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Objectives: To investigate the burden of chronic diseases among rural-urban residents in Xuzhou, China. Study design: Retrospective study. Methods: The mortality rates and standardized mortality rates of neoplasms, diabetes mellitus, ischaemic heart disease and cerebrovascular diseases were calculated for the 10 years from 1997 to 2006 in Xuzhou. The potential years of life lost, rate of life lost and standardized rate of life lost were calculated for each disease. Direct treatment costs were also analysed. Results: The age-standardized mortality rates of the four diseases were 150, 9, 78 and 96 per 100,000, respectively. The standardized rates of life lost among urban residents were 11.7, 0.8, 4.9 and 4.1‰, respectively, and among rural residents were 15.0, 0.3, 2.9 and 2.8‰, respectively. The total direct medical expenses, including outpatient and inpatient costs, was 6.07 hundred million Yuan. Conclusion: Chronic diseases place a heavy burden on rural and urban residents in Xuzhou. A multidimensional and multidisciplinary health promotion and disease management plan is urgently needed to control these diseases. [ABSTRACT FROM AUTHOR]