Non-communicable diseases (NCDs) have increasingly become a significant global public health challenge and a leading cause of premature death. Research has shown that a higher density of healthcare workers can reduce the overall burden of disease. This study explores the association between the density of human resources for health (HRH) and the burden of NCDs. We utilized the data on disability-adjusted life years (DALYs) for NCDs from 2010 to 2019 in the 2019 Global Burden of Disease Database (GBD) provided by the Institute for Health Metrics and Evaluation (IHME). Meanwhile, data from the World Health Organization (WHO) regarding the number of medical doctors, nursing and midwifery personnel, and pharmaceutical personnel (per 10,000 population) over the same period was also available. Covariates were sourced from the World Bank Database. We analyzed the association between the density of health human resources and DALYs for NCDs based on ordinary least squares (OLS) regression and panel regression models. Additionally, we examined the correlation between human resource density for health and the burden of NCDs across countries with different income levels to assess heterogeneity. The density of medical doctors (coefficient = -4.543, P < 0.001) and pharmaceutical personnel (coefficient = -8.721, P < 0.001) was found to be negatively correlated with the burden of NCDs. An increase of one point in the density of medical doctors per 10,000 population will, on average, reduce the burden of NCDs by 4.543 points (95

Background:In the present study, telemedicine volume is considered in a bounded measurement sense: as an administratively registered count of remote care activity whose relationship to access expansion requires separate assessment. Its interpretation remains uncertain in a territorially uneven environment, where territorial digital readiness and the resource configuration of the ambulatory sector shape the infrastructural-resource context, while the reporting regime affects the composition of the registered flow. The study assessed regional proxies of ambulatory contact and structural capacity; the national Russian Federation-year series was examined separately as a measurement signal sensitive to the composition of the reported flow and its temporal stability. Methods:An observational regional panel study used official data for 85 Russian territories in 2018-2024, comprising 595 region-year observations. Sources were Rosstat/EMISS and Form No. 30. Outcomes were physician visits per 1,000 population, treated as the realized contact intensity (RCI) proxy, and ambulatory care organization (ACO) capacity per 10,000 population, treated as the structural capacity of ambulatory care (SCA) proxy; both were aggregated regional proxies, without extrapolation to individually realized access. The digital environment was measured using the Digital Infrastructure Index (DII). Analyses included descriptive diagnostics, correlations, two-way fixed effects (TWFE) models, and first-differences (FD) models; the national series was analyzed separately for measurement sensitivity. Results:Digital-environment associations with ambulatory indicators were expressed mainly interregionally. The DII-physician visit association changed from +0.258 in the pooled specification to -0.031 after two-way centering; the association with ACO capacity shifted from +0.087 to -0.003. The national telemedicine series increased from 0.39-0.68 million consultations in 2018-2019 to 7.00 million in 2020 and 15.94 million in 2024. The patient-physician share reached 0.919 in 2020 and declined to 0.496 in 2024. Conclusions:In the Russian regional context, growth in telemedicine volume is insufficient to interpret telemedicine as an autonomous mechanism for equalizing access. It should be read as a bounded monitoring signal: territorial digital context and ambulatory-sector resource configuration define interpretation, while contact modality and the comparability of reporting definitions impose further inferential limits. Digital health monitoring should link telemedicine counters to patient-pathway segments, distinguishing remote-channel scaling from factual expansion of realized access.

Since children's participation in social health insurance (SHI) in China is voluntary, fluctuations in enrollment or dropout are inevitable. Using data from the two waves of the China Family Panel Study in 2020 and 2022, this study aims to examine these participation dynamics and their impact on children's health service utilization and medical expenses. Specifically, a balanced panel of 1958 children under the age of 15 was constructed, first-difference and difference-in-difference models were employed to assess the factors influencing children's SHI enrollment or dropout, as well as the impact of these changes on health service utilization and medical expenses. Robustness checks were conducted after excluding new enrollees and dropouts separately. Our analysis showed that between 2020 and 2022, 263 children (13.4%) were newly enrolled in SHI, while 135 (6.9%) dropped out. Maternal SHI enrollment increased the likelihood of children's enrollment and reduced the probability of dropout. Children with commercial insurance were 34% less likely to enroll and 58% more likely to dropout. Compared to children with unchanged participation status, newly enrolled children were about 8% more likely to use outpatient services and had 77% higher medical expenses in the past year, whereas no significant changes were observed among those who dropped out. These findings highlight the dynamic nature of children's SHI participation in China and suggest that passive enrollment policies and parental participation could help promote universal coverage. Improving the reimbursement system, particularly for children's outpatient care, is also recommended.

