Objective: To analyze the trend of child and adolescent mortality rate in China from 2004 to 2018 and explore the possible policy effects. Methods: This study used the mortality data of child and adolescent aged 5 to 19 years from 2004 to 2018 based on the National Disease Surveillance System. Age-standardized mortality rate was calculated by using the population from the sixth national census. Joinpoint regression was used to analyze the trend of child and adolescent mortality with different features from 2004 to 2018. Results: From 2004 to 2018, the overall mortality rate of children and adolescents in China dropped from 40.02 per 100 000 to 22.00 per 100 000, and the average annual percentage change (AAPC) was -4.28 (95%CI:-5.35,-3.20,P<0.001). The mortality rate dropped rapidly from 2004 to 2006, and the annual percentage change (APC) was -9.20 (95%CI:-15.63,-2.28,P=0.017). The decline rate slowed down between 2006 and 2013, and the APC was -1.56 (95%CI:-2.78,-0.33,P=0.020). The downward trend accelerated from 2013 to 2018, and the APC was -5.99 (95%CI:-7.52,-4.43,P<0.001). The trend of child mortality rate in rural area, females, eastern provinces of China, children aged 10 to 14 years, children aged 15 to 19 years, and injury mortality rate were basically consistent with the overall trend. The child mortality rate in urban area, central provinces of China and the mortality rate of infectious diseases, maternal and infant, and nutritional deficiencies diseases showed a uniform downward trend from 2004 to 2018, with AAPC values about -3.59 (95%CI:-4.38,-2.78,P<0.001), -2.89 (95%CI:-3.24,-2.54,P<0.001) and -6.66 (95%CI:-7.64,-5.68,P<0.001), respectively. Conclusion: The mortality rate of children and adolescents aged 5 to 19 years in China continues to decline from 2004 to 2018, and the decline rate becomes faster after 2011.
目的： 分析2004—2018年中国儿童青少年死亡率变化趋势，探索可能的政策效应。 方法： 基于全国疾病监测系统得出的2004—2018年间5~19岁儿童青少年死亡率数据，采用第六次全国人口普查提供的分年龄段人口数计算标化死亡率，使用Joinpoint回归分析2004—2018年不同特征儿童青少年死亡率变化趋势。 结果： 2004—2018年，中国儿童青少年整体死亡率由40.02/10万下降到22.00/10万，平均年变化百分比（AAPC）为-4.28（95%CI：-5.35，-3.20，P<0.001）；2004—2006年间死亡率的年变化百分比（APC）为-9.20（95%CI：-15.63，-2.28，P=0.017）；2006—2013年间死亡率下降速率放缓，APC值为-1.56（95%CI：-2.78，-0.33，P=0.020）；2013—2018年间死亡率再次快速下降，APC值为-5.99（95%CI：-7.52，-4.43，P<0.001）。女生、乡村、东部地区、10~14岁、15~19岁儿童青少年死亡率以及伤害死亡率的变化趋势与整体基本一致；城市、中部地区儿童青少年死亡率和感染性、母婴及营养缺乏性疾病的死亡率在2004—2018年间下降速率呈均匀下降趋势，其AAPC值分别为-3.59（95%CI：-4.38，-2.78，P<0.001）、-2.89（95%CI：-3.24，-2.54，P<0.001）和-6.66（95%CI：-7.64，-5.68，P<0.001）。 结论： 2004—2018年中国5~19岁儿童青少年死亡率持续下降，且在2011年后下降速率变快。.