Study On Prevalence Of Chronic Diseases And Its Equity Among Adults Of Rural Areas In Jiangxi Province

Objective:In order to understand the prevalence of chronic diseases and its variation among adults of rural areas in Jiangxi province, explore the in?uencing factors associated with chronic disease, evaluate its equity among different income groups, and analyze the influencing factors on the inequality of chronic diseases prevalence. Consequently, provide a feasible theoretical basis for strategies-making on prevention and control of chronic diseases, for promoting the equity on prevalence of chronic diseases, and improving the standard of health among rural adults in Jiangxi province. Methods:Multi-stage stratified random sampling method was used to get 3 counties, 9 townships, 27 administrative villages in Jiangxi province, and then randomly selected 70 permanent households from each administrative village to conduct questionnaire surveys. Baseline survey was performed in the year of 2003-2004, and five follow-up surveys were performed in the year of 2006, 2008, 2010, 2012 and 2014. We selected respondents aged no less than 18 years old as research objects. Prevalence rate was applied to describe the conditions of chronic diseases. Chi-square test and non-conditional logistic regression were conducted to analyze the influencing factors associated with prevalence of chronic diseases. Using seven kinds of grouping method, CI and SII were applied as equity evaluation indexs. Decomposition of CI was used to explore the influencing factors on the inequality of chronic diseases prevalence. Results:1. Prevalence rate of chronic diseases: the age standardized prevalence rates of chronic diseases among sampling population were 14.10%、10.10%、11.34%、9.22%、9.29%、7.68% respectively in baseline survey and in the year of 2006, 2008, 2010, 2012, 2014, in which a declining trend was noted as a whole(χ2=173.447, P=0.000).2. Influencing factors associated with prevalence of chronic diseases: the factors which may result in higher prevalence rate of chronic diseases among sampling population from the six surveys were increasing age(OR=1.618), female(OR=1.085), occupation(farmer OR=1.513), marital status(divorced or widowed OR=1.553). The factors which may result in lower prevalence rate of chronic diseases were survey conducted in the year of 2006(OR=0.579), 2008(OR=0.561), 2010(OR=0.431), 2012(OR=0.457), 2014(OR=0.387), higher educational level(OR=0.851), higher per capita annual income(OR=0.962) and employment(employed OR=0.729). The influencing factors associated with prevalence of chronic diseases in the year of 2014 were age(OR=1.657), gender(female OR=1.217), occupation(farmer OR=1.909), marital status(divorced or widowed OR=1.857), employment(employed OR=0.640), smoking(OR=1.656) and drinking(OR=1.133).3. Equity of chronic diseases prevalence: For the six surveys, CI were-0.100,-0.059,-0.086,-0.168,-0.159,-0.131 respectively. All the absolute values of CI were fluctuated around 0.1, and achieving the maximum in the year of 2012. SII were-0.436,-0.555,-0.757,-0.508,-0.479,-0.791 respectively, and the absolute values showed a increasing trend overall.4. Contributors on the inequality of chronic diseases prevalence: the factors increased the inequality of chronic diseases prevalence were divorced or widowed(contribute rate 67.92%) and age(66.54%) in baseline survey. In the year of 2006, they were divorced or widowed(119.69%), age(51.09%) and female(13.05%). In the year of 2008, they were age(89.36%), divorced or widowed(31.40%) and married(13.50%). In the year of 2010, they were divorced or widowed(104.59%), age(65.93%) and farmer(14.86%). In the year of 2012, they were divorced or widowed(64.78%) and age(44.02%). In the year of 2014, they were age(45.04%), smoking(35.88%), drinking(26.23%) and divorced or widowed(17.41%). Conclusions:1. Health of rural adults in Jiangxi province is in a good condition. The prevalence rate of chronic diseases is relatively lower as a whole, showing a declining trend year by year. It is prompted that the funding level of New Rural Co-operative Medical System was increasing year by year, the strength of compensation was also increasing, and farmers’ health service demand was gradually eased.2. Age is the main influencing factor of chronic diseases prevalence. The risk of suffering from chronic diseases gradually increased with age. Smoking and drinking are risk factors of chronic diseases. Prevention of chronic diseases should be centred on elderly population. In addition, health concerns on females, farmers, those with a low level of education, those who are divorced or widowed and those who are unemployed should be strengthened. Behavior intervention should be conducted on those who have bad behavior habits such as smoking and drinking.3. Equity on chronic diseases prevalence of rural adults in Jiangxi province is in a good condition as a whole. However, the economic income level has a certain influence on the prevalence of chronic diseases, which tend to the lower income population. Relevant policies need to be promoted continuely to improve the accessibility of medical service for the low-income population in future.4. Age and divorced or widowed are the main contributors of the inequality on chronic diseases prevalence. Smoking and drinking also increase the inequality on chronic diseases prevalence to a certain extent. On the other hand, higher educational level and employed have an opposite effect on it.