The goals of medical insurance fund supervision will influence the selection of supervisory methods and their effectiveness. This study aims to identify the multiple goals of China’s medical insurance fund supervision and to examine the hierarchy and proximity among these goals. 133 national-level policies related to the goals of medical insurance fund supervision in China were selected. Frequency ranking and social network analysis were used to explore the hierarchical relationships among these goals. The Ochiai coefficient in the similarity matrix was used to assess the proximity. Clustering analysis was performed via the generation of a dendrogram, while multidimensional scaling was applied to validate the clustering results. Fund security was the most frequently cited goal (11.01

This article examines the association between population density, maternal mortality, and under-5 mortality in countries throughout the world, as well as the mediating impacts of the Universal Health Coverage Service Coverage Index (UHC-SCI). The World Health Organization’s website provided data on maternal mortality and the Universal Health Coverage Service Coverage Index for the years 2000–2020. The World Bank database included information on population density and under-5 mortality rates for nations between 2000 and 2020. Panel regressions were used to examine the association between population density and maternal and under-5 mortality in each nation, as well as the mediating influence of the Universal Health Coverage Service Coverage Index, while accounting for economic, environmental, and medical factors. Finally, data is divided into regressions based on World Bank member countries’ income levels to examine heterogeneity. The study included 175 countries and found a significant negative correlation between population density, maternal mortality, and under-5 mortality (B = -1.015, -1.146, P < 0.05). The Universal Health Coverage Service Coverage Index mediated this relationship (B = -1.044, -1.141, P < 0.05). Increasing population density in countries around the world has helped to reduce maternal and child mortality. As population density has increased, so has the level of the Universal Health Coverage Service Coverage Index, which has proven effective in lowering maternal and under-5 mortality. Governments should plan interventions to build basic health facilities and allocate resources to health services based on population density, level of economic development, and the current state of their health systems, with the goal of stabilizing the rate of change in maternal and under-5 mortality and, eventually, achieving the Sustainable Development Goals.

Background Medical surge capacity is the ability of a medical institution to meet peak medical demand during an emergency. This study aims to explore strategies for enhancing medical surge capacity in future emergency responses to better safeguard public safety. Methods A double-case comparative analysis was conducted focusing on the characteristics and responses to the medical surge during the COVID-19 outbreak in Shanghai and the nationwide epidemic in China. Results Medical surges can be categorized into "single-point surges" and "multi-point surges". While there are differences between the two, they also share many similarities. The experiences of Shanghai and China demonstrated that medical surge capacity involves more than expanding resources. It also demands coordinated management of patient monitoring and triage, information sharing, treatment process optimization, and safety maintenance. Conclusions Enhancing medical surge capacity requires the integration of surge identification, surge diversion, and resource security. Surge identification entails the timely recognition and classification of patients. Surge diversion involves directing patients to appropriate medical institutions based on this classification. Resource security supports effective surge diversion by promoting mutual assistance among medical institutions and enabling flexible adjustments to their functions.

The identification of the benefits of the medical insurance system (IBMIS) serves as an important indicator of the effectiveness of medical insurance policy implementation and provides valuable feedback during the ongoing reform phase of the medical insurance system (MIS). This research aims to analyze the IBMIS from the perspective of medical insurance-related professionals and to identify potential associate factors with IBMIS. In 2021, we conducted a cross-sectional questionnaire survey (n = 1829) in Heilongjiang Province, located in Northeast China, to collect data. Interviewees were selected using a multi-stage stratified cluster random sampling method. A binary logistic regression model was employed to identify the factors influencing the IBMIS. Overall, 66

