Three decades of population health changes in Japan, 1990–2021: a subnational analysis for the Global Burden of Disease Study 2021

作者：Shuhei Nomura, Michio Murakami, Santosh Kumar Rauniyar, Naoki Kondo, Takahiro Tabuchi, Haruka Sakamoto, Yasuharu Tokuda, Nishali Patel, José Miguel León Pablo, Joseph L. Dieleman, Angela Ya-Ping Chang, Vegard Skirbekk, Sarah Krull Abe, Norito Kawakami, Erika Ota, Scott Glenn, Chimedsuren Оchir, Hiroaki Miyata, Manami Inoue, Kenji Shibuya, Isaac Yeboah Addo, Mohammed Ahmed Akkaif, Syed Mahfuz Al Hasan, Waad Ali, Mohammad Sami Al-Wardat, Hany Mohamed Aly, Anayochukwu Edward Anyasodor, Jalal Arabloo, Ahmed Y. Azzam, Kavita Batra, Sonu M. M. Bhaskar, Samuel Adolf Bosoka, Ester Cerin, Vijay Kumar Chattu, Dong‐Woo Choi, Bryan Chong, Samuel Demissie Darcho, Nicole Davis Weaver, Kuldeep Dhama, Robert Kokou Dowou, Temitope Cyrus Ekundayo, Ibrahim Farahat El Bayoumy, Pietro Ferrara, Nuno Bravo Ferreira, Takeshi Fukumoto, Xiang Gao, Samer Hamidi, Simon Iain Hay, Yuta Hiraike, Mehdi Hosseinzadeh, Nayu Ikeda, Arit Inok, Md. Rabiul Islam, Masao Iwagami, Ammar Abdulrahman Jairoun, Mihajlo B Jakovljevic, Inn Kynn Khaing, Mohammad Jobair Khan, Atulya Aman Khosla, Tea M. Lallukka, Thao T. Le, Munjae Lee, Seung Won Lee, Wei‐Chen Lee, Raimundas Lunevičius, Medha Mathur, Hadush Negash Meles, Mohammadreza Mobayen, Jama Mohamed, Abdollah Mohammadian-Hafshejani, Yanjinlkham Munkhsaikhan, Christopher J L Murray, Ganesh R. Naik, Samidi Nirasha Kumari Navaratna, Phuong The Nguyen, Dieta Nurrika, Bogdan Oancea, Michael Safo Oduro, Takayoshi Ohkubo, Osaretin Christabel Okonji, Sok King Ong, Mahesh Padukudru P A, Jagadish Rao Padubidri, Romil R Parikh, Sungchul Park, Mahmoud Mohammed Ramadan, Shakthi Kumaran Ramasamy, Sheena Ramazanu, Elrashdy M Moustafa Mohamed Redwan, Taeho Greg Rhee, Cameron John Sabet, Vijaya Paul Samuel, Jennifer Saulam, Mohammad Ali Shamshirgaran, Premalatha K Shetty, Mika Shigematsu, Aminu Shittu, Emmanuel Edwar Siddig, Zhong Sun, Chandan Kumar Swain, Ruri Syailendrawati, Sree Sudha Tanguturi Yella, Jabeen Taiba, Masayuki Teramoto, Ngoc Ha Tran, Nguyen Tran Minh Duc, Dominique Vervoort, Muhammad Salman Waqas, Kazumasa Yamagishi, Yuichiro Yano, Yuichi Yasufuku, Dong Keon Yon, Naohiro Yonemoto, Iman Zare, Zhiqiang Zhang, Hanqing Zhao, Claire Chenwen Zhong, Mohsen Naghavi · 发表于：The Lancet Public Health · 年份：2025 · DOI：10.1016/s2468-2667(25)00044-1 · 被引用次数：34 · 研究领域：COVID-19 and healthcare impacts、Insurance, Mortality, Demography, Risk Management、Health disparities and outcomes

BACKGROUND: Given Japan's rapidly ageing demographic structure, comprehensive and long-term evaluations of its national and subnational health progress are important to inform public health policy. This study aims to assess Japan's population health, using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to analyse the country's evolving disease patterns. METHODS: GBD 2021 used Japanese data from 1474 sources, covering 371 diseases, including COVID-19, and 88 risk factors. The analysis included estimates of life expectancy, mortality, and disability-adjusted life-years (DALYs). Estimates were generated using the standardised GBD methodology, which incorporates various data sources through statistical modelling, including the Cause Of Death Ensemble Model for mortality, Bayesian Meta-Regression Disease Model for non-fatal outcomes, and risk factor estimation frameworks to quantify attributable burdens. Life expectancy decomposition by cause of death and annualised rates of change of age-standardised mortality and DALYs were calculated for 1990-2005, 2005-15, and 2015-21. FINDINGS: Between 1990 and 2021, life expectancy in Japan rose from 79·4 years (95% uncertainty interval 79·3-79·4) to 85·2 years (85·1-85·2), with prefecture-level disparities widening. Gains were primarily driven by reduced mortality from stroke (adding 1·5 years to life expectancy), ischaemic heart disease (1·0 years), and neoplasms, particularly stomach cancer (0·5 years), with va...