Shandong University, Jinan, People's Republic of China.
Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
Int J Equity Health. 2017 Mar 14;16(1):50. doi: 10.1186/s12939-017-0545-7.
China has experienced a rapid increase in hypertension over the past decade, especially in rural. Therefore, the aim of this research is to examine the dynamic trends in urban-rural disparities in hypertension prevalence, detection, and medication use among Chinese adults from 1993 to 2011.
Data were extracted from the seven latest waves of the China Health and Nutrition Survey (CHNS). We used the hukou system to distinguish between urban and rural residents. Chi-square tests were performed to examine urban-rural gaps in hypertension prevalence, detection and medication use. Multiple logistic regressions were used to confirm these disparities and to explore whether the urban-rural gaps have narrowed or widened from 1993 to 2011, after controlling for health-related behaviors, BMI, demographic variables and socioeconomic characteristics. Blinder-Oaxaca decomposition technique was also used to calculate the extent to which urban-rural disparities reflect an endowments effect or a coefficients effect.
Hypertension prevalence, detection, and medication use among rural adults were significantly lower than urban adults, with the significant level at p < 0.001. The urban-rural gaps in hypertension prevalence and medication use gradually narrowed during the period 1993-2011, whereas the gaps in hypertension detection grew wider. After controlling for confounding variables, urban adults were about 24.5, 49.4, and 89.5% more likely to be hypertensive, detected, and medicated than their rural counterparts (p < 0.01), respectively. The Blinder-Oaxaca decomposition suggested that approximately 22 and 26% of the urban-rural gap in hypertension detection and medication use could be attributed to coefficient difference, respectively.
Although hypertension prevalence among rural adults was comparable to that of urban adults, hypertension detection and medication use of rural adults were still suboptimal. Unusually large urban-rural gaps and an expanding trend in hypertension detection deserve the attention of health policymakers and researchers.
在过去的十年中，中国的高血压患病率迅速上升，尤其是在农村地区。因此，本研究旨在探讨中国成年人城乡高血压患病率、检出率和药物治疗率的动态变化趋势。
数据来自中国健康与营养调查（CHNS）的最新 7 个波次。我们采用户口制度区分城市和农村居民。采用卡方检验比较高血压患病率、检出率和治疗率的城乡差异。采用多因素逻辑回归模型控制健康相关行为、BMI、人口统计学变量和社会经济特征后，进一步确认这些城乡差异，并探讨 1993 年至 2011 年城乡差距是否缩小或扩大。此外，我们还采用 Blinder-Oaxaca 分解技术来计算城乡差距在多大程度上反映了禀赋效应或系数效应。
农村成年人的高血压患病率、检出率和治疗率均显著低于城市成年人，差异具有统计学意义（p<0.001）。1993 年至 2011 年期间，高血压患病率和治疗率的城乡差距逐渐缩小，而高血压检出率的差距则逐渐扩大。控制混杂因素后，城市成年人患高血压、被检出和接受药物治疗的可能性分别比农村成年人高 24.5%、49.4%和 89.5%（p<0.01）。Blinder-Oaxaca 分解表明，高血压检出率和治疗率的城乡差距约有 22%和 26%可以归因于系数差异。
尽管农村成年人的高血压患病率与城市成年人相当，但农村成年人的高血压检出率和治疗率仍不理想。城乡差距较大且呈扩大趋势，这一现象值得卫生政策制定者和研究人员关注。
