| Objective:The aim of this study was to know the prevalence of chronic non-communicable diseases and their risk factors in Gansu province, in order to analyze and formulate the appropriate integrated systems and comprehensive intervention strategies of chronic diseases, and also to provide basic data for evaluating the health status and effectiveness of public health policies.Methods:(1) The data referring to the cause of chronic disease death were acquired by retrieving annual reports and certifications of registration of death in disease monitoring points of Gansu province from 1992 to 2007. (2) The data of demographic characteristics of chronic diseases and the demand for medical service of Gansu province population were acquired by analyzing the data of the forth national health services survey. (3) With the employing of non-probability judgmental sampling, a cross-sectional study of 2466 residents from 33 urban and two county communities was conducted using a face-to-face anonymous questionnaire in Qilihe district of Lanzhou city of Gansu province.Results:(1) It has been being the main reason for residents of Gansu province to die from chronic diseases, which has an upward trend. The sum of the proportion of the four main chronic diseases, including chronic lower respiratory tract diseases, cerebrovascular diseases, heart diseases and tumor, was arising and made up of above 60% of the total proportion. The average growth rate of the four main chronic diseases reached 3.24%,7.70%,11.48% and 4.46% respectively during these sixteen years. (2) The chronic diseases of circulatory system, digestive system and locomotor’s system were the main diseases affecting residents’health, which accounted for 37.81%,16.34%and 14.77% respectively in all proportion. The distribution of demographic characteristics of chronic diseases was associated with the prevalence of chronic diseases. The prevalence of chronic diseases in Gansu province was 16.70%, (city 20.32%, countryside 13.97%), of which the male was 14.53% and the female was 18.83%. The prevalence of female was higher than that of male (P<0.01). The prevalence of men who was older than 65 was the highest, up to 53.02%. The difference between different age groups has statistical significance (P<0.01). Moreover, with the increase of age, the prevalence of chronic diseases showed a rising trend (r=1.000). (3) The whole medical requirement level of Gansu province was low, and economic difficulty was the ultimate reason to restraint the demand for medical service. The two-week consultation rate was 10.17%, and the rate of not seeking health care was 53.69%. The reason that 43.10% of patients can’t seek health care was that they cured by themselves.25.08% of patients who cured by themselves didn’t go to hospital due to the economic difficulty. The hospitalization rate of residents was 5.88%, and the non-hospitalization rate was 36.20%.69.67% of patients who should be in hospital didn’t go to hospital due to economic difficulty. (4) Knowledge regarding to chronic diseases should be improved among the residents of Gansu province. The proportion knowing the diagnostic standard of systolic pressure and diastolic pressure were only 28.14% and 22.22%. The awareness of the risk factors of coronary heart diseases was 38.52%(hyperlipidemia),37.15% (hypertension) and 33.90% (alcoholism).22.38% of residents had associated eating sweetmeats with diabetes.18.69% of residents believed that diabetes related to eating high-fat diets. About a half of residents didn’t know how to prevent cervical cancer and breast cancer, which account for 51.18% and 50.20%. (5) Health risk behaviors among daily life were the important reasons for residents to affect their health, so the life style of residents needed to be improved urgently. In this study, the smoking rate was 31.67%, the drinking rate was 21.33%, the exercise rate was 26.76%,51.01% of residents felt common as average in high-salt diets and 27.82% of residents always ate high-fat diets. (6) Obesity and unhealthy dietary behaviors were significantly associated with chronic diseases among residents both in city and rural. According to the case-control study,①cardiovascular diseases was associated with obesity (OR=3.092, OR95%C.I:1.402-6.822) and body mass index (OR=1.595, OR95%CI:1.168-2.179).②digestive system diseases were associated with high-salt diet (OR=1.482, OR95%CI:1.106-1.985) and high-fat diet (OR=1.492. OR95%CI:1.130-1.970).③disc diseases was associated with body mass index (OR=1.592, OR95%CI:1.073-2.362).④diabetes was associated with high-fat diet (OR=3.700, OR95%CI: 1.896-7.222) and edible oil (OR=3.901, OR95%CI:1.632-9.324). (7) There were so great demands for the knowledge of prevention and cure of diseases among general residents, and they hope that the knowledge might be got better through a popular and undemanding way. The knowledge regarding on hypertension, diabetes, hepatitis, cervical spondylosis and tumor were hoped to be acquired by residents. The television, doctor and journalism were the popular way for residents to gain information of the prevention and control of diseases.Conclusion:(1) Although the prevalence of chronic disease among residents in Gansu province has an upward trend, the demand and utilization for medical and hygiene services were significantly inadequate. (2) They should be the effective measures for improving residents’health status step by step, if the national health education of chronic disease had been actively carried out, and different educational patterns had been formulated for different gropes, which could help to enhance a sense of health in the entire population. (3) It was necessary to continue to establish and complete the registration and monitoring network system of death and chronic diseases. Moreover, it was also important to ensure the accuracy and reliability of the monitoring data. So the intervention strategies and government’s decision of chronic diseases would be completed on that scientific basis. |
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