[Subnational analysis of probability of premature mortality caused by four main non-communicable diseases in China during 1990-2015 and " Health China 2030" reduction target].

Objective: To investigate the current status, temporal trend and achieving Health China 2030 reduction target of probability of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases, tumour, diabetes, and chronic respiratory disease in China both at national and provincial level during 1990 to 2015. Methods: Using the results of Global Burden of Disease study 2015 (GBD 2015), according to the method of calculating premature mortality probability recommended by WHO, the current status and temporal trend by different gender from 1990 to 2015 were calculated, analyzed, and compared. Referring to " Health China 2030" target of reduction 30% of probability of premature mortality caused by major NCDs, we evaluated the difficulty of achieving the reduction target among provinces (not including Taiwan). Results: From 1990 to 2015, the probabilities of premature mortality in cardiovascular and cerebrovascular diseases, tumour, and chronic respiratory disease were all declined consistently for both men and women in China, the total of four main NCDs decreased from 30.69% to 18.54% with higher decreasing in women (from 25.97% to 12.40%) than that in men (from 34.94% to 24.19%). In 2015, the top five provinces in terms of probability of premature mortality caused by four main NCDs were Qinghai (28.81%), Tibet (25.88%), Guizhou (24.67%), Guangxi (23.56%), and Xinjiang (23.21%) in turn, while the top five provinces with the lowest probability were Shanghai (8.40%), Beijing (9.39%), Hong Kong (10.10%), Macao (10.31%), and Zhejiang (11.70%). If achieving the " Health China 2030" target, the probabilities of premature mortality in Qinghai and Tibet with the highest probability should decline to about 20.17%, and 18.12%, respectively in 2030, while 5.88%, and 6.57% in Shanghai and Beijing, respectively. From 1990 to 2015, the probability of premature mortality of four main NCDs declined by 2.00% a year on average, the top five provinces with the fastest decline were Beijing (3.48%), Shanghai (3.24%), Zhejiang (2.81%), Fujian (2.75%), and Guangdong (2.67%), and 11 provinces including these five provinces could achieve the " Health China 2030" target by the usual rate of decline, while other 22 provinces could not achieve the target, they need greater rate of decline in order to achieve the target. Conclusion: From 1990 to 2015, the probabilities of premature mortality of four main NCDs were declined consistently in China both at national and provincial level, compared with women, the men had higher probabilities and declined slower, there were significant different in probabilities of premature mortality and their change speed among provinces. Based on the results from 1990 to 2015, there were about two thirds of the provinces, which the task of achieving the Health China 2030 target will be daunting.目的：分析1990—2015年中国全国及各省份心脑血管疾病、肿瘤、糖尿病和慢性呼吸系统疾病等四类慢性病早死概率、变化趋势，以及实现"健康中国2030"重大慢性病早死概率下降目标的情况。 方法：利用2015年全球疾病负担研究结果，根据WHO推荐的早死概率计算方法，计算、分析和比较1990—2015年中国全国及各省份（不包括中国台湾数据）不同性别四类慢性病早死概率及其年均变化速度；并以"健康中国2030"重大慢性病早死概率目标——下降30％为标准，评价各省四类慢性病早死概率实现目标的难度。 结果： 1990——2015年中国男性和女性心脑血管疾病、肿瘤和慢性呼吸系统疾病早死概率均呈持续下降的趋势，四类慢性病合计的早死概率由30.69％降至18.54%，女性的下降速度（由25.97％降至12.40%）远快于男性（由34.94％降至24.19%）。2015年四类慢性病早死概率较高的前5位省份依次为青海（28.81%）、西藏（25.88%）、贵州（24.67%）、广西（23.56%）和新疆（23.21%），而较低的前5位依次为上海（8.40%）、北京（9.39%）、香港特别行政区（10.10%）、澳门特别行政区（10.31%）和浙江（11.70%）；如果实现"健康中国2030"目标，2030年早死概率较高的两个省份青海和西藏应分别下降至20.17％和18.12%，而上海和北京则应分别下降至5.88％和6.57%。1990—2015年中国四类慢性病早死概率的年均下降速度为2.00%，下降速度较快的前5个省份依次是北京（3.48%）、上海（3.24%）、浙江（2.81%）、福建（2.75%）和广东（2.67%），且包括这5个省份在内的11个省份按既往下降速度均能实现"健康中国2030"目标，而其他22个省份则无法实现控制目标，需要更大的下降速度才能达标。 结论： 1990—2015年中国全国及各省份四类慢性病早死概率呈持续下降趋势，与女性相比，男性的早死概率较高且下降速度较慢，各省份的四类慢性病早死概率及其变化速度存在着较大差异，根据1990—2015年的数据，约有2/3的省份与实现"健康中国2030"的目标尚有相当距离。.