| With the aggravation of climate change,its influence on human health is attracting more and more attentions.The anomalous change of weather and climate will falling or aggravate some diseases(such as diseases of respiratory system and circulatory system)which can be called the weather sensitive diseases.And the IPCC fifth report pointed out that the disease which threatens human health has shifted from infectious diseases to chronic diseases and injuries.Especially in rural areas of China,in recent years,the spectrum of diseases has changed significantly.Respiratory and circulatory diseases are the two main diseases.The growth rates of them are much higher than that of cities.The previous studies of the relationships between the two systems and the meteorological environment are aimed at urban areas,however,the habits of eating behavior,the economic situation of city residents and the meteorological conditions are different from the rural areas,and the research results of the urban areas are not suit for the rural areas,and no affect prevention can be established.Meanwhile,the previous researches are focused on the overall population analysis,and there is no meticulous relative study on the risk of increasing age.In addition,previous studies usually focused on epidemiological analysis and pathogenesis,and no useful research results applied to the prevention and intervention of diseases.Funan is a demonstration county of medical treatment alliance in rural areas.Put the prevention of disease as the key of reform and breakthrough the traditional way of prevention,all of above is the first time that the prevention of meteorological sensitive diseases is part of the medical reform.As mentioned above,this paper analyzed the disease spectrum in the area of Funan County,and found that the two major diseases in this area were respiratory diseases and circulatory diseases.Then the generalized additive model and nonlinear distribution lag model were used to analyze the influence of meteorological elements on the two systemic diseases in rural areas and further analyze the influence of meteorological elements on the vulnerable population of the two diseases,the two models were also used to find a comprehensive index,thermal index,and explore the effect of temperature and humidity on the two system diseases in different seasons and make a risk grade map of high incidence of disease.Finally,according to the previous research results,with the local government management departments,the research and practice are combined,and a set of two system disease intervention programs for rural areas was formulated.The Elman neural network algorithm model was used to construct the weather sensitive disease forecasting system in this area and evaluate the effect of the intervention scheme.This study can utilize the results effectively and provide theoretical support and new ideas for disease prevention and intervention.The main results are as follows: 1.Characteristics of Disease Spectrum and Analysis of Vulnerable Groups in Funan(1)The study found that the top five prevalence rates in the rural population were: circulatory,respiratory,digestive,orthopedic and urinary system diseases.Circulatory system(32.45%)and respiratory system(12.96 %)accounted for 45.41% of the total prevalence,and the disease composition ratio of these two systems was much higher than in urban areas.(2)The high-risk groups of respiratory diseases are infants under 3 years of age and people over 60 years old.45-55 years old is also a small peak of incidence.The number of male hospitalization is greater than that of females;the high incidence of circulatory diseases is concentrated in people over 60 years old.Higher than men.From the trend of disease change,the growth rate of the circulatory system is significantly higher than that of the respiratory system.The number of respiratory diseases is highest in the winter and lowest in the summer.The incidence of circulatory diseases was highest in the late winter and early spring,followed by the summer and least in the fall.2.Correlation analysis of meteorological factors on respiratory and circulatory system diseases in Funan area(1)Study of the impact of meteorological factors on respiratory diseases in rural areas found that respiratory diseases in rural areas are more susceptible to low temperatures,and the rate of respiratory diseases is significantly higher when temperatures are lower.Because there is no heat island effect and high temperature has no significant effect,low temperature is a key meteorological factor for prevention of respiratory diseases.In the 48-hour study of temperature change,it was found that the increase in temperature is a risk factor for the occurrence of the disease,and it is real-time.Humidity alone is mainly reflected in the relatively low humidity conditions.Lagging 2-4 days is the high incidence time to induce systemic disease.