Chinese Medical Journal reports on emerging trends and implications of non-communicable diseases in China

Non-Communicable Diseases (NCDs) are a major global health issue, characterized by their chronic nature and long-term impact on quality of life. NCDs, such as cardiovascular diseases (CVDs), cancers, chronic respiratory diseases (CRDs), and musculoskeletal disorders, contribute significantly to mortality and disability worldwide. In China, a country with a vast population and rapidly changing socio-economic conditions, understanding the extent and distribution of NCDs is essential for developing effective public health strategies and interventions.

To address this, a research team from Shandong University and the Chinese Center for Disease Control and Prevention conducted a comprehensive analysis to assess the impact of NCDs on China's health system over the past three decades. The study, led by Professor Maigeng Zhou, was published on August 28, 2024, in the Chinese Medical Journal. The study assessed the impact of NCD using mortality rates and Disability-Adjusted Life Years (DALYs), key indicators of disease burden. By analyzing these trends, the study intends to highlight significant areas of concern, evaluate the progress made in addressing NCDs, and offer data-driven recommendations for public health strategies.

The study used data from the Global Burden of Disease (GBD) 2021, including model-estimated figures on NCDs across various regions and sexes in China. It analyzed both absolute and age-standardized mortality and DALY rates for NCDs, comparing these with global averages and examining regional and sex-based variations in disease burden.

Prof. Zhou shares, “In 2021, NCDs accounted for 91.0% of deaths and 86.7% of DALYs in China. Although age-standardized mortality and DALY rates have declined, the absolute numbers of deaths and DALYs have increased, indicating that, despite advancements in disease management, the overall burden remains high due to population growth and aging.”

CVDs were the leading cause of NCD-related deaths, accounting for nearly half of all such deaths. In 2021, China’s CVD mortality rate (357.4 per 100,000) and DALY rate (7043.3 per 100,000) were significantly higher than global averages. Contributing factors include hypertension and excessive salt intake. While age-standardized rates for cancer mortality and DALYs have decreased, the burden from neoplasms remains substantial. China has advanced in cancer prevention through surveillance and screening programs, but challenges persist due to risk factors like smoking and alcohol consumption.

CRDs ranked third in NCD deaths, with a notable mortality rate. Recent improvements in air quality, thanks to government initiatives, have reduced DALY rates. However, regional disparities, especially in high-altitude areas, continue to present challenges. Musculoskeletal disorders have seen a significant rise in DALYs, contributing more to disability than to mortality. This highlights the need for attention to aging populations and work-related conditions.

“Economically developed regions, such as Hong Kong SAR and Zhejiang, have a lower NCD burden compared to less developed areas like Qinghai and Xizang. This disparity reflects differences in healthcare resources, health literacy, and living conditions. The burden of NCDs was also found to be heavier for males than females” explains Professor Zhou. Specific conditions, such as musculoskeletal disorders, have a higher impact on females, likely due to physiological factors and life stages like pregnancy.

The study provides valuable insights into the evolving landscape of NCDs in China. It highlights the major contributors to disease burden and offers a comparative perspective with global data. It also highlights the progress made in certain areas, such as cancer prevention, while identifying ongoing challenges. The findings inform public health policy and resource allocation, helping to prioritize interventions for the most impactful conditions.

Despite the valuable insights provided, the study also has several limitations. The reliance on model-estimated data introduces some uncertainty, and there is a need for more specific data from remote and impoverished regions. Future research should focus on collecting more granular data, exploring emerging risk factors, and assessing the effectiveness of targeted interventions.

This research offers a comprehensive overview of the NCD burden in China, emphasizing the need for continued and targeted public health efforts. By understanding the trends and regional variations in NCDs, China can better address the challenges posed by these diseases and improve overall health outcomes. The study serves as a vital resource for guiding future health policies and research initiatives.

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Reference

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

Journal: Chinese Medical Journal

DOI: https://doi.org/10.1097/CM9.0000000000003270