低、人类发展指数高的省份,HALE0增幅更大。传染病、孕产妇、新生儿和营养类疾病(3.17年)、非传染病(3.13年)和伤害(1.10年)的缓解均促进了HALE0增加。对HALE0变化正向贡献最大为COPD、下呼吸道感染、中风、早产并发症和腹泻;负向最大为糖尿病、腰颈痛、慢性肾病、间质性肺病和伴随药物过度的头痛。死亡率下降是HALE0增加的主导原因(95.26%),带残预期寿命延长1.03年。慢性病防控和健康老龄化政策是未来人口健康改善的关键因素。

关键词: 出生时健康调整预期寿命(HALE0), 变化, 分解, 疾病和伤害, 省际差异