Analysis On The Characteristics Of The Longevity Distribution And Health Status Of The Elderly In Hechi City

BackgroundThe life expectancy has been prolonged and aging of the population come with the continuous development of social,economic,medical and health undertakings.The human being has been in the aging of the population in the21 st century.The increasing of the elderly and the oldest-old has attracted wide attention from all over the world.The regional phenomenon of longevity is obvious due to the different longevity level.It is one of the longevous provinces---Guangxi.The largest number of longevity population is in Hechi city of 14 cities in Guangxi province.But the attention has been mainly focused on Bama and less attention was on other counties/cities in Hechi city.The health and longevity are common ideal and pursuit of the human being.But they can appear some chronic diseases or chronic disease states owing to physical and psychological changes with the growth of the age.There are lots of factors that can affect the health of the elderly including the activities of daily living and the social support.The quality of life will decrease and the morbidity and mortality will increase with the impaired activities of daily living.So the activities of dailyliving is an important index for evaluating the health status of the elderly.What's more,there is close relationship between the social support and the physical,mental health and life quality of the elderly.The higher social support is beneficial to the physical,mental health and longevity of the elderly.We will analyze the population census data from 1990 to 2010 and the data of the statistical yearbook to understand the longevity level and influencing factors of longevity in Hechi city.And it can provide the basis of further researching the longevity.We will select the elderly(over the age of 60)that live in the two towns of which the longevity level is higher for health physical examination and questionnaire investigation.And thus we can understand the health status(general health status,the activities of daily living and the social support)of the local elderly and the influencing factors to make suggestions for promoting the healthy longevity of the elderly.PART?ANALYSIS OF DISTRIBUTION CHARACTERISTICS AND INFLUENCING FACTORS OF THE LONGEVITY IN HECHI CITYObjective: To explore the characteristics of spatial and temporal distribution and influence factors of the longevity in Hechi City and to provide the basis of further researching the longevity and provide the reference for better development of promoting health and longevity in Hechi city.Methods: We made the maps of the space distribution and spatial analysis(spatial autocorrelation analysis and Getis-Ord Gi hot-spot analysis)according to the data of the fourth(in 1990),the fifth(in 2000),the sixth(in 2010)National Population Census in Hechi city with Arc GIS10.2.2.We Collected the data of the social and economic development and meteorological data of Hechi city in recent years.The correlation analysis of the longevity level was conducted with SPSS16.0.Results: 1.The factors of the longevity were mostly higher in Hechi city from 1990 to 2010 compared with in Guangxi.2.The aging population coefficient gradually increased from 1990 to 2010.The ultra-octogenarian index(UOI)and longevity index(LI)were from 11.11%(in 1990)to 12.79%(in 2010)and from 1.28%(in 1990)to 2.78%(in 2010),respectively.The total number and the ratio of centenarians were on the rise from 1990 to 2010.The average life expectancy was 70.82 years in 2000 and79.03 years in 2010 in Hechi city.The comprehensive score of the longevity level was higher in 2010(0.55)than in 2000(0.31).The aging population coefficient,UOI and LI,the total number and the ratio of centenarians,the average life expectancy and the comprehensive score of the longevity level: The highest distribution was in Duan(5.94%),Fengshan(14.17%)and Bama(2.45%),Bama(66 subjects,29.46/105)county in 1990,respectively.The highest distribution was in Duan(8.50%),Donglan(15.02%)and Bama(3.75%),Bama(74 subjects,33.38/105),Jinchengjiang district(72.93years)and Bama county(0.60)in 2000,respectively.The highest distribution was in Donglan(12.12%),Duan(15.15%)and Bama(4.24%),Bama(80subjects,35.61/105),Yizhou city(82.17 years)and Bama county(0.75)in 2010,respectively.The fastest growth rate was in Donglan county.It has increased26.28/105 during 20 years.The lowest levels of most indexes were in Jinchengjiang district.3.Spatial autocorrelation and hot-spot analysis: The proportion of centenarians showed a stable concentration in space.The hot-spot area was mainly in Bama,Fengshan and Donglan county in Hechi city during 20 years.The UOI was from a random distribution to a clumped distribution and shift to a random distribution from 1990 to 2010.The hot-spot area of UOI concentrated mainly on Bama,Fengshan and Donglan county in Hechi city.The spatial distribution of LI was from random to cluster and there was the relatively stable LI in Donglan-Bama-Fengshan area.There was no obvious significance of the average life expectancy as a random distribution.The spatial distribution of the comprehensive longevity level was from cluster to random and the relative hot-spot area was in Bama,Fengshan and Donglan county from 2000 to 2010 in Hechi