Urban-rural disparities in injury mortality in China, 2002–2021

Injury represents a major public health concern both globally and in China, with persistent urban-rural disparities posing a particular challenge for injury prevention. This study examined urban-rural disparities in injury mortality in China using the latest official data (2002–2021), stratified by age, sex, and cause of injury. Data were collected from the most recent available Chinese Health Statistics Yearbooks. Urban and rural injury mortality rates were analyzed by sex, age group, and external cause of injury. Temporal changes in rural-to-urban mortality rate ratios were assessed using annual percent change (APC) and average annual percent change (AAPC) estimated by Joinpoint regressions. From 2002 to 2021, age-standardized injury mortality rates were generally higher in rural areas than in urban areas of China. Rural-to-urban mortality ratios ranged from 1.07 to 2.37, with no significant temporal changes in the overall disparity magnitude. Similar patterns were observed across sex and age groups. The urban-rural disparity was mainly a result of disparities in transport-related injuries, suicide, and falls, although cause-specific urban-rural disparities were most pronounced for suicide and drowning. The urban-rural gap widened significantly over the study period for falls and poisoning. Persistent urban-rural disparities in injury mortality highlight the need for targeted, context-specific injury prevention strategies in rural areas. Strengthening injury prevention efforts nationwide is essential for advancing health equity in China.