Study On The Prevalence And Behavioral Risk Factors Of Chronic Disease Of Rural Residents In Shandong Province

BackgroundWith the development of social economy, the speeding up of aging process, residents’ living standard and lifestyle changes rapidly, the problem of chronic disease becomes much more serious and threats to human health, being the leading health killer. Chronic disease not only caused heavy economic burden to individuals and the society, also became important factor of poverty. In recent years, compared with cities, the prevalence of chronic diseases in rural residents increased rapidly and the gap between them was shrinking gradually. Because of the indifferent health conscious, lack of medical knowledge, relatively low health services and medical security level, to carry out chronic disease research in rural residents is very necessary. The chronic disease etiology research shows that chronic disease is the result of the joint action of multiple risk factors and the risk factors relate to genetic, environmental, individual behavior and health care, etc. Data from the United States revealed that 70% of diseases related to people’s behavior way of life and the WHO has announced that the health and life depends on behavioral factors at 60%. Among them, behavioral risk factors are most active and also can be personally controlled. Health promotion has been acknowledged as the most economic and effective method for chronic disease prevention and control, for the effect of individual leveled prevention and control method was not very ideal. Health promotion aims at both behavior risk factors in the middle of chronic disease cause chain and the social and environmental factors in far side of chronic disease cause chain. Therefore, to quantify the relationship between social economic factors, behavior risk factors and health care behavior factors and their influence on chronic disease has a vital significance in formulating chronic disease related health promotion interventions.ObjectivesThe main purpose of this research is to study the prevalence of chronic disease and its behavior risk factors, to analyze the main factors of chronic disease, to quantify the relationship between social economic factors, behavior risk factors and health care behavior factors and their influence path and degree on chronic disease, to explore the feasibility of using structural equation model to analyze chronic disease affecting factors, to provide a basis for health promotion strategy which focuses on both behavior risk factors in the middle of chronic disease cause chain and the social and environmental factors in far side of chronic disease cause chain.The specific objectives are:(1) to understand the basic situation of rural residents, including the prevalence of main chronic diseases, self-reported health status, social economic characteristics, behavior risk factors epidermal situation and the distribution of health care behavior;(2) to find out chronic diseases affecting factors using univariate analysis;(3) to screen the main factors of chronic diseases using multivariate analysis;(4) to quantify the relationship between social economic factors, behavioral risk factors and health care behavior factors, and its influence path and degree on chronic disease.MethodsAccording to economic and geographic features, stratified random sampling method was used to select samples. Sample involved in Shandong province were 3 counties,9 towns and 27 villages. In each village,30 families, about 60 people were randomly selected, and total of 810 households,1624 residents were in the survey.This study used descriptive analysis to describe prevalence of the main chronic diseases, social economic characteristics, behavioral risk factors and health care behavior; the method of single factor and multiple factors Logistic analysis was used to analyze main influencing factors of chronic diseases; structural equation model was used to quantify the relationship of social economic factors, behavior risk factors and health care behavior factors, and to analyze their affect path and degree on chronic disease.Main Results and Conclusions(1)The overall health condition of rural residents in Shandong province was not good, for 56.3% of people had chronic diseases and the prevalence rate of hypertension and diabetes were respectively 41.5% and 8.2%, and heart disease, cerebrovascular disease were also common chronic diseases;(2)Behavioral risk factors such as smoking, drinking, lack of physical activity and unhealthy diet were in prevalent in rural residents and the rate of smoking, alcohol drinking, lack of exercise and high-salt diet were respectively 26.5%,27.5%, 76.8% and 57.2%;(3)Social economy factors not only directly affected chronic disease, also indirectly affected chronic disease by acting on behavior risk factors and health care behaviors, and the direct, indirect and total impact effect values were 0.532,0.243 and 0.775 respectively;(4)Health care behavior had no significant impact on chronic disease.Policy Suggestions(1) Strengthen monitoring the epidemic of chronic disease and its behavioral risk factors in rural areas;(2) Strengthen health education for rural residents to improve their health literacy and shift their health belief;(3) Carry out the whole population-based chronic disease prevention and control strategies;(4) Differentiate the population with different characteristics so to make the prevention and control strategies chronic diseases targeted, focus on strengthening health education and health promotion about chronic disease in women, the elderly, low education and low-income people;(5) Consummate the system of general practitioners and improve the assessment and compensation mechanisms.