Abstract
BACKGROUND: Asthma prevalence in China has risen due to rapid industrialization, environmental changes, and improved diagnostics. While efforts in asthma control have expanded nationwide, research on asthma-related mortality remains limited. Understanding death patterns from asthma is important to identify key regions and populations at risk, and to support more effective prevention and treatment strategies suitable for China's population and healthcare system. METHODS: We conducted a retrospective study using China CDC's DSPs data, stratifying asthma mortality by sex, region, urban-rural residence, and age. This is a nationwide population and mortality survey study, including data on the total surveyed population and deaths from 2008 to 2021, covering approximately 25% of the total population. Trend analysis was conducted on the total surveyed population stratified by age, sex, and region to explore patterns of mortality changes. Based on mortality trend changes, decomposition analysis of asthma mortality and future trend projections considering population changes were performed to further identify key regions and populations. RESULTS: Asthma mortality in China showed significant regional variation, with higher rates in the southwestern region and lower rates in northern and coastal regions. The crude mortality rate of asthma in China (2008-2021) generally decreased, especially in the older population (33.8% decline), but increased in individuals aged 15-19 in recent years. Mortality rates peaked around 2015 and then declined annually. Geographically, the most substantial decline rate was observed in the eastern region (10.5% decline), followed by the central region (8.1% decline). However, the decline rate in the western region was less pronounced and even displayed an upward trend, particularly in urban areas. Both decomposition analysis and BAPC analysis revealed an unclear mortality trend in urban areas of the western region, while mortality declined in the eastern and central regions. CONCLUSION: The asthma mortality rate in China has experienced a comprehensive decline over the past decade. However, rates in certain groups, like the older population and those in western China, remained higher than the global average, while in the youth population a slight upward trend was observed. Addressing these disparities is crucial for future efforts.