The Effects of Economic Transition on Mortality in Shanghai, China

Much research has linked an increase in adult mortality with the socioeconomic transition of former European socialist societies after 1989. Few studies examine corresponding experiences in China, however. Using the death certificates of Shanghai residents, we examined any such sudden mortality change and crisis when China went through economic transformation. We explored trends in life expectancy at birth and age-specific mortality in Shanghai. We applied Arriaga’s decomposition method to analyze the contributions of specific ages and the causes to the changes in life expectancy. We used harmonic regression models to assess the statistical significance of rising and falling mortality over time. The analysis shows that, coinciding with the economic transition of 1992–1996, the previously steady improvement of life expectancy in Shanghai slowed down. Mortality among working-age males (20–44 years old) increased (P<.001) in Shanghai, largely due to rising cardiovascular disease (CVD) (P<.05) and injury (P<.001). Suicide and liver disease remained stable or fell, while transportation deaths increased in Shanghai. The economic reform in Shanghai seems to include the privatization of state-owned enterprises, economic growth, and initial increases in working-age male mortality in the 1990s