Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 5, 13

Rural-urban Differentials of Premature Mortality Burden in South-West China


Rural-urban Differentials of Premature Mortality Burden in South-West China

Le Cai et al. Int J Equity Health.


Background: Yunnan province is located in south western China and is one of the poorest provinces of the country. This study examines the premature mortality burden from common causes of deaths among an urban region, suburban region and rural region of Kunming, the capital of Yunnan.

Methods: Years of life lost (YLL) rate per 1,000 and mortality rate per 100,000 were calculated from medical death certificates in 2003 and broken down by cause of death, age and gender among urban, suburban and rural regions. YLL was calculated without age-weighting and discounting rate. Rates were age-adjusted to the combined population of three regions. However, 3% discounting rate and a standard age-weighting function were included in the sensitivity analysis.

Results: Non-communicable diseases contributed the most YLL in all three regions. The rural region had about 50% higher premature mortality burden compared to the other two regions. YLL from infectious diseases and perinatal problems was still a major problem in the rural region. Among non-communicable diseases, YLL from stroke was the highest in the urban/suburban regions; COPD followed as the second and was the highest in the rural region. Mortality burden from injuries was however higher in the rural region than the other two regions, especially for men. Self-inflicted injuries were between 2-8 times more serious among women. The use of either mortality rate or YLL gives a similar conclusion regarding the order of priority. Reanalysis with age-weighting and 3% discounting rate gave similar results.

Conclusion: Urban south western China has already engaged in epidemiological pattern of developed countries. The rural region is additionally burdened by diseases of poverty and injury on top of the non-communicable diseases.


Figure 1
Figure 1
Comparison of male age-specific mortality in three regions.
Figure 2
Figure 2
Comparison of female age-specific mortality in three regions.

Similar articles

See all similar articles

Cited by 7 PubMed Central articles

See all "Cited by" articles


    1. World Development Report 1993: investing in health. New York: Oxford University Press; 1993.
    1. Fan SG, Zhang LX, Zhang XB. Growth, Ineqyality, and Povety in Rural China: the Role of Public Investments. IFPRI Research Report 125. 2002.
    1. Yu DZ. Changes in Health Care Financing and Health Status: The Case of China in the 1980s. Economic Policy Series, No 34, International Child Development Centre, UNICEF; 1992.
    1. Wu SL, Zhu AR. The direction and method to allocate health resources for Chinese government. Journal of Chinese Rural Health Management. 1999;19:33–34.
    1. Yunnan Statistical Yearbook: 2004 . Compiled by Yunnan Province Statistical Bureau. Beijing: China Statistics Press; 2005.

LinkOut - more resources