Study On Healthy Life Expectancy Of Elderly People And Countermeasures In Jing’an District, Shanghai

The proportion of the elderly population is gradually increasing with the acceleration of population ageing. It is a sign of the progress of human society and the inevitable trend of the world’s population’s development. The elderly’s physical function is declining with increasing ageing, and the elderly easily suffer from a variety of chronic diseases and even disability. China is facing a heavy ageing population pressure with the lower economic level."Healthy ageing" and "Active ageing" are the strategic objectives to solve the problems due to the population ageing.Based on WHO’s health concept, health is not only a state of complete physical, such as without paralysis or blindness, and social well-being, such as walking, eating, etc, but also not merely the absence of activity, and a good mental state and social relations. So much attention should be paid to the elderly’s quality of life. The study of the elderly’s quality of life will help to make the decision on the development and implementation problems of the elderly, and provide the basis for the reform of China’s economic and health development. Healthy life expectancy, which combines the quality of life and death, is an important health indicator to measure disease burden. Few researches at domestic and abroad for the elderly’s health life expectancy was found, among them mainly on the description of the current situation. The present study employed a typical case study method, focused on countermeasures taken in the past10years follow-up data when Jing’an District, Shanghai developed a healthy city propram, analyzed the health of the elderly and their healthy life expectancy’s trend in the same area. And the present study also horizontally compared the states of the elderly’s health of different countries in the same time, combined with the differences of local political system and the environment, targeted policy recommendations. It is hoped that The studywould provide a scientific basis to solve the health problems of the elderly for the development of countermeasures and a theoretical basis for the health policy recommendations of the quality of elderly’s life through applying the vertical and horizontal description. GoalThe health status of the elderly in Jing’an District, Shanghai was investigted, and the health trends of the elderly and its influencing factors were longitudinally and horizontally analyzed, in order to provide a theoretical basis for the health policy recommendations of improving quality of the elderly’s life.Objectives·To longitudinally analyze the health trends of the elderly and its influencing factors with the elderly health surveys of the lasted10years in Jingan District, Shanghai.·To evaluate the health of the elderly and their quality of life in Jingan District and to explore the indicators of the health status of the elderly.·To explore the relationship between social capital and health, and hope to explore the sources and means of external resources conducive for the health of the elderly.·To explore healthy life expectancy from community organizations and policy level with different streets and different parts. To explore the countermeasures to meet the health needs of the elderly.SubjectsThe elderly in Jing’an District, three times survey data in2002,2007,2011were selected. Healthy life expectancy of different countries was analyzed.Contents1. The study of health problems of the elderly10years followed-up in Jing’an District.2. The study of the health-related quality of the elderly with ecology model in Jing’an District and countermeasuresMethodsIt was a typical case study.3times of cross-sectional surveyes were conducted to collect longitudinal data through a10-years follow-up. The quantitative and qualitative analysis was employed. The quantitative method involved questionnaire survey. The qualitative analysis included focus group discussion. The statistical methods included descriptive analysis, univariate analysis, multivariate linear regression, binary logistic regression, ordinal logistic regression, qualitative analysis methods.ResultsLongitudinal study results:Random cluster sampling method was applied. The elderly with60years old and over in Jing’an District was investigated. Totally there were1880people in2002,2593people in2007, and3049people in2011being investigated. Through the10-years follow-up, the present study found that life expectancy (LE) and healthy life expectancy (HLE) of the elderly in each age group, increased over time. In this disctric, LE and HLE of60-year-old group were26.3years and18.9years respectively in2011, which were higher than the old people in the same age group in2007of25.0years old and17.8years old, far higher than the2002group of23.4years and14.6years old. The loss of HLE in2011was28.0%, significantly lower than that in2007(28.8%) and that in2002(37.6%). The trend was same both in men and women in different year groups., LE in women, however, was higher than men, and HLE in men was higher than women overall the calendar year. Diseases were the main factors affecting the quality of life of the older persons. Among the diseases, cerebrovascular disease led to the loss of HLE62.1%in2011, declined from77.9%in2002. The life loss of HLE due to other chronic diseases rose quickly, such as hypertension increased from20.4%in2002to44.0%in2011. The