老年人慢性病影响因素的健康生态学模型解释

Explaining the Influencing Factors on Chronic Diseases of the Elderly Using Health Ecological Model

目的从健康生态学模型的角度,分层次探讨老年人的慢性病影响因素。方法对2009年中国健康和营养调查(CHNS)进行数据整理,筛选出年龄在60岁以上的老年人,探究老年人慢性病发生的影响因素。以老年人慢性病患病情况为因变量,生活习惯、个人特征、经济条件等方面的指标为自变量,进行χ2检验和Logistic回归分析。结果年龄、对疾病的感知、体质指数、饮水习惯、家庭人口、是否在职、饮用水获得方式和人均收入是老年人慢性病的影响因素。每加入一个层次的影响因素,对结果的解释程度也增加,其中人际网络、生活和工作条件两大分类因素增加后对结果解释的程度提高最明显。结论老年人慢性病的影响因素是多维度的,且不同层次的影响因素之间有复杂的关系;健康生态学模型将近端因素和远端因素相结合,可更加全面地分析健康的影响因素。

Objective To investigate the influencing factors on chronic diseases of the elderly in the community using health ecological model.Methods Based on data from 2009 China Health and Nutrition Survey（CHNS）,people aged 60 years old and above were included in the study.The condition of the chronic diseases of the elderly was made dependent variable,and their living habits,individual characteristics,economic conditions and other factors were made independent variables.Chi-square test and logistic regression analysis were applied.Results Age,perception of disease,BMI,water drinking habit,family size,employment status,drinking water supply and family annual income per capita were identified as influencing factors on chronic diseases of the elderly.Each influencing factor added to the explanation of the outcome.Among them,social network and living and working conditions greatly contributed to the outcome.Conclusion The influencing factors on chronic diseases of the elderly in the community are multidimensional and relations among the factors in different categories are complex.Health ecological model combining immediate factors and mediate factors can provide a more comprehensive analysis of the influencing factors on health.