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. 2024 Oct 5;137(19):2325-2333.
doi: 10.1097/CM9.0000000000003270. Epub 2024 Aug 28.

Burden of non-communicable diseases in China and its provinces, 1990-2021: Results from the Global Burden of Disease Study 2021

Hanxiao Liu  1   2 , Peng Yin  2 , Jinlei Qi  2 , Maigeng Zhou  1   2
Affiliations

Burden of non-communicable diseases in China and its provinces, 1990-2021: Results from the Global Burden of Disease Study 2021

Hanxiao Liu et al. Chin Med J (Engl). .

Abstract

Background: Non-communicable diseases (NCDs) are the primary causes of disability and death. The aim of this study is to analyze the disease burden of NCDs in China from 1990 to 2021.

Methods: This study used data on NCDs in China and its provinces from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The study analyzed the disease burden of NCDs in 2021 and its changes from 1990 to 2021 using indicators including deaths and disability-adjusted life years (DALYs).

Results: Between 1990 and 2021, the NCD burden in China exhibited an upward trend. In 2021, China had 10.6 (95% uncertainty interval [UI]: 9.0-12.2) million deaths and 349.3 (95% UI: 301.5-401.2) million DALYs due to NCDs, accounting for 91.0% (95% UI: 90.4-91.7%) of all deaths and 86.7% (95% UI: 86.0-87.4%) of all DALYs. NCDs caused a lower disease burden in females than in males. Cardiovascular diseases and neoplasms were the main NCD level 2 causes of deaths and DALYs, resulting in 5.1 (95% UI: 4.3-5.9) and 2.8 (95% UI: 2.3-3.4) million deaths and 100.2 (95% UI: 84.6-116.6) million and 71.2 (95% UI: 59.3-85.2) million DALYs in 2021, respectively. Chronic respiratory diseases were the third leading cause of NCD deaths, while musculoskeletal disorders were the third leading cause of NCD DALYs. Qinghai, Xizang, and Heilongjiang had the highest age-standardized mortality rates and age-standardized DALY rates (per 100,000) for NCDs, while Hong Kong Special Administration Region (SAR), Macao SAR, and Shanghai recorded the lowest age-standardized mortality rates and age-standardized DALY rates.

Conclusions: NCDs caused a high disease burden in China and exhibited heterogeneity across sexes and provinces. China needs to focus on addressing key NCDs and implement intervention measures tailored to the disease distribution characteristics to reduce the NCD burden.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Trend of changes in death and DALYs for NCDs in China from 1990 to 2021. (A) Absolute deaths (millions). (B) Absolute DALYs (millions). (C) Mortality rate (per 100,000). (D) DALY rate (per 100,000). (E) Age-standardized mortality rate (per 100,000). (F) Age-standardized DALY rate (per 100,000). Shaded regions are 95% UIs. DALYs: Disability-adjusted life years; NCDs: Non-communicable diseases; UIs: Uncertainty intervals.
Figure 2
Figure 2
Proportion of deaths and DALYs attributable to each of the four level 1 causes in China, 2021. DALYs: Disability-adjusted life years.
Figure 3
Figure 3
Ranking of NCD level 2 causes by mortality rate (A) and DALY rate (B) in China from 1990 to 2021. DALY: Disability-adjusted life year; NCD: Non-communicable disease.
Figure 4
Figure 4
Mortality rate (A) and DALY rate (B) due to NCD level 2 causes in China, by sex, in 2021. Error bars show 95% UIs. DALY: Disability-adjusted life years; NCD: Non-communicable disease; UIs: Uncertainty intervals.
Figure 5
Figure 5
Age-standardized mortality rate (A) and age-standardized DALY rate (B) due to NCD level 2 causes by province in China in 2021 (data from the Taiwan Province of China were not included). DALY: Disability-adjusted life year; NCD: Non-communicable disease; SAR: Special administration region.
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