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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2016

Open Access 01-12-2016 | Research

Age-period-cohort analysis of infectious disease mortality in urban-rural China, 1990–2010

Authors: Zhi Li, Peigang Wang, Ge Gao, Chunling Xu, Xinguang Chen

Published in: International Journal for Equity in Health | Issue 1/2016

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Abstract

Background

Although a number of studies on infectious disease trends in China exist, these studies have not distinguished the age, period, and cohort effects simultaneously. Here, we analyze infectious disease mortality trends among urban and rural residents in China and distinguish the age, period, and cohort effects simultaneously.

Methods

Infectious disease mortality rates (1990–2010) of urban and rural residents (5–84 years old) were obtained from the China Health Statistical Yearbook and analyzed with an age-period-cohort (APC) model based on Intrinsic Estimator (IE).

Results

Infectious disease mortality is relatively high at age group 5–9, reaches a minimum in adolescence (age group 10–19), then rises with age, with the growth rate gradually slowing down from approximately age 75. From 1990 to 2010, except for a slight rise among urban residents from 2000 to 2005, the mortality of Chinese residents experienced a substantial decline, though at a slower pace from 2005 to 2010. In contrast to the urban residents, rural residents experienced a rapid decline in mortality during 2000 to 2005. The mortality gap between urban and rural residents substantially narrowed during this period. Overall, later birth cohorts experienced lower infectious disease mortality risk. From the 1906–1910 to the 1941–1945 birth cohorts, the decrease of mortality among urban residents was significantly faster than that of subsequent birth cohorts and rural counterparts.

Conclusions

With the rapid aging of the Chinese population, the prevention and control of infectious disease in elderly people will present greater challenges. From 1990 to 2010, the infectious disease mortality of Chinese residents and the urban-rural disparity have experienced substantial declines. However, the re-emergence of previously prevalent diseases and the emergence of new infectious diseases created new challenges. It is necessary to further strengthen screening, immunization, and treatment for the elderly and for older cohorts at high risk.
Footnotes
1
Age effects refer to the risk differences between different age groups. As people age, changes in physiological status, social roles and life experiences will bring these differences. Period effects refer to the risk differences between different years. These differences reflect the changes of environment or the impact of historical events. Birth cohort effects refer to the risk between different birth cohorts. Different birth cohorts go through stages of life in different years and therefore different life trajectories bring them unique effects [32, 33].
 
2
It refers to the program of reforms called “socialism with Chinese characteristics” since 1978 and involves economic, political, cultural and other domains. In the economic domains, China has gradually established the socialist market economic system, and actively tried to attract foreign investment and develop foreign trade. In this process, the Chinese economy has achieved great achievements, but the gap between rich and poor has also been widening rapidly.
 
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Metadata
Title
Age-period-cohort analysis of infectious disease mortality in urban-rural China, 1990–2010
Authors
Zhi Li
Peigang Wang
Ge Gao
Chunling Xu
Xinguang Chen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2016
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-016-0343-7

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