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Updated: Jun 26, 2026

An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
[Estimation on the mortality and disease burden attributed to selected risk factors in Shandong province]
Ai-qiang Xu1, Jian-dong Sun, Zi-long Lu
1Shandong Center for Disease Control and Prevention, Jinan 250014, China.
Objective:
To determine the major health related risk factors and provide evidence for policy-making, using health burden analysis on selected factors among general population from Shandong province.
Methods:
Based on data derived from the Third Death of Cause Sampling Survey in Shandong, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) were calculated according to the GBD methodology. Deaths and DALYs attributed to the selected risk factors were than estimated together with the PAF data from GBD 2001 study. The indirect method was employed to estimate the YLDs.
Results:
51.09% of the total deaths and 31.83% of the total DALYs from the Shandong population were resulted from the 19 selected risk factors. High blood pressure, smoking, low fruit and vegetable intake, alcohol consumption, indoor smoke from solid fuels, high cholesterol, urban air pollution, physical inactivity, overweight and obesity and unsafe injections in health care settings were identified as the top 10 risk factors for mortality which together caused 50.21% of the total deaths. Alcohol use, smoking, high blood pressure, low fruit and vegetable intake, indoor smoke from solid fuels, overweight and obesity, high cholesterol, physical inactivity, urban air pollution and iron-deficiency anemia were proved as the top 10 risk factors related to disease burden and were responsible for 29.04% of the total DALYs.
Conclusion:
Alcohol use, smoking and high blood pressure were determined as the major risk factors which influencing the health of residents in Shandong. The mortality and burden of disease could be reduced significantly if these major factors were effectively under control.
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