区域人口非传染性疾病脆弱性评估理论和技术方法研究

A Study on the vulnerability assessment theories and technical methods of noncommunicable diseases in regional population

目的创建区域人口非传染性疾病(noncommunicable diseases,NCDs)脆弱性评估新理念、基本理论、指标体系和技术方法,为开展NCDs脆弱性评估提供技术支持。方法采用ISO风险评估和WHO公共健康风险评估标准判定法研究提出NCDs脆弱性评估新理念和理论体系框架;运用分层加权分析法对区域全人口、全生命周期、疾病全过程及其危险因素进行分层分析,建立评估指标体系;综合运用资料分析、文献回顾和专家咨询等方法选择评估指标、优先排序和权重分数分配,最终得出脆弱性大小;然后,再采用矩阵分析法确定脆弱性等级。结果建立了以区域高敏感人口、防控能力缺失与不足、危险因素暴露超敏感性、健康不均等化评价为核心的NCDs脆弱性评估新理念及基本理论;构建了分类分级加权指标体系,包括4个一级指标、17个二级指标、58个三级指标、78个四级指标和五级指标(评分基准与依据);创建了区域人口NCDs单因素、多因素和综合因素脆弱性评估模型与矩阵指数分布表。结论首次较为全面系统地构建了区域人口NCDs脆弱性评估理念、基本理论、指标体系和技术方法,为评估区域人口NCDs脆弱性水平和系统防控提供科学依据。

Objective To create the new concept,basic theories,index system,technical methods for providing technical support of noncommunicable diseases（NCDs）vulnerability assessment in regional population.Methods The outline of new concept and basic theories for NCDs vulnerability assessment was profiled based on the criteria defined method of ISO risk assessment and WHO guideline of public health risk assessment.The analytic hierarchy process（AHP）was used to analyze hierarchically the whole life cycle and disease process as well as the related risk factors for the entire population in order to establish assessment index system.The assessment indicators were obtained,prioritized and weighted based on the data analysis,literature review and expert consultation and the final vulnerability level was determined by using the matrix analysis. Results The new concept and basic theories of NCDs vulnerability assessment was established which was centered by vulnerable population,imperfect capacities,excessive risk factor exposure and health inequalities of NCDs.A well-classified,stratified and weighted index system,including 4 first level indicators,17 second level indicators,58 third level indicators,78 fourth level indicators and rating criteria was build up.The single,multiple and synthetic factor assessment models and risk assessment matrix index table were created. Conclusions For the first time ever,the new concept,basic theories,index system,technical methods have been comprehensively established for the NCDs vulnerability assessment among the entire regional population which may provide the scientific evidence for disease prevention and control.