JMIR Publications

ABSTRACT

Background:

Asthma is a public health problem that affects people all over the world and of all age groups. Understanding the burden of asthma-related premature death is important for formulating evidence-based prevention and treatment strategies.

Objective:

This study aimed to clarify the epidemiology of asthma-related deaths and comorbidities in Shanghai, China.

Methods:

Mortality data were derived from the Vital Statistics System of Pudong New Area (PNA), Shanghai, China, during 2005–2019. Temporal trends for the mortality rates and burden of asthma were analysed. Comorbidities, crude mortality rate (CMR), age-standardised mortality rate by Segi’s world standard population (ASMRW), and years of life lost (YLL) were calculated. The mortality rates related to demographic and non-demographic factors were stratified by the decomposition method.

Results:

A total of 845 asthma-related deaths were recorded. CMR and ASMRW were 2.01/105 and 0.83/105 person-years, respectively. The top comorbidities were heart diseases and respiratory diseases. The YLL was 8693.92 years, and the YLL rate was 20.70/105 person-years. YLL and YLL rate in males (5213.04 years, 24.86/105) were higher than in females (3480.88 years, 16.55/105). The YLL rate decreased in the age groups 0-29, 70-79, and ≥80 years (P<0.01). Although the YLL rate decreased in ≥80 age group, the proportion of population aged 80 and above gradually increased during 2005–2019, due to population aging. The rates of asthma deaths caused by demographic factors increased by 25.01% (95% CI, 12.23% to 39.25%; P=0.001), while non-demographic factors decreased by -9.34% (95% CI, -4.09% to -14.31%; P=0.003).

Conclusions:

Population ageing, comorbidities, early diagnosis and timely treatment may affect long-term changes in asthma-related deaths in the PNA of Shanghai, China. The premature death from asthma is decreasing, probably due to non-demographic factors, such as economic development, living conditions, medical technology, health promotion and so on. However, a significant burden of asthma still exists and will be a long-standing challenge for developing countries, we should make more efforts in the prevention and treatment of asthma in the total population.