Key result
The Qinghai-Tibet Plateau had the highest standardized mortality rates for non-communicable diseases (711.6-896.1 per 100,000) compared to the lowest rates in developed megacities (290.6-389.6 per 100,000) in China.
Why the study?
Non-communicable diseases and risk factors such as obesity are major causes of preventable deaths in China, yet NCD disparities remain under-studied.
There are large disparities in non-communicable disease mortality and risk factor prevalence between China's least developed plateau regions and most developed megacities, highlighting the need for targeted, region-specific public health interventions.
Regional NCD disparities in China call for targeted prevention in underdeveloped provinces; leaves open causal roles of socioeconomic and dietary factors.
Background Non-communicable diseases (NCDs) including risk factors, e.g., obesity, are the major causes of preventable deaths in China, yet NCD disparities in China remain under-studied. Objective This study aimed to compare the determinants and burden of NCDs within four selected provinces in mainland China: the least developed Qinghai-Tibet Plateau group (PG, Tibetan Autonomous Region [TAR] and Qinghai Province) and most developed megacity group (MCG, Shanghai, and Beijing). Methods Studies, reports, and other official sources with comparable data for NCD burden and related determinants for the four provinces were searched. Geographic, demographic, socioeconomic, and dietary characteristics and selected health indicators (e.g., life expectancy) were extracted from the China Statistical Yearbook and China Health Statistics Yearbook. Data on NCD burdens were extracted from the National Chronic Disease and Risk Factor Surveillance Study and other nationally representative studies. Results The overall NCD mortality rates and prevalence of metabolic risk factors including obesity, hypertension, and diabetes in mainland China have increased in the past 20 years, and this trend is expected to continue. The PG had the highest level of standardized mortality rates (SMRs) on NCDs (711.6–896.1/100,000, 6th/6-level); the MCG had the lowest (290.6–389.6/100,000, 1st/6-level) in mainland China. The gaps in SMRs were particularly high with regard to chronic respiratory diseases (PG 6th / 6-level, MCG 1st/6-level) and cardiovascular diseases (6th/6 and 4th/6 in TAR and Qinghai; 1st/6-level and 2nd/6-level in Shanghai and Beijing). In contrast, the prevalence rates of obesity, hypertension, and diabetes were generally higher or comparable in MCG compared to PG. Diabetes prevalence was particularly high in MCG (5th/5-level, 13.36–14.35%) and low in PG (1st/5-level, 6.20–10.39%). However, awareness, treatment, and control of hypertension were poor in PG. Additionally, PG had much lower and severely inadequate intakes of vegetables, fruits, and dairy products, with additional indicators of lower socioeconomic status (education, income, etc.,) compared with MCG. Conclusion Evidence showed large disparities in NCD burden in China's provinces. Socioeconomic disparity and dietary determinants are probably the reasons. Integrated policies and actions are needed.
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Peng et al. (2023) conducted a review in Non-communicable diseases and obesity. Living in the Qinghai-Tibet Plateau vs. Living in developed megacities (Beijing and Shanghai) was evaluated on Standardized mortality rates (SMRs) due to NCDs. The Qinghai-Tibet Plateau had the highest standardized mortality rates for non-communicable diseases (711.6-896.1 per 100,000) compared to the lowest rates in developed megacities (290.6-389.6 per 100,000) in China.
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