city.4.Analysis of influence factors of the longevity levelThere was a negative correlation among the UOI and average per capitaGDP and the educational level.The positive correlation existed among UOI and illiteracy rates and mortality in 2000.There was a negative correlation among the LI and GDP,per capita GDP,per capita net income of farmers,educational level,the number of medical institutions and the number of hospital beds and there was a positive correlation among the LI and the number of medical staff and illiteracy rates.The results showed the negative correlation among the proportion of centenarians and the educational level and the medical staff number.There was a negative correlation between the life expectancy and the birth rate.It was a negative correlation between the comprehensive longevity level and the educational level.There were positive correlations among the life expectancy and average temperature,air pressure and negative correlation with relative humidity.The correlation was positive between the number of centenarians and sunshine duration in 2000.There was a negative correlation between the UOI and average per capita GDP in 2010.It showed a negative correlation among the LI and GDP,per capita GDP and educational level and there was a positive correlation among the LI and illiteracy rate and birth rate.It was a negative correlation among the proportion of centenarians and GDP,per capita net income of farmers and the educational level.And there was a positive correlation among the proportion of centenarians and illiteracy rate and birth rate.It was a negative correlation among the comprehensive longevity level and GDP,per capita net income of farmers and the educational level.And there was a positive correlation among the comprehensive longevity level and illiteracy rate and birth rate.It was a positive correlation between the UOI and wind speed and there was a positive correlation among the sunshine duration and UOI,LI and the number of centenarians in 2010.Conclusions: 1.The age structure of the population had changed from young-adult society(in 1900)to the elder society(in 2010)in Hechi city.They have been in the elder society for all areas.2.The factors of the longevity level(UOI,LI,life expectancy,the proportion of centenarians and the comprehensive longevity level)increased from 1990 to 2010.The areas of the higher ratio(the longevity level)were in Bama,Donglan,Fengshan and Duan and the lower ratio was in Jinchengjiang district and Nandan county.3.There is spatial clustering of the longevity level in Hechi city.And the regions of high level of the longevity gather mainly in the areas of Bama,Donglan and Fengshan county in Hechi city.4.Many factors can affect the longevity level including natural factors,social economic factors and medical and health factors in Hechi city.It is still the natural longevity area.PART ? ANALYSIS OF HEALTH STATUS OF THE ELDERLYAND INFLUENCING FACTORS IN SOME COUNTY OF HECHI CITYObjective:To understand the health status(including the general health condition,the status of the Activities of Daily Living(ADL)and social support)of the elderly and the influencing factors in some county of Hechi city,and to make suggestions for improving the health of the elderly.Methods : We selected the participants aged over 60 years with cluster sampling from two towns in some county.The questionnaire surveys and physical examinations were conducted with the elderly.The questionnaires included the general demographic characteristics,Social Support Rating Scale(SSRS)and Activities of Daily Living(ADL)questionnaires.Physical examinations included height,weight,blood pressure,blood lipids and grip strength and so on.Epidata3.1 and SPSS16.0 were used for inputting data and analyzing data.Results: 1.Social demographic characteristics: The total number of the subjects was 2200 in our study.There were 922 males(accounting for 41.9%)and 1278 females(accounting for 58.1%).The average age was 69.24±6.17 years and the minimum age and the maximum age were 60 and 96,respectively.The major nationality was the Zhuang nationality.2.There were 727 older people(33.0%)without the chronic disease and it accounted for 67.0% with one and more chronic diseases.The bone mineral density was mainly normal for the 49.3% elderly.The bone loss andosteoporosis accounted for 28.5% and 22.2%,respectively.The detection rates of hypertension,diabetes,hyperlipidemia and hyperurieemia were 47.6%,4.5%,25.4% and 31.3%,respectively.The detection rate of hypertension was higher in the older men of other minority.The detection rates of hypertension,diabetes,hyperlipidemia and hyperurieemia were higher with greater BMI and WHR.The detection rate of diabetes was higher in the elderly with smoking or drinking and the detection rate of hyperurieemia was higher with drinking.The detection rates of the hypertension,hyperlipidemia and hyperurieemia were higher in the CH/HDL>5 old people than CH/HDL?5.The detection rate of osteoporosis was higher with older,lower weight or obesity and lower level of education for women.These differences were statistically significant.3.Status of the Activities of Daily Living: The prevalence rate of disability for Physical Activity of Daily Living(PADL)was 10.0% and the worst-hit was walking.The prevalence rate of disability for Instrumental