amount of physical activity in the elderly increased significantly with years, the regularity excercise rate rose from39.2%in2002to54%in2011. Psychological and emotional disorders of older persons remained high in the10years, and the female were more severe than men.The horizontal analysis results (2011data):Individual level:The survey investigated total3049people,1361men,1688women, with an average age of72.39±9.13years.54.1%of the elderly had regular excercise.14.2%of elderly people smoke.6.7%of the elderly drank.23.2%of the elderly perceived that their health (self-rated health (SRH)) was above average.60.7%of the elderly was the same. SRH of the men was better than that of the women. For the SRH, the behavior lifestyle of physical activity is a protective factor, OR=2.759. SRH of the elderly without the psychological problems was better than that with the psychological problems.It was a statistically significant difference. The influential factor of activities of daily life (ADL) was age. For the male elderly in this disctrict ADL was10.7%of the60-65age-group, it increased51.5%of the85age-group. For the women, ADL damage rate rose11.4%of60-65years old group to68.9%of85-age-group, with an average of27.5%. The higher loss of ADL were found with household chores and shopping, the lower loss of ADL were grooming and on the bed. The loss of Instrumental ADL was higher than that of Physiological ADL.The highest prevalence of the chronic diseases of the elderly in the disctric was hypertension, being50.8%. The influential factors of HLE were different with chronic diseases, the highest rate of the loss of HLE was cerebrovascular disease. LE of each age group in women was higher than men, HLE of all age groups in men was higher than women.Comparing different socio-economic status and HLE, the highest HLE was found among the elderly married and the spouse alive. The income influenced HLE; HLE of the higher income elderly was higher than that of the low-income elderly; HLE of the elderly with the higher level of education was also higher. HLE was a statistically significant difference in the different age groups and SRH. The total level of social capital associated with the SRH of the elderly, SRH the better the higher the level of social capital. ADL of the elderly and social capital also showed a correlation, social capital of the elderly with ADL damaged was lower than that without ADL harming.Community levelOrganization participation and ADL in the elderly had a positive correlation. Impaired ADL was more likely to occur in the elderly of low social cohesion and sense of trust. Different social capital occurred in different streets. Social capital of the elderly in Jing’an Temple Street was highest, the score was10.88±1.60, HLE of this street was also the highest,60-year-old group was21.35years old,85-year-old group was4.72years old. LE, HLE and the loss of HLE of different streets related to their social capital. Different streets had different ADL loss rate. Through qualitative interviews with the elderly information onunderstanding and feelings about elderly care, elderly services provided by different groups were collected. The finding showed that the elderly satisfied with living environment, but social participation and enthusiasm was not high, and less paid work opportunities provided. The elderly hoped to strengthen the information exchanges.Culture and policy levelHLE was an important indicator to assess the health of the elderly. The overall health level of the elderly in Jing’an District was better than the country. Economic factors affected the health factors of HLE. HLE of the elderly in urban was higer than that in rural. Comparing HLE in different countries in2010, the lowest HLE was in Haiti and the highest was in Japan. Chinese-born men’s HLE was65.5years, ranked37. Female’s HLE was70.4years, ranked24. China was among the highest in the developing world.ConclusionsHealthy life expectancy was an important indicator to assess the health of the elderly. A steady increased in HLE of the elderly in Jing’an District through the10years, it was found that the loss rate of HLE gradually improved, the quality of the older persons’life was steadyly improved. But the speed of the older peoples’quality life slowed down in recent years, chemotaxis to stability. The overall health level of the elderly in Jing’an District was better than other countries. It indirectly reflected the achievement from the Healthy Cities Program. Economic factors affect HLE. Diseases were the main factors affecting the quality of life of older persons, cerebrovascular disease led to the most loss. Other chronic diseases’life loss of HLE rose quickly, such as hypertension, heart disease, chronic bronchitis and emphysema. In order to improve the quality of life of older persons, it was a way to control chronic non-communicable diseases. In order to improve HLE of the elderly, medical care services for senior citizens and female should be enhanced. Social capital related to the health of the elderly, it was a good way to improve older people’s organizations participate, social cohesion and sense of trust. It is recommended that to improve the quality of older people’s life, it should improve the level of regional economic development, promote health self-management, and promote "active ageing". Healthy city programs would be a good platform to improve the quality of life of the elderly in China.