慢性病史对新疆和田地区墨玉县35～74岁居民自评健康状况影响的归因分析

Analysis of the influence of chronic diseases history on the self-rated health status of residents aged 35～74 years in Moyu, Hetian, Xinjiang

目的了解新疆和田地区墨玉县35~74岁居民慢性病史对自评健康(SRH)状况影响,为该地区公共卫生政策制定提供依据。方法利用"新疆多民族自然人群队列建设研究"基线调查资料,分析指标包括一般社会人口学信息、生活方式、家族史、慢性病史(心血管系统、呼吸系统、骨骼肌系统、神经及消化系统等)等内容。采用二分类Logistic回归分析该地区居民自评健康状况影响因素及慢性病史暴露的人群归因危险度百分比(PAR%)。结果研究共分析11,334名农村居民,9,441人(83.30%)报告自评健康为好;慢性病史暴露的人群归因危险度百分比位居前三位的疾病分别为:高血压:PAR%=11.27%,95%CI(7.65%-15.01%);冠心病:PAR%=9.74%,95%CI(7.65%-15.01%);肺气肿/支气管炎:PAR%=6.59%,95%CI(4.00%-9.50%)。多因素分析显示,性别、年龄、文化程度、收入、家族史及慢性病史(P均<0.05)为自评健康的影响因素。结论新疆和田地区墨玉县35~74岁居民不良自评健康状况受高血压、冠心病及肺气肿/支气管炎三类疾病影响较大,应通过合理制定卫生政策、加强慢性病健康教育宣传、心理干预等措施改善居民自评健康状况。

Objective To explore the influence of the history of chronic diseases on the self-rated health(SRH) of residents aged 35~74 years in Moyu, Hetian, Xinjiang and provide advice for public health policy development in the region. Methods The baseline data of "Xinjiang multi-ethnic cohort study" were used to measure general social demography information, lifestyle, family history and chronic diseases. Binary logistic regression analysis was used to analyze the influencing factors of residents′ SRH status and the percentage of population attributable risk(PAR%) exposed to chronic diseases history. Results Among the 11 334 residents analyzed, 9 441(83.30%) reported well in SRH;the top three populations at risk of exposure to chronic diseases history were: hypertension: PAR%=11.27%, 95%CI(7.65%-15.01%);coronary heart disease: PAR%=9.74%, 95%CI(7.65%-15.01%);emphysema/bronchitis: PAR%=6.59%, 95%CI(4.00%-9.50%). Multivariate analysis showed that gender, age, education level, income, physical exercise, family history of disease and chronic diseases history were the influencing factors of self-rated health(P<0.05). Conclusion The poor self-rated health status of residents aged 35~74 years in Moyu, Hetian, Xinjiang is greatly affected by hypertension, coronary heart disease and emphysema/bronchitis. The self-rated health status of residents should be improved by rationally formulating health policies, strengthening health education and psychological interventions for chronic diseases.