目的 分析2009—2019年间不同地区5岁以下儿童意外伤害死亡率变化情况,为明确降低5岁以下儿童死亡率的工作重点和制定儿童意外伤害预防策略提供科学依据。方法 收集2009—2019年儿童因意外伤害死亡数据,利用Joinpoint Regression程序对儿童意外伤害死亡率进行对数线性回归分析。结果 2009—2019年中国<1岁组和1~<5岁组儿童意外伤害死亡率下降幅度低于总死亡率。城市1~<5岁儿童意外伤害死亡率(AAPC=-4.3%,P<0.05)下降幅度低于农村(AAPC=-7.4%,P<0.001)。城市和农村<1岁组儿童意外伤害致死占总死因构成比虽较小,但都处于上升的趋势。东部城市1~<5岁儿童意外伤害死亡率(AAPC=-4.1%,P<0.05)下降幅度低于西部城市(AAPC=-5.7%,P<0.05)。东部城市<1岁组儿童与1~<5岁组儿童意外伤害占总死因构成比在2013年以后都有上升趋势。东部城市1~<5岁儿童跌落死亡率从2009年的0.200/105上升到2019年的1.313/105(AAPC=23.7%,P<0.001)。结论 在继续做好农村儿童意外伤害预防的同时,还要加强城市儿童意外伤害的预防;需提升东部城市儿童意外伤害预防的关注力度,尤其是东部城市<1岁儿童的道路交通伤害,1~<5岁儿童的跌落伤害。
Abstract
Objective To understand and analyze the trends of unintentional injury deaths of children under 5 years old in different regions during 2009-2019, so as to provide scientific basis for clarifying priorities for reducing the mortality of children under 5 years of age and formulating child unintentional injury prevention strategies. Method Data on childhood deaths due to unintentional injuries from 2009-2019 were collected and analyzed by log-linear regression using the Joinpoint Regression procedure for childhood unintentional injury mortality. Results During 2009-2019, the mortality rate of unintentional injuries among children < 1 year old and aged 1 to <5 years in China decreased less than the overall mortality rate. The decrease of unintentional injury mortality among children aged 1 to <5 years in urban areas (AAPC= -4.3%, P<0.05) was less than that in rural areas (AAPC=- 7.4%, P<0.001). The proportion of unintentional injury death in the total cause of death of children < 1 year old in urban and rural areas was on the rise, although it was small. The rate of death from unintentional injuries among children aged 1 to <5 years in eastern cities (AAPC=-4.1%, P<0.05) decreased less than that in western cities (AAPC=-5.7%, P<0.05). The composition ratio of unintentional injuries to total causes of death for children in the <1 year old group and children in the 1 to <5 years old group in the eastern cities both tended to increase after 2013. The fall mortality rate among children aged 1 to <5 years in eastern cities increased from 0.200/105 in 2009 to 1.313/105 in 2019 (AAPC = 23.7%, P < 0.001). Conclusions While continuing to do a good job of preventing unintentional injuries among rural children, there is a need to strengthen the prevention of unintentional injuries among urban children. The attention to the prevention of unintentional injuries among children in eastern cities needs to be increased, especially road traffic injuries among children under 1 year old and fall injuries among children aged 1 to <5 years.
关键词
5岁以下儿童 /
意外伤害 /
死亡率
Key words
children under 5 years old /
unintentional injuries /
mortality
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] World Health Organization. World report on child injury prevention[M]. Geneva: WHO,2008.
[2] Ozanne-Smith J, Li Q. A social change perspective on injury prevention in China[J]. Inj Prev,2018, 24 (Suppl 1): i25-i31.
[3] Cao H, Wang J, Li YC, et al. Trend analysis of mortality rates and causes of death in children under 5 years old in Beijing, China from 1992 to 2015 and forecast of mortality into the future:An entire population-based epidemiological study[J]. BMJ Open, 2017,7(9): 015941.
[4] 妇幼健康司. 中国妇幼健康事业发展报告(2019)[EB/OL].http://www.nhc.gov.cn/fys/s7901/201905/bbd8e2134a7e47958c5c9ef032e1dfa2.shtml.
[5] 杨柳,张建新,李春荣,等.2005—2014年成都市5岁以下儿童意外死亡情况分析[J].中国儿童保健杂志,2017,25(2):194-197.
Yang L, Zhang JX, Li CR, et al. Analysis of accidental mortality in children under five years old in Chengdu, China from 2005 to 2014[J]. Chin J Child Health Care, 2017,25(2):194-197.(in Chinese)
[6] Sun L, Shao Y, Xu R, et al. Unintentional injury deaths among children under five in Suzhou during 2016-2020[J]. J Pub Health Prev Med, 2022, 33(1):85-89.
[7] Wang L, Cheng X, Yin P, et al. Unintentional drowning mortality in China, 2006—2013[J]. Inj Prev, 2019, 25:47-51.
[8] Wang L, Wu Y, Yin P, et al. Poisoning deaths in China, 2006—2016[J]. Bull World Health Organ, 2018, 96:314-326.
[9] Byard RW. SIDS or suffocation-The problem continues[J]. Acta Paediatr, 2021,110(1):364.
[10] Kim HJ, Fay MP,Feuer EJ,et al. Permutation tests for joinpoint regression with applicat-ions to cancer rates[J]. Stat Med,2000,19(3):335-351.
[11] 姜玉,孙源樵,周鹏,等.学龄前儿童居家环境安全防护用品使用现况及影响因素分析[J].中国儿童保健杂志,2018,26(10):1151-1154.
Jiang Y, Sun YQ, Zhou P, et al. Analysis of the current status and influencing factors of safety protection products use in preschool children[J]. Chin J Child Health Care, 2018,26(10):1151-1154.(in Chinese)
[12] 余长缨,陈虹杏,王午喜.重庆市南岸区茶园片区在园留守儿童健康状况调查[J].中国儿童保健杂志,2017,25(9):954-957.
Yu CY, Chen HX, Wang WX. Physical health investigation of the unattended children in the garden in Chayuan area, Nanan district, Chongqing[J]. Chin J Child Health Care, 2017,25(9):954-957.(in Chinese)
[13] 段成荣,吕利丹,王宗萍,等.我国流动儿童生存和发展:问题与对策-基于2010年第六次全国人口普查数据的分析[J].南方人口,2013,28(4):44-55,80.
Duan CR, Lv LD, Wang ZP, et al. The survival and development status of floating children in China: An analysis of the sixth population census data[J]. South China Poplation, 2013,28(4):44-55,80.(in Chinese)
[14] 孙丽,邵琰,徐蓉,等.2016—2020年苏州市5岁以下儿童意外伤害死亡特征和原因分析[J].公共卫生与预防医学,2022,33(1):85-89.
Sun L, Shao Y, Xu R, et al. Unintentional injury deaths among children under five in Suzhou during 2016—2020[J]. J Pub Health Prev Med, 2022,33(1):85-89.(in Chinese)
[15] 姜玉, 夏庆华, 周鹏,等. 0~3 岁儿童的父母有关儿童乘车安全相关知识和行为调查[J]. 中华疾病控制杂志, 2015, 19(1):31-34.
Jiang Y, Xia QH, Zhou P, et al. Investigation on child passengers′ safety related knowledge and practice among parents of child aged 0 - 3[J]. Chin J Dis Control Prev, 2015, 19(1):31-34.(in Chinese)
基金
国家自然科学基金(71974037,71573049)