1990年与2017年中国居民期望寿命的性别差异分析

Gender differences in life expectancy of Chinese Residents in 1990 and 2017

陈海; 杨志杰; 王璐; 申倩; 钱云; 刘佳; 郭亮亮; 董昀球

目的 分析1990年与2017年中国居民期望寿命的性别差异，探讨不同年龄组及疾病死因变化对期望寿命性别差异的影响。方法 采用全球疾病负担研究中中国居民1990年与2017年的死亡数据，应用简略寿命表法及期望寿命差异分解法，评估年龄别和死因别死亡率变化对性别差异的影响。结果 1990到2017年中国居民期望寿命的性别差异从3.5岁上升至5.3岁。1990年影响期望寿命性别差异的主要疾病死因是肿瘤（1.07岁，30.57%）、心脑血管疾病（0.62岁，17.57%）、慢性呼吸系统疾病（0.43岁，12.26%）、交通伤害（0.45岁，12.80%）和意外伤害（0.53岁，15.21%），其中肿瘤的影响集中在50-74岁（20.63%）。到2017年，肿瘤（31.49%）和心脑血管疾病（31.36%）的贡献进一步加大。与1990年相比，心脑血管疾病导致的性别差异增幅最大（1.05岁），且集中在45-79岁（24.18%），而交通和意外伤害的贡献虽略有下降，但仍超7%。结论 中国居民期望寿命的性别差异仍处在较高水平，并有所增长，男性期望寿命持续低于女性。缩小期望寿命的性别差异，不断提高居民的期望寿命，应重点关注≥50岁男性的肿瘤和心脑血管疾病的死亡率，同时不可忽视≥60岁老年人的慢性呼吸系统疾病及<50岁人群的交通和意外伤害等的影响。

Objectives To compare gender differences of life expectancy in China in 1990 and 2017, and to explore the influence of different age groups and changes in mortality rates of major diseases on gender differences in life expectancy. Methods Mortality data of China in 1990 and 2017 from global burden of disease were analyzed with abridged life table and decomposition method of life expectancy to evaluate the effects of age and cause-specific mortality changes on gender differences. Results Gender differences increased from 3.5 years in 1990 to 5.3 years in 2017. In 1990, the main causes of death affecting gender differences in life expectancy were neoplasms (1.07 years, 30.57%), cardiovascular diseases (0.62 years, 17.57%), chronic respiratory diseases (0.43 years, 12.26%), transport injuries (0.45 years, 12.80%) and unintentional injuries (0.53 years, 15.21%), among which neoplasms had the greatest impact in the 50-74 age group (20.63%). By 2017, the contribution of neoplasms (31.49%) and cardiovascular diseases (31.36%) was further increased. Compared with 1990, gender differences caused by cardiovascular diseases increased the most (1.05 years) in the 45-79 age group (24.18%), while contribution of transport and unintentional injuries decreased slightly, but still accounted for >7%. Conclusions Gender differences in life expectancy of Chinese residents are still at a high level, and have increased. Life expectancy of male is lower than that of female. In order to narrow gender differences of life expectancy and improve life expectancy, we should pay more attention to the mortality of neoplasms and cardiovascular diseases in men over 50 years. At the same time, we should not neglect the influence of chronic respiratory diseases in the elderly over 60 years and transport or unintentional injuries for those <50 years.