(2)The impact of meteorological elements on circulatory diseases in rural areas found that,as the heating conditions in rural areas are worse than those in cities,the effects of daily average temperature on the circulatory system mainly reflect the effects of low temperature,and the temperature is between –5 and 5°C.Lagging 3-6 days,the low temperature effect is obvious,showing high predisposing factors.High temperatures can also cause multiple diseases,but due to the weakening of rural high-temperature intensity relative to urban areas,their induced effects are correspondingly weaker.In the study of the effect of variable temperature on the circulatory system disease,it was found that only when the temperature change significantly(late winter or early spring)both daily temperature range and the 24 and 48-hour temperature changes will increases the risk of circulatory system disease.When the relative humidity is lower than 45 or higher than 80,it is a high precipitating factor with no hysteresis effect and has a certain cumulative effect.3.The Relationship Analysis of the meteorological impact on the respiratory and circulatory diseases morbidity within vulnerable population in Funan County(1)Throughout the research of how meteorological factors might influence the morbidity of respiratory diseases within vulnerable population,it is discovered that,for infant(less than 3 years old)intervals of the daily mean temperature from minus 5°C to 5°C are of high risks for respiratory diseases,which have no lags and the effect could span for dozens of days.The cumulative effect of cold temperature on infants last longer than the whole population.Simultaneous research found that,the relative risk of high temperature is higher to infants than the whole population,which specifically,is referred as 5%.Meanwhile the infants tend to suffer more risks from temperature difference in 24 hours the whole population and high relative humidity tend to induce diseases.When temperature changes drastically,especially in the condition of sudden surge,precaution should be paid more attention.Elders aged 60 above behave analogously with the infant group in the research,but the cold effect lags about 3 to 5 days and the influence of temperature difference on morbidity is demonstrated by the ascending temperature and descending relative humidity.(2)Several findings are found through the research of how meteorological factors affect the circulatory system of the vulnerable population: Elders aged 60 above tend to be attacked by circulatory diseases induced by meteorological factors in this region,which is manifested as cold effects,and compared to the whole population with the same low temperature condition the elders receive 1% more relative risks.Daily temperature range,temperature differences during 24 and 48 hours all shows the high morbidity when temperature changes dramatically.With the same temperature fluctuation,the elders get more risks of circulatory system diseases paroxysm than the whole population and the cumulative effect displays stronger similarly.4.The relationship between comfort index of different seasons and respiratory and circulatory system diseasesBased on the previous studies,it can be found that the leading meteorological factors that influence the occurrence of disease are temperature and humidity in this area,and comfort index which can reflect the relationship between meteorological factors and two systems of disease is a more comprehensive meteorological index than temperature and humidity alone.Different from the urban area,low comfort index cause two system diseases,the lag days and comfort indexes which can cause two system diseases are different in different seasons.Based on the discovery of disease risk by comfort index of temperature and humidity effect,it can be found that when the relative humidity is low,the daily maximum temperature is the main factor affecting the onset of the two systems;and when the relative humidity is high,the daily maximum temperature and relative humidity will have impacts on the two system disease.5.Construction weather sensitivity prediction system of FunanConstruction of weather sensitivity disease prediction of Funan Machine learning modelling method like multiple regression model,BP neural network model and Elman model were applied for respiratory system disease and circulation system disease simulation.Elman model was found to have the best prediction result for time series modelling.Therefore Elman was used for local disease prediction and help construction Funan weather sensitivity prediction system and provide technical support for local disease prediction.6.Prevention,design of intervention plan and evaluation of respiratory and circulatory system diseases in FunanAs a backbone of the team,I had worked with the local government to design the two system disease intervention program.The program was implemented in 7 villages and towns in 2016.It was set up as an intervention group and a control group in 7 other towns.The results showed that the intervention of respiratory system and circulatory system in rural areas achieved good results.Compared with the control groups,in 2016,the number of hospitalized patients and the burden of respiratory system disease decreased 31.27% and 35.47%,respectively;the number of hospitalized patients and the burden of circulatory system disease decreased 9.54% and 9.39%,respectively.Based on this data analysis,the intervention program and the meteorological sensitive disease prediction system have achieved good results in rural areas.On the basis of improvement and modification,they can be popularized and popularized for different regions. |
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