Non-communicable disease burden in China, 1990–2023: Evidence from the Global Burden of Disease Study 2023

Abstract Background: Non-communicable diseases (NCDs) are the leading cause of disease burden worldwide. Amid rapid population aging, China faces a substantial NCD burden. This study aimed to assess the NCD burden in China in 2023 using data from the Global Burden of Disease Study 2023. Methods: This study used data from the Global Burden of Disease Study 2023, which covers 31 provinces in Chinese mainland and the Hong Kong and Macao Special Administrative Regions. Age-standardized and all-age mortality and disability-adjusted life year (DALY) rates for NCDs were estimated and compared between 1990 and 2023. Analyses were conducted according to sex, age group, and region. Level 3 NCD causes were ranked according to mortality and DALY rates. Results: NCDs were the major contributor to China’s disease burden in 2023. Cardiovascular diseases (316.08/100,000), neoplasms (180.02/100,000), and chronic respiratory diseases (73.15/100,000) were the leading causes of NCD-related mortality rates. Cardiovascular diseases (6262.68/100,000) and neoplasms (4456.46/100,000) were the top contributors to DALY rates. Age-standardized mortality and DALY rates for major NCDs have declined since 1990; however, the absolute numbers continue to rise because of population aging. Notable increases in disease burden were observed. Compared to 1990, the mortality rate increased by 239.14% and the DALY rate by 77.04% for neurological disorders. For mental disorders, mortality increased by 382.34% and the DALY rate by 25.82%. For musculoskeletal disorders, the DALY rate increased by 48.17%. Geographic disparities persisted, with higher NCD burdens concentrated in the western and northeastern provinces, whereas the more developed eastern regions showed relatively lower rates. Conclusions: NCDs remain the leading cause of disease burden in China and vary significantly by disease type, sex, age, and region. Strengthening prevention, improving the management of high-risk populations, and enhancing data accuracy are essential for more effective and equitable NCD control.