Activity of Daily Living(IADL)was 40.7%,and using transportation fell most obviously.The rate of disability for the total ADL was 41.7% including the rate of mild disability(35.1%)and the rate of severe disability(6.6%).4.Univariate analysis of ADL4.1 Univariate analysis of PADLThere were significant differences of the PADL disability for different age,nationality,marital status,kinds of chronic disease,hypertension,diabetes(P<0.05).Compared with the normal group,the sleeping time was longer and the content of the hemoglobin and the grip strength were lower in the group of PADL disability.The differences were statistically significant(P<0.05).4.2 Univariate analysis of IADLThere were statistically significant differences of the IADL disability fordifferent sex,age,educational level,marital status,living arrangements,the status of the smoking and drinking,kinds of chronic diseases,the bone mineral density and waist-to-hip ratio(P<0.05).Compared with the normal group,the sleeping time was longer and the contents of the creatinine,hemoglobin,TG and the grip strength were lower in the group of IADL disability.The differences were statistically significant(P<0.05).4.3 Univariate analysis of total ADLThere were statistically significant differences of the ADL disability for different gender,age,education,marital status,living arrangements,drinking status,doing farm work,doing household,bone density,waist-to-hip ratio and diabetes(P<0.05).Compared with the normal group,the sleeping time was longer,the contents of the creatinine,hemoglobin and TG,and the grip strength were lower in the group of ADL disability.The difference was statistically significant(P<0.05).5.the logistic regression analysis of Activities of Daily Living5.1 Binary logistic regression analysis of PADLThe advanced age,the longer sleeping time,many kinds of chronic disease,lower objective support and bigger waist-to-hip may be the risk factors of PADL.The higher subjective support and utilization of support may be protective factors of PADL.5.2 Binary logistic regression analysis of IADLThe advanced age,female,the longer sleeping time,bigger waist-to-hip,living with their children,without wife/husband and passive smoking may be the risk factors of IADL.The higher objective support and the bigger grip strength and the higher educational level may be the protective factors of IADL.5.3 Multinomial logistic regression analysis of ADLThe advanced age,female,living with their children,non-doing farm work and non-doing household may be the risk factors of ADL.The higher objective support and utilization of support,the bigger grip strength,smaller waist-to-hip ratio,non-diabetes may be the protective factors of ADL.6.Basic social supportThe lowest score of social support was 16 and the highest was 56 for the elderly.The average score was 40.68±6.48.The average score of the objective support was 24.07±3.93,and the average score of subjective support was8.21±2.33.The average score of the utilization of social support was 8.40±2.37.The percentage of the low social support was 11.82%,the middle social support was 62.95% and the highest social support was 25.23% of the elderly.7.Univariate analysis of social supportThe scores of the objective support can be affected by the different age,gender,nationality,occupation,the educational level,marital status,living mode,the statuses of taking medicine in recent 2 weeks and chronic diseases.The scores of the subjective support were significantly different among the different age,gender,nationality,occupation,the educational level,marital status,living mode,smoking status and the kinds of chronic diseases.The scores of the utilization of social support can be affected by the different gender,nationality,smoking status and the kinds of chronic diseases.The scores of the social support were significantly different among the different age,nationality,occupation,the educational level,marital status,living mode and the status of taking medicine in recent 2 weeks.There were statistically significant differences for all the above-mentioned factors.8.Multinomial logistic regression analysis of social supportThey gained more social support with wife/husband for common socialsupport.The elderly with Zhuang nationality,the PADL normal and total ADL mild disability and living with their children got more social support compared with low social support.They gained more social supports with wife/husband and with Han and Zhuang nationality,the PADL normal,total ADL normal and mild disability and living with others.Conclusions: 1.The general health conditions of the elderly are well and the detection rates of some chronic diseases are higher in some county of Hechi city.The percent of ADL disability is high in some county in Hechi city.The sleeping time,subjective support,grip strength,gender,age,marital status,living arrangements,waist-to-hip ratio and so on are the influence factors of total ADL.2.The level of social support is upper in some county of Hechi city.There is significant difference for social support in nationality,marital status and living arrangements,and so on.3.In order to decrease the rate of ADL disability and get more social support for the rural elderly to improve the health of the elderly,we should make corresponding measures according to the different influence factors.