BACKGROUND:The mechanisms connecting childhood socioeconomic status (SES) to later-life depression remain underexplored. This study aims to examine the mediating roles of education level and subjective social status (SSS) between childhood SES and later-life depression among middle-aged and older adults in China, with a focus on potential gender differences. METHODS:5485 individuals aged 45 years and older from the 2022 China Family Panel Study were selected for analysis. Depression was assessed via the short form of the Center for Epidemiological Studies Depression Scale. Childhood SES was derived through principal component analysis. The bootstrap program was used to test the chained mediation effects. RESULTS:The average depression score among the participants was 6.00 ± 4.365. Childhood SES, education level, and subjective social status were negatively associated with depression (P < 0.05). The chain mediation effect was significant for all participants, with education level exhibiting a 2.4 times stronger mediating effect in women than in men. Additionally, a negative correlation was observed between participants' education level and their present SSS (P < 0.05), which contributed to a positive chain-mediated effect that links childhood SES to depression (Effect = 0.011, 95%CI = 0.006 to 0.016). LIMITATIONS:Retrospective self-reported data and a cross-sectional design. CONCLUSIONS:Poorer childhood SES was associated with an increased risk of later-life depression in middle-aged and older adults, and this relationship can be partially explained by education level and subjective social status. Attention should be given to those with poor childhood SES to improve their subjective perception of social status along with educational attainment.

Emotional support, as a key component of social support, may influence the health of floating elderly individuals. This study aims to examine the characteristics of emotional support networks and assess their impact on health-related quality of life (HRQoL) among the floating elderly, with a focus on gender differences. Data were collected through questionnaires from 2,330 floating elderly in Beijing and Nanjing, China. HRQoL was measured using the EuroQol 5-Dimensions 3-Level scale, while emotional support network characteristics were assessed in terms of size, density, composition, heterogeneity, and convergence. Tobit regression models were employed to analyze the impact of emotional support networks on HRQoL. The mean HRQoL of the participants was 0.884 ± 0.138, with females reporting higher utility values than males (P < 0.05). Emotional support network size was negatively associated with HRQoL (P < 0.01), whereas a larger number of kin members and greater age convergence had positive effects (P < 0.01). Compared to males, higher network density (β=-0.073, P < 0.05) and greater educational heterogeneity (β=-0.116, P < 0.01) were associated with lower HRQoL of female elderly. The overall HRQoL of floating elderly individuals was relatively good. Their emotional support networks were generally “small in size and high in density”, with greater convergence than heterogeneity. A large emotional support network may not be necessary, and priority attention should be given to those lacking kin-based emotional support. It is also crucial to emphasize the role of peers and consider gender differences when designing emotional support networks for the floating elderly.

Background/Objectives: Artificial intelligence is rapidly permeating the field of psychiatry. It offers novel avenues for the diagnosis, treatment, and prediction of mental health disorders. This structured review aims to consolidate current approaches to the application of AI in telepsychiatry. In addition, it evaluates their technological maturity, clinical utility, and ethical–legal robustness. Methods: A systematic search was conducted across the PubMed, Scopus, and Google Scholar databases for the period spanning 2015 to 2025. The selection and analysis processes adhered to the PRISMA 2020 guidelines. The final synthesis included 44 publications, among which 14 were empirical studies encompassing a broad spectrum of algorithmic approaches—ranging from neural networks and natural language processing (NLP) to multimodal architectures. Results: The review revealed a wide array of AI applications in telepsychiatry, encompassing automated diagnostics, therapeutic support, predictive modeling, and risk stratification. The most actively employed techniques include natural language and speech processing, multimodal analysis, and advanced forecasting models. However, significant barriers to implementation persist—ethical (threats to autonomy and risks of algorithmic bias), technological (limited generalizability and a lack of explainability), and legal (ambiguous accountability and weak regulatory frameworks). Conclusions: This review underscores a growing disconnect between the rapid evolution of AI technologies and the institutional maturity of tools suitable for scalable clinical integration. Despite notable technological advances, the clinical adoption of AI in telepsychiatry remains limited. The analysis identifies persistent methodological gaps and systemic barriers that demand coordinated efforts across research, technical, and regulatory communities. It also outlines key directions for future empirical studies and interdisciplinary development of implementation standards.

