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All-Cause and Cause-Specific Burden of Asthma in a Transitioning City in China: Population Study
Xuelin Cheng1, Xiaoling Wu1, Wenjing Ye2
1Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, 180 Fenglin Rd, Xuhui, Shanghai, 200030, China, 86 13621925210.
Background:
Understanding the impact of asthma on public health is crucial for evidence-based prevention and treatment strategies.
Objective:
This study aimed to identify the causes of asthma-related mortality in Pudong, Shanghai, China, offering insights for managing similar regions or countries in transition.
Methods:
Mortality statistics were obtained from the Vital Statistics System of Pudong for 2005-2021. Temporal patterns for the burden of asthma were examined. The crude mortality rate (CMR), age-standardized mortality rate by Segi's world standard population (ASMRW), and years of life lost (YLL) for both all-cause and asthma-specific deaths were computed. Mortality rates associating with aging and other variables were categorized using the decomposition technique. The autoregressive integrated moving average model was used to forecast the asthma-related death mortality rate by 2035.
Results:
A total of 1568 asthma-related deaths occurred during the follow-up period, with the CMR and ASMRW being 3.25/105 and 1.22/105 person-years, respectively. The primary underlying causes of death were chronic lower respiratory diseases, coronary heart diseases, and cerebrovascular disease. The YLL due to total asthma-related deaths added up to 14,837.76 years, with a YLL rate of 30.73/105 person-years. Male individuals had more YLL (8941.81 vs 5895.95 y) and a higher YLL rate (37.12/105 vs 24.38/105 person-years) than female individuals. From 2005 to 2021, the ASMRW declined by 3.48%, and both the CMR and YLL rate decreased in the 0-29, 70-79, and ≥80 years age groups (all P<.01). However, asthma-related deaths increased from 329 people between 2005 and 2008 to 472 people between 2017 and 2021. The proportion of the population aged 80 years and older gradually increased by 1.43% (95% CI 0.20%-2.68%; P=.03), and the mortality rates of asthma deaths attributable to population aging rose by 21.97% (95% CI, 11.58%-33.32%; P<.001) annually.
Conclusions:
Asthma remains a significant public health challenge in transitioning countries, requiring increased attention and resource allocation.
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