Dataset Information

Analysis of death causes of residents in poverty-stricken Areas in 2020: take Liangshan Yi Autonomous Prefecture in China as an example.

ABSTRACT:

Background

Continuous surveillance of death can measure health status of the population, reflect social development of a region, thus promote health service development in the region and improve the health level of local residents. Liangshan Yi Autonomous Prefecture was a poverty-stricken region in Sichuan province, China. While at the end of 2020, as the announcement of its last seven former severely impoverished counties had shaken off poverty, Liangshan declared victory against poverty. Since it is well known that the mortality and cause of death structure will undergo some undesirable changes as the economy develops, this study aimed to reveal the distribution of deaths, as well as analyze the latest mortality and death causes distribution characteristics in Liangshan in 2020, so as to provide references for the decision-making on health policies and the distribution of health resources in global poverty-stricken areas.

Methods

Liangshan carried out the investigation on underreporting deaths among population in its 11 counties in 2018, and combined with the partially available data from underreporting deaths investigation data in 2020 and the field experience, we have estimated the underreporting rates of death in 2020 using capture-recapture (CRC) method. The crude mortality rate, age-standardized mortality rate, proportion and rank of the death causes, potential years of life lost (PYLL), average years of life lost (AYLL), potential years of life lost rate (PYLLR), standardized potential years of life lost (SPYLL), premature mortality from non-communicable diseases (premature NCD mortality), life expectancy and cause-eliminated life expectancy were estimated and corrected.

Results

In 2020, Liangshan reported a total of 16,850 deaths, with a crude mortality rate of 608.75/100,000 and an age-standardized mortality rate of 633.50/100,000. Male mortality was higher than female mortality, while 0-year-old mortality of men was lower than women's. The former severely impoverished counties' age-standardized mortality and 0-year-old mortality were higher than those of the non-impoverished counties. The main cause of death spectrum was noncommunicable diseases (NCDs), and the premature NCD mortality of four major NCDs were 14.26% for the overall population, 19.16% for men and 9.27% for women. In the overall population, the top five death causes were heart diseases (112.07/100,000), respiratory diseases (105.85/100,000), cerebrovascular diseases (87.03/100,000), malignant tumors (73.92/100,000) and injury (43.89/100,000). Injury (64,216.78 person years), malignant tumors (41,478.33 person years) and heart diseases (29,647.83 person years) had the greatest burden on residents in Liangshan, and at the same time, the burden of most death causes on men were greater than those on women. The life expectancy was 76.25 years for overall population, 72.92 years for men and 80.17 years for women, respectively, all higher than the global level (73.3, 70.8 and 75.9 years).

Conclusions

Taking Liangshan in China as an example, this study analyzed the latest death situation in poverty-stricken areas, and proposed suggestions on the formulation of health policies in other poverty-stricken areas both at home and abroad.

SUBMITTER: Liao R

PROVIDER: S-EPMC8758188 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BACKGROUND:Due to historical perceptions of Liangshan Yi Autonomous Prefecture (Sichuan Province, China) as being a violent place, and due to its rugged terrain, cultural differences, and relative inaccessibility, few researchers have conducted in-depth ethnobotanical investigations in Liangshan. But wild edible plants (WEPs) are widely consumed by the Yi people of Liangshan, and their associated ethnobotanical knowledge remains relatively unknown, especially outside of China. This study aimed to (1) investigate the WEPs used by the Liangshan Yi, (2) document the traditional knowledge held about these plants, (3) analyze their special preparation methods and consumption habits, and (4) identify species with important cultural significance to the Liangshan Yi. METHODS:During 2016-2017, 396 Yi individuals were interviewed in 1 county-level city and 6 counties across Liangshan. Prior informed consent was obtained, and multiple ethnographic methods were utilized, including direct observation, semi-structured interviews, key informant interviews, informal discussions, and field visits. Market surveys were conducted in April, July, and August 2017 by interviewing 38 Yi merchants selling WEPs in 6 Liangshan traditional markets. We collected information about the parts consumed, preparation methods, consumption habits, growth pattern of species, collection months, market prices, and other uses of WEPs. Use values (UVs) were calculated to analyze the relative cultural importance of each WEP. RESULTS:In total, 105 plant species belonging to 97 genera and 62 families were recorded. Rosaceae was the family with the largest number of species (14), and herbs (58 species) were the dominant growth form reported. Fruits (34 species), roots (21 species), and tender shoots (20 species) were the primary plant parts used for snacking and cooking. There were 6 main preparation and consumption methods of WEPs reported, ranging from primary food, famine food, snack, spice, culinary coagulant, and medicine, among a few other uses. The Liangshan Yi mainly collect WEPs from March to October, seldom collecting from November to February. There were 35 species of WEPs sold in the markets we visited in Liangshan. The price of medicinal plants was much higher than the price of food and fruits. In total, we documented 49 species of edible medicinal plants in Liangshan, accounting for 44.7% of all WEPs. They can be used for treating 27 medical conditions, including cough, diarrhea, injury, and headaches. The plants with the highest UVs were Berberis jamesiana (1.92), Pyracantha fortuneana (1.87), and Artemisia capillaris (1.44) indicating that these species are the most commonly used and important to the Liangshan Yi's traditional life and culture. CONCLUSIONS:The traditional knowledge of WEPs from the accumulated experience of the Yi people's long period residing in Liangshan reflects the cultural richness of the Yi and the plant diversity of the region. Future research on the nutrition, chemical composition, and bioactivity of the WEPs are needed. Some species with high medicinal value but with sharp wild population decline should be surveyed for resource assessment, conservation, and domestication potential.