IntroductionEmergency drills are critical practices that can improve the preparedness for crisis situations. This study aims to comprehend the evaluation of emergency drill effectiveness by the staff at the Centers for Disease Control and Prevention (CDC) in Heilongjiang Province, China. It identifies potential factors that could influence the personnel’s appraisal of outcomes throughout the emergency drill procedure.MethodsA cross-sectional survey was conducted among public health professionals from various CDCs in Heilongjiang, a northeastern Chinese province. The binary logistic regression analysis identified the factors associated with the CDC staff’s assessment of emergency drill efficacy, while the Interpretative Structural Modeling (ISM) elucidated the hierarchical structure among the influencing factors.Results53.3% (95% CI = 50.6–55.4) of participants perceived the emergency drills’ effectiveness as low. Binary logistic regression analysis revealed that the following adverse factors associated with the emergency drills increased the risk of a lower evaluation: lack of equipment and poor facilities (OR = 2.324, 95% CI = 1.884–2.867), poor training quality (OR = 1.765, 95% CI = 1.445–2.115), low leadership focus (OR = 1.585, 95% CI = 1.275–1.971), insufficient training frequency (OR = 1.539, 95% CI = 1.258–1.882), low skill in designing emergency drill plans (OR = 1.494, 95% CI = 1.180–1.890), lack of funding (OR = 1.407, 95% CI = 1.111–1.781), and poor coordination between departments (OR = 1.335, 95% CI = 1.085–1.641). The ISM revealed the hierarchical relationship of the influential factors, which were classified into three levels: Surface, Middle and Bottom. The Surface Level factors were training frequency, training quality, leaders’ focus, and inter-departmental coordination. The Middle Level factors were equipment availability and skill in designing emergency drill plans. The Bottom Level factor was funding guarantee.DiscussionThis survey revealed that over half of the CDC staff rated the effectiveness of public health emergency drills as low. The Logistic-ISM Model results indicated that the evaluation of drill effectiveness was negatively influenced by insufficient facility and equipment support, financial constraints, lack of departmental coordination, and inadequate leadership attention. Among these factors, funding guarantee was the most fundamental one. Therefore, this calls for strategic decisions to increase funding for equipment, leadership training support, and effective emergency coordination.

Background The high costs of innovative anticancer drugs hinder a number of cancer patients’ access to these drugs in China. To address this problem, in 2018, the medical insurance access negotiation (MIAN) policy was implemented, when the prices of 17 innovative anticancer drugs were successfully negotiated and they were therefore included in the reimbursement list. This study aimed to explore the impact of the MIAN policy on the utilization of innovative anticancer drugs. Methods With monthly data on drug expenditures and defined daily doses (DDDs) of each innovative anticancer drug from January 2017 to December 2019, interrupted time series analysis was employed to estimate both the instant (change in the level of outcome) and long-term (change in trends of outcomes) impacts of the MIAN policy on drug utilization in terms of drug expenditures and DDDs. Our sample consists of 12 innovative anticancer drugs. Results From January 2017 to December 2019, the monthly drug expenditures and DDDs of 12 innovative anticancer drugs increased by about 573% (from US$8,931,809.30 to US$51,138,331.09) and 1400% (from 47,785 to 668,754), respectively. Overall, the implementation of the MIAN policy led to instant substantial increases of US$8,734,414 in drug expenditures and 158,192.5 in DDDs. Moreover, a sharper upward trend over time was reported, with increases of US$2,889,078 and 38,715.3 in the monthly growth rates of drug expenditures and DDDs, respectively. Regarding individual innovative anticancer drugs, the most prominent instant change and trend change in drug utilization were found for osimertinib, crizotinib, and ibrutinib. In contrast, the utilization of pegaspargase was barely affected by the MIAN policy. Conclusions The MIAN policy has effectively promoted the utilization of innovative anticancer drugs. To ensure the continuity of the effects and eliminate differentiation, supplementary measures should be carried out, such as careful selection of drugs for medical insurance negotiations, a health technology assessment system and a multichannel financing mechanism.

Introduction Young and middle-aged people are important participants in the fight against health insurance fraud. The study aims to investigate the differences in their willingness to report health insurance fraud and the factors influencing it when it occurs in familiar or unfamiliar healthcare settings. Methods Data were obtained from a validated questionnaire from 828 young and middle-aged people. McNemar’s test was used to compare the public’s willingness to report under the two scenarios. Chi-square tests and multiple logistic regression analysis were used to analyze the determinants of individuals’ willingness to report health insurance fraud in different scenarios. Results Young and middle-aged people were more likely to report health insurance fraud in a familiar healthcare setting than in an unfamiliar one (McNemar’s χ²=26.51, P < 0.05). Their sense of responsibility for maintaining the security of the health insurance fund, the government’s openness about fraud cases, and the perception of their ability to report had significant positive effects on the public’s willingness to report in both settings ( P < 0.05). In a familiar healthcare setting, the more satisfied the public is with government measures to protect whistleblowers, the more likely they are to report ( OR = 1.44, P = 0.025). Those who perceive the consequences of health insurance fraud to be serious are more likely to report than those who perceive the consequences to be less serious ( OR = 1.61, P = 0.042). Conclusion Individuals are more likely to report health insurance fraud in familiar healthcare settings than in unfamiliar ones, in which their awareness of the severity of the consequences of health insurance fraud and their perceived risk after reporting it play an important role. The government’s publicizing of fraud cases and enhancing the public’s sense of responsibility and ability to maintain the safety of the health insurance fund may be a way to increase their willingness to report, regardless of whether they are familiar with the healthcare setting or not.

