Xu Fei, Ah Tse Lap, Yin Xiaomei, Yu Ignatius Tak-sun, Griffiths Sian
Nanjing Municipal Center for Disease Control & Prevention, Nanjing, PR China.
BMC Public Health. 2008 May 21;8:170. doi: 10.1186/1471-2458-8-170.
An inverse relationship between better socioeconomic status (total household income, education or occupation) and stroke has been established in developed communities, but family size has generally not been considered in the use of socioeconomic status indices. We explored the utility of Family Average Income (FAI) as a single index of socioeconomic status to examine the association with stroke prevalence in a region of China, and we also compared its performance as a single index of socioeconomic status with that of education and occupation.
A population-based cross-sectional study was conducted in Nanjing municipality of China during the period between October 2000 and March 2001. A total of 45 administrative villages were randomly selected using a multi-stage sampling approach and all regular local residents aged 35 years or above were included. Descriptive statistics and logistic regression models were used in analysis.
The overall prevalence of diagnosed stroke was 1.54% in all 29,340 eligible participants. An elevated prevalence of stroke was associated with increasing levels of FAI. After adjustment for basic demographic variables (age, urban/rural area and gender) and a group of defined conventional risk factors, this gradient still remained significant, with participants in the highest (OR = 1.94, 95% CI = 1.40, 2.70) and middle (OR = 1.43, 95% CI = 1.01, 2.02) categories of FAI having higher risks compared with the lowest category. A significantly elevated OR of stroke prevalence was found in white collar workers compared to blue collar workers, while no significant relationship was observed with education.
Our study consistently revealed that the prevalence of stroke was associated with increasing levels of all SES indices, including FAI, education, and occupation. However, a significant gradient was only observed with FAI after controlling for important confounding factors. The findings suggested that, compared with occupation and education, FAI could be used as a more sensitive index of socio-economic status for public health studies in China.
在发达社区中，较好的社会经济地位（家庭总收入、教育程度或职业）与中风之间存在负相关关系，但在使用社会经济地位指标时，家庭规模通常未被考虑在内。我们探讨了家庭平均收入（FAI）作为社会经济地位单一指标在中国某地区与中风患病率之间关联的效用，并且还将其作为社会经济地位单一指标的表现与教育程度和职业进行了比较。
2000年10月至2001年3月期间，在中国南京市开展了一项基于人群的横断面研究。采用多阶段抽样方法随机选取了45个行政村，纳入了所有35岁及以上的当地常住居民。分析中使用了描述性统计和逻辑回归模型。
在所有29340名符合条件的参与者中，确诊中风的总体患病率为1.54%。中风患病率的升高与FAI水平的增加相关。在对基本人口统计学变量（年龄、城乡地区和性别）以及一组确定的传统危险因素进行调整后，这种梯度仍然显著，与FAI最低类别相比，最高（OR = 1.94，95%CI = 1.40，2.70）和中间（OR = 1.43，95%CI = 1.01，2.02）类别的参与者中风风险更高。与蓝领工人相比，白领工人中风患病率的OR显著升高，而与教育程度未观察到显著关系。
我们的研究一致表明，中风患病率与包括FAI、教育程度和职业在内的所有社会经济地位指标水平的增加相关。然而，在控制重要混杂因素后，仅FAI观察到显著梯度。研究结果表明，与职业和教育程度相比，FAI可作为中国公共卫生研究中更敏感的社会经济地位指标。
