Sex differences in disease burden in China from 1990 to 2023 triangulating GBD and CHARLS.

Sex and gender shape health across the life course, but nationally comparable evidence on how fatal and non-fatal disease burden differs between females and males in China is needed for health planning. We analyzed Global Burden of Disease 2023 estimates for the 20 leading level-3 causes of age-standardized disability-adjusted life-year rates in China, compared patterns with global estimates, projected trends to 2030, and triangulated selected findings using CHARLS 2018. In 2023, males had greater burden from mortality-driven cardiovascular diseases, cancers, and injuries, especially stroke, ischemic heart disease, lung cancer, falls, and road injuries. Female disadvantage was concentrated in gynecological diseases, musculoskeletal disorders, dementia, depressive symptoms, functional limitation, and older-age fall burden. Smoking, alcohol use, occupational risks, and household air pollution contributed differently by sex. These findings support sex-responsive prevention, rehabilitation, and long-term care strategies in China.