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Health transition of the causes of mortality between 2005 and 2015 in Guangdong, China
  1. Xue-yan Zheng1,
  2. Qian Yi1,2,
  3. Yan-jun Xu1,
  4. Xin-ying Zeng3,
  5. Xiao-jun Xu1,
  6. Ge Chen2,
  7. Shu-li Ma2,
  8. Si-li Tang4,
  9. Li-feng Lin1
  1. 1 Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
  2. 2 Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
  3. 3 National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
  4. 4 School of Public Health, Southern Medical University, Guangzhou, China
  1. Correspondence to Dr Li-feng Lin, Guangdong Center for Disease Control and Prevention, 511430, Guangzhou, Guangdong, China; 1396320174{at}


Objectives To analyse the patterns of transition of health burden for 110 causes of death by stratification of age, sex and geographic regions in Guangdong between 2005 and 2015.

Methods We analysed the age-specific, sex-specific, region-specific mortality in Guangdong based on assembled databases. County-level surveillance data were calculated to inform city-level changes.

Results The age-standardised mortality of all causes, non-communicable diseases (NCDs), communicable diseases, maternal diseases, neonatal diseases, malnutrition and injury declined progressively. Despite declining mortality of NCDs, the overall burden of disease was dominated by NCDs (ie, cerebrovascular disease, chronic obstructive pulmonary disease) that still accounted for 86.93% and 88.12% of death in 2005 and 2015, respectively. Considerable variations across geographic regions were observed (lowest in Pearl River Delta and highest in west Guangdong). There was a modest shift to transport injuries at younger ages and unintentional injuries in the elderly.

Conclusions We have documented a dramatic change in the overall mortality and age-specific, sex-specific and cause-specific mortality in Guangdong province between 2005 and 2015. The significant burden of NCDs remains a major healthcare issue despite the notable progress in reducing mortality in Guangdong, China. Our findings highlight important unmet needs to refine healthcare services by taking into account the inequity of age, sex and geographic regions. Identification of the ‘treatable’ risk factors and improved disease surveillance should be continuously improved to minimised the overall and cause-specific mortality.

  • health policy
  • epidemiology
  • public health

Data availability statement

Data are available upon reasonable request.

Statistics from

Data availability statement

Data are available upon reasonable request.

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  • X-yZ, QY, Y-jX and X-yZ are joint first authors.

  • Contributors X-jX, Y-jX and L-fL conceived of the study and provided overall guidance. X-yZ, QY, X-yZ and L-fL prepared the first draft and finalized the manuscript based on comments from all other authors and reviewer feedback. X-yZ, QY, X-yZ, Y-jX and L-fL played a key role in formulating the analysis. All other authors contributed to the analysis and reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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