Project description:Yi people make up about 50% of the population in Liangshan Prefecture, Sichuan Province, China, but accounted for 88.07% of new HIV cases in the prefecture from 2011 to 2013. This study evaluated HIV prevalence in pregnant women of Liangshan Prefecture using HIV sentinel surveillance (HSS) data over the period of 2009 to 2015.Xichang, Zhaojue County, and Butuo County were selected as HSS sites. We investigated the temporal trends in HIV prevalence in these areas, and the association between demographic and behavioral characteristics and risk of HIV infection.Data on a total of 2797 pregnant women in Xichang and 3983 pregnant women in Zhaojue and Butuo was collected for the period 2009 to 2015. There was a fluctuating HIV prevalence among pregnant women of Xichang, with a rate of 0.75% in 2015 (?2trend = 2.27, P = 0.13). HIV prevalence among pregnant women of Zhaojue and Butuo was consistently high, varying between 3.4% (9/267, 2011) and 10.3% (82/796, 2012) over the period of 2010 to 2015 (?2trend = 0.12, P = 0.73). In Xichang, we found that Yi ethnicity (OR = 11.37, 95% CI = 2.92-44.25) and a husband who used drugs (OR = 32.13, 95% CI = 5.33-193.67) were significantly associated with HIV risk in pregnant women. For Zhaojue and Butuo, we observed that pregnant women had a higher risk of HIV infection when they were over 30 years old (OR = 1.72, 95% CI = 1.17-2.52), when they had a higher number of previous births, when their husbands had a history of migrating for work (OR = 1.56, 95% CI = 1.16-2.08), and when they had a history of other sexually transmitted infections (OR = 2.19, 95% CI = 1.16-2.08). Compared to those with a primary school education or below, pregnant women with a secondary or high school education level had a lower risk of HIV infection (OR = 0.28, 95% CI = 0.09-0.89).Our results indicate that there is a serious HIV epidemic among pregnant Yi women, especially for those with less education, more past births, or a husband with a history of out-migrating for work or STD infection.

Project description:BackgroundUnderutilization of health services among chronic non-communicable disease sufferers, especially for hypertension (HBP) and diabetes mellitus (DM), was considered as a significant contributing factor to substantial cases in terms of both avoidable morbidity and mortality. However, evidence on health services underutilization and its associated factors in poverty-stricken areas remain scarce based on previous literature. This study aims to describe health services underutilization for people diagnosed with chronic diseases in impoverished regions and to identify its associated factors, which are expected to provide practical implications for the implementations of interventions tailored to the specific needs of disadvantaged residents in rural China to achieve effective utilization of health services in a timely manner.MethodsData were collected from a cross-sectional survey conducted through face-to-face interviews among 2413 patients from six counties in rural central China in 2019. The Anderson behavioral model was adopted to explore the associated factors. A two-level logistic model was employed to investigate the association strengths reflected by adjusted odds ratios (AOR) and 95% confidence intervals in forest plots.ResultsOn average, 17.58% of the respondents with HBP and 14.87% with DM had experienced health services underutilization during 1 month before the survey. Multilevel logistic regression indicated that predisposing factors (age), enabling factors (income and a regular source of care), and need factors (self-reported health score) were the common predictors of health service underutilization both for hypertensive and diabetic patients in impoverished areas, among which obtaining a regular source of care was found to be relatively determinant as a protective factor for health services underutilization after controlling for other covariates.ConclusionsOur results suggested that the implementation of a series of comprehensive strategies should be addressed throughout policy-making procedures to improve the provision of regular source of care as a significant determinant for reducing health services underutilization, thus ultimately achieving equal utilization of health services in impoverished regions, especially among chronic disease patients. Our findings are expected to provide practical implications for other developing countries confronted with similar challenges resulting from underdeveloped healthcare systems and aging population structures.