Background Avoidable mortality (AM) refers to deaths preventable through effective prevention measures or timely medical treatment, and reducing AM is crucial for improving child survival rates. We conducted an analysis of the situation and temporal trends of AM among under-five (U5) children in China. Methods Data were extracted from the China Death Surveillance Dataset. The Joinpoint regression and multivariate linear regression were used. Results The AM rate among U5 children decreased from 233.99/100,000 in 2004 to 34.54/100,000 in 2021, with an average annual percentage change of −10.72% (−11.90%, −9.98%). The proportion of AM generally showed a downward trend, with urban-rural disparities observed particularly evident by year-end 2021. Perinatal mortality is declining at an average rate of 9.75% per year, the proportion of perinatal deaths to all deaths has not changed significantly, and even the proportion of deaths caused by birth injury and suffocation has increased (annual percent change: 0.95%, 95% CI:0.39% to 1.59%). For boys and girls aged 1-5 years, the leading causes of death are drowning and land transport accidents, respectively, with the incidence of drowning in rural areas being higher than in urban areas. Conclusions China has reduced AM in U5 children, but rural areas still need targeted interventions to address preventable deaths and achieve Sustainable Development Goals. Impact <UnorderedList Mark="Bullet"> <ItemContent> Avoidable mortality among children under-five in China decreased by an average of 10.72% between 2004 and 2021, with urban-rural differences. </ItemContent> <ItemContent> Perinatal mortality declined by 9.75% annually, but the proportion of perinatal deaths remained stable, while deaths from birth injury and suffocation increased. </ItemContent> <ItemContent> For boys aged 1–5 years, drowning is the leading avoidable cause of death, while for girls, it is land transport accidents, with drowning more prevalent in rural areas. </ItemContent> <ItemContent> Increasing health technicians in rural areas may narrow the rural-urban gap, with targeted interventions needed for birth injury and suffocation, drowning, and land transport accidents. </ItemContent> </UnorderedList>

Temporal trends of avoidable mortality among children under-five in China from 2004 to 2021

期刊论文
发表日期：

2025年3月7日

查看全文

You-xiang Wang,
Yao-dong Zhang,
Yi-ran Wang,
Yu-wei Hou,
Kai-juan Wang

摘要

Background

Avoidable mortality (AM) refers to deaths preventable through effective prevention measures or timely medical treatment, and reducing AM is crucial for improving child survival rates. We conducted an analysis of the situation and temporal trends of AM among under-five (U5) children in China.

Methods

Data were extracted from the China Death Surveillance Dataset. The Joinpoint regression and multivariate linear regression were used.

Results

The AM rate among U5 children decreased from 233.99/100,000 in 2004 to 34.54/100,000 in 2021, with an average annual percentage change of −10.72% (−11.90%, −9.98%). The proportion of AM generally showed a downward trend, with urban-rural disparities observed particularly evident by year-end 2021. Perinatal mortality is declining at an average rate of 9.75% per year, the proportion of perinatal deaths to all deaths has not changed significantly, and even the proportion of deaths caused by birth injury and suffocation has increased (annual percent change: 0.95%, 95% CI:0.39% to 1.59%). For boys and girls aged 1-5 years, the leading causes of death are drowning and land transport accidents, respectively, with the incidence of drowning in rural areas being higher than in urban areas.

Conclusions

China has reduced AM in U5 children, but rural areas still need targeted interventions to address preventable deaths and achieve Sustainable Development Goals.

Impact

Avoidable mortality among children under-five in China decreased by an average of 10.72% between 2004 and 2021, with urban-rural differences.

Perinatal mortality declined by 9.75% annually, but the proportion of perinatal deaths remained stable, while deaths from birth injury and suffocation increased.

For boys aged 1–5 years, drowning is the leading avoidable cause of death, while for girls, it is land transport accidents, with drowning more prevalent in rural areas.

Increasing health technicians in rural areas may narrow the rural-urban gap, with targeted interventions needed for birth injury and suffocation, drowning, and land transport accidents.