中国老年人口疾病转型:传统与现代
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摘要
20世纪后半叶特别是改革开放以来,我国社会处在巨大的转型之中。在人口转变和流行病学转型的共同推动下,老年人口疾病类型发生了变化。以"中国老年健康影响跟踪调查"(CLHLS)的数据为基础,分析我国老年人口疾病模式转型以及慢性病易感人群的转变。从慢性病患病结构状况来看,心脑血管疾病、糖尿病的患病比例明显增加,而关节炎风湿病、慢性呼吸系统疾病的患病比例则有所降低,出现了慢性病患病结构构成中的一"升"一"降"的现象。从患病的群体分布上看,社会经济地位高、居住在城镇和东部地区的老年人容易患现代型疾病,而社会经济地位低、居住在西部地区的老年人更容易患传统型疾病。从疾病转型的速度上看,其对社会经济地位较低、居住在农村和西部地区的老年人冲击更大,这一部分老年人在现代型疾病患病率上升速度较快的同时,其传统型疾病患病率下降速度也更快。
The types of diseases in elderly Chinese population have changed because of population and epidemiological transitions.In the context of the huge transition and population aging,using the 2002 to 2014 wave of CLHLS data,we will describe the patterns of chronic diseases transition in the elderly and explore the transition pattern in different groups.Research shows that the proportion of chronic diseases has changed.The proportion of cardiovascular disease and diabetes has obviously increased.On the contrary,the proportion of rheumatoid and chronic respiratory disease declined.Diseases that have increased are called "modern style chronic disease".Diseases that have declined are called "traditional style chronic disease".Research indicated the elderly with lower socioeconomic status and living in rural and western area suffered more from the disease transition. The prevalence of modern and traditional style chronic disease increased and decreased more rapidly in the elderly with lower socioeconomic status and living in rural and western area.
The types of diseases in elderly Chinese population have changed because of population and epidemiological transitions.In the context of the huge transition and population aging,using the 2002 to 2014 wave of CLHLS data,we will describe the patterns of chronic diseases transition in the elderly and explore the transition pattern in different groups.Research shows that the proportion of chronic diseases has changed.The proportion of cardiovascular disease and diabetes has obviously increased.On the contrary,the proportion of rheumatoid and chronic respiratory disease declined.Diseases that have increased are called "modern style chronic disease".Diseases that have declined are called "traditional style chronic disease".Research indicated the elderly with lower socioeconomic status and living in rural and western area suffered more from the disease transition. The prevalence of modern and traditional style chronic disease increased and decreased more rapidly in the elderly with lower socioeconomic status and living in rural and western area.
引文
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中华人民共和国卫生部.中国卫生统计年鉴[M].北京:中国协和医科大学,2017.
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National Center for Chronic and Noncommunicable Disease Control,Center for Disease Control Prevention,Chronic Disease Risk Factor Surveillance Survey(Beijing:NCCNDC,2010).转引自世界卫生组织.中国老龄化与健康国家评估报告[R].2016.资料来源网址:www.who.int
Kramer M.The Rising Pandemic of Mental Disorders and Associated Chronic Diseases and Disabilities[J].Acts Psychiatrica Scandinavica,1980,285(62):282- 297.
曾毅、冯秋石等.中国高龄老人健康状况和死亡率变动趋势[J].人口研究,2017,41(4):22-32.
中华人民共和国卫生部.中国卫生统计年鉴[M].北京:中国协和医科大学,2017.
Zhou M,Wang H,Zhu J,et al.Cause-specific Mortality for 240 Causes in China during 1990-2013:a Systematic Subnational Analysis for the Global Burden of Disease Study 2013.[J].Lancet,2015,387(10015):251-272.
Omran A R.The Epidemiological Transition:a Theory of the Epidemiology of Population Change [J].Milbank Memorial Fund Quarterly Bulletin.1971:509-538.
安格斯·迪顿.逃离不平等:健康、财富及不平等的起源[M].北京:中信出版社,2014.28-38.
Olshansky S J,Ault A B.The Fourth Stage of the Epidemiologic Transition:the Age of Delayed Degenerative Diseases.[J].Milbank Quarterly,1986,64(3):355-391.
R G.Rogers,R Hackenberg.Extending Epidemiologic Transition Theory:A New Stage [J].Soc Biol,1987,34(3-4):234-243.
宋新明.流行病学转变——人口变化的流行病学理论的形成和发展[J].人口研究,2003,27(6):52-58.
World Health Organization.Lifestyles and Health[R].World Health Organization,1986.
Peng Gong,Song Liang,Elizabeth J Carlton,et al.Urbanisation and Health in China [J].Lancet,2012,379(9818):843-52.
中华人民共和国卫生部.中国卫生统计年鉴[M].北京:中国协和医科大学,2014.
Yang G,Kong L,Zhao W,et al.Emergence of Chronic Non-communicable Diseases in China.[J].Lancet,2008,372(9650):1697-705.
曾洪波,吴月,李志杰等.关于心脑血管疾病健康教育计划与评价[J].健康导报:医学版,2014,(9):273-274.
范涛,曹乾,蒋露露等.老年人慢性病影响因素的健康生态学模型解释[J].健康管理,2012,15(10).
齐良书、徐少英.我国农村居民不同社会经济地位群体之间的健康差距[J].中国卫生政策研究,2011,4(5):34-40.
夏翠翠,李建新.社会经济地位对中老年人口慢性疾病患病的影响分析——以心脑血管疾病和慢性呼吸系统疾病为例[J].人口学刊,2018,(3).
National Center for Chronic and Noncommunicable Disease Control,Center for Disease Control Prevention,Chronic Disease Risk Factor Surveillance Survey(Beijing:NCCNDC,2010).转引自世界卫生组织.中国老龄化与健康国家评估报告[R].2016.资料来源网址:www.who.int
Kramer M.The Rising Pandemic of Mental Disorders and Associated Chronic Diseases and Disabilities[J].Acts Psychiatrica Scandinavica,1980,285(62):282- 297.
曾毅、冯秋石等.中国高龄老人健康状况和死亡率变动趋势[J].人口研究,2017,41(4):22-32.