Purpose Medical insurance fraud has caused huge losses to countries around the world, and public reporting has become an important means to combat medical insurance fraud. The attitude of medical insurance fraud whistleblowers affects people’s reporting behavior, and understanding people’s attitude toward medical insurance fraud whistleblowers provides a basis for further improving the system and policy of public participation in medical insurance fund supervision. Methods We adopted the questionnaire method to conduct a national cross-sectional survey of the Chinese public and analyzed the data using Chi-square tests, Fisher’s exact tests, and binary logistic regression models. Results A total of 837 respondents were included, and 81.8% of the population had a supportive attitude toward medical insurance fraud whistleblowers, with gender, whether they had used medical insurance reimbursement, and present life satisfaction being statistically significant ( P < 0.05). Conclusion The public is generally supportive of medical insurance fraud whistleblowers, and women, those who have used medical insurance for reimbursement, and those who are satisfied with their lives are more likely to be supportive of medical insurance fraud whistleblowers.

Objectives The purpose of this study is to investigate the factors influencing the occurrence of medical insurance opportunistic behavior among the public in Northeast China and its importance ranking. Methods Data are from a self-administered anonymous questionnaire survey of participants in Northeast China conducted from January to December 2019. Using a stratified sampling method, a sample of 895 residents aged 18 years or older was selected for the study and analysis. We used a stepwise logistic regression model to analyze the factors influencing the opportunistic behavior of the public within the medical insurance domain and standardized the coefficients of the independent variables in the model to further determine the degree of importance of the relevant influencing factors. Results Opportunistic behavior was found in 34.2% of the participants. The order of importance of the factors influencing participants’ opportunistic behavior were the frequency of occurrence of overmedication by medical practitioners, age, participants’ evaluation of the harm of opportunistic behavior in medical insurance, marital status, participants’ evaluation of the nature of opportunistic behavior in medical insurance, and participants’ evaluation of the prevalence of opportunistic behavior in medical insurance. Conclusion One-third of the participants in northeastern China engage in medical insurance opportunistic behavior. Among them, the frequency of occurrence of overmedication by medical practitioners is the most important factor influencing whether opportunistic behavior occurs.

BackgroundCatastrophic disease sufferers face a heavy financial burden and are more likely to fall victim to the “illness-poverty-illness” cycle. Deeper reform of the medical insurance system is urgently required to alleviate the financial burden of individuals with catastrophic diseases.MethodsData were obtained from a cross-sectional questionnaire survey conducted in Heilongjiang in 2021, and logistic regression and restricted cubic spline model was used to predict the core factors related to medical insurance that alleviate the financial burden of people with catastrophic diseases.ResultsOverall, 997 (50.92%) medical insurance-related professionals negatively viewed financial burden relief for people with catastrophic diseases. Factors influencing its effectiveness in relieving the financial burden were: whether or not effective control of omissions from medical insurance coverage (OR = 4.04), fund supervision (OR = 2.47) and degree of participation of stakeholders (OR = 1.91). Besides, the reimbursement standards and the regional and population benefit package gap also played a role. The likelihood of financial burden relief increased by 21 percentage points for each unit increase in the level of stakeholder discourse power in reform.ConclusionChina’s current medical insurance policies have not yet fully addressed the needs of vulnerable populations, especially the need to reduce their financial burden continuously. Future reform should focus on addressing core issues by reducing the uninsured, enhancing the width and depth of medical insurance coverage, improving the level and capacity of medical insurance governance that provides more discourse power for the vulnerable population, and building a more responsive and participatory medical insurance governance system.

Medical insurance legal system is an important legal support for adjusting social relations of medical insurance in China. The completeness and foresight of its content are closely related to the orderly and standardized operation of medical insurance system in China. On the basis of defining the concept and characteristics of medical insurance legal system, this paper refined the current medical insurance law from horizontal and vertical directions, and put forward the framework of China’s medical insurance legal system. To comb the current situation of the development of China’s medical insurance legal system, and given the lack of overarching laws, legislative gaps in key legal areas, and backward legislation in its development, to propose countermeasures to speed up legislation in core legal areas and promote the development of the medical insurance legal system in the direction of prior prevention, so as to promote the continuous improvement of China’s medical insurance legal system.

目的:了解全国范围内未参保人群特征以及影响因素,为促进全民医保制定相关政策提供参考依据.方法:利用2019年中国家庭金融调查(CHFS)数据进行分析.对未参保人群特征进行描述性统计分析,并采用logistic回归分析未参保的影响因素.利用多重对应二维图分析未参保人群与影响因素的对应关系.结果:有94.49%的居民参加了社会医疗保险,5.51%的居民未参加任何社会医疗保险.年龄、家庭年收入、婚姻状况、居住地、地理位置、工作性质和个人负债等都影响个人的未参保行为(P＜0.05).多重对应结果显示,未参保与东北、中部、西部地区,初中和小学学历,年收入1～5万以及务农的群体特征联系密切.结论:虽然我国医疗保障覆盖率稳步提升,但仍有一部分群体未参保.为了实现全民医保的目标,国家相关部门应采取相应措施提高居民的参保率.

Background To assess the effectiveness of China's medicine and health care reform in promoting equity in health care utilization among rural residents, it is necessary to analyze temporal trends in equity in health care utilization among rural residents in China. This study is the first to assess horizontal inequity trends in health care utilization among rural Chinese residents from 2010 to 2018 and provides evidence for improving government health policies. Methods Longitudinal data obtained from China Family Panel Studies from 2010 to 2018 were used to determine trends in outpatient and inpatient utilization. Concentration index, concentration curve, and horizontal inequity index were calculated to measure inequalities. Decomposition analysis was applied to measure the contribution of need and non-need factors to the unfairness. Results From 2010 to 2018, outpatient utilization among rural residents increased by 35.10%, while inpatient utilization increased by 80.68%. Concentration indices for health care utilization were negative in all years. In 2012, there was an increase in the concentration index for outpatient utilization (CI = -0.0219). The concentration index for inpatient utilization decreased from -0.0478 in 2010 to -0.0888 in 2018. Except for outpatient utilization in 2012 (HI = 0.0214), horizontal inequity indices for outpatient utilization were negative in all years. The horizontal inequity index for inpatient utilization was highest in 2010 (HI = -0.0068) and lowest in 2018 (HI = -0.0303). The contribution of need factors to the inequity exceeded 50% in all years. Conclusions Between 2010 and 2018, low-income groups in rural China used more health services. This seemingly pro-poor income-related inequality was due in large part to the greater health care need among low-income groups. Government policies aimed at increasing access to health services, particularly primary health care had helped to make health care utilization in rural China more equitable. It is necessary to design better health policies for disadvantaged groups to reduce future inequities in the use of health services by rural populations.

Background: To identify the high-risk pollutants and evolving patterns of attributed mortality burden, more detailed evidence is needed to examine the contribution of different air pollutants to death across the disease spectrum, partic-ularly considering population change as well as the context of the era. Methods: We explored the evolving patterns of all-cause and disease-specific deaths attributed to overall air pollution and its main subcategories by using the estimated annual percentage change and additionally assessing the contribu-tion of population growth and ageing to death burden using the decomposition method. Age-period-cohort model and Joinpoint analysis were used to evaluate birth cohort effects specific-disease death burden owing to high-risk air pol-lution subcategories. Findings: The number of deaths caused by air pollution increased by 2.62 %, which was driven by ambient particulate matter pollution and ambient ozone pollution, whereas household air pollution decreased. Population ageing contrib-uted 28.88 % of the deaths increase change for air pollution. Compared with other subcategories, the age-standardized mortality rate (ASMR) attributed to ambient particulate matter pollution remained the heaviest attributed death burden, comprehensively considering of bivariate burden. In 2019, ischemic heart disease attributed to ambient par-ticulate matter pollution exhibited the highest ASMR, which may be impacted by a rapid increase era from 1950 to 1980 birth cohort in woman and 1970 to 1990 birth cohort in man. Diabetes mellitus attributed to ambient particulate matter pollution showed the largest increase for ASMR, which was driven primarily by men born 1910-1975 and women born 1950-1975.Uzbekistan showed the highest ASMR for ischemic heart disease, with Equatorial Guinea showing the fastest increase for diabetes mellitus. Conclusion: Priority intervention targets for air pollution and health should emphasize the susceptibility of the elderly population as well as the structural factors of the era, in particular sensitive diseases to the ambient particulate matter pollution.