中国中老年人群中糖尿病患病率和治疗率的社会经济因素及不平等。
Socioeconomic Factors and Inequality in the Prevalence and Treatment of Diabetes among Middle-Aged and Elderly Adults in China.
机构信息
School of Health Policy & Management, Nanjing Medical University, 211166 Nanjing, China.
Creative Health Policy Research Group, Nanjing Medical University, 211166 Nanjing, China.
出版信息
J Diabetes Res. 2018 Dec 27;2018:1471808. doi: 10.1155/2018/1471808. eCollection 2018.
BACKGROUND
In China, the prevalence of diabetes has increased significantly over recent decades, owing to the county's rapidly aging population. Although many studies have examined the prevalence of diabetes worldwide, there has been little analysis of the inequalities in its prevalence and treatment among middle-aged and elderly people.
OBJECTIVES
This study evaluates influence factors and inequality in respect to the prevalence of diabetes and medication treatment among middle-aged and elderly Chinese adults.
METHODS
Data were obtained from the China Health and Retirement Longitudinal Study, a nationally representative household survey of middle-aged and elderly people (i.e., 45 years of age or older). Logistic regression models and the concentration index were used to estimate socioeconomic factors and inequalities in diabetes prevalence and treatment.
RESULTS
The prevalence of self-reported diabetes among middle-aged and elderly Chinese adults was 8.4%; this figure was significantly higher in urban areas than in rural areas. Concentrations of prevalence were observed among the poor in urban areas and among the rich in rural areas. Overall, the incidence of receiving antidiabetic medication among diabetes patients was 64.3%; this was significantly higher for individuals in urban areas than those in rural areas, suggesting that awareness of diabetes treatment in urban areas is better than that in rural areas. A disproportionate concentration of incidence of receiving antidiabetic medication was observed among the rich in both urban and rural areas. Socioeconomic factors significantly affected the prevalence of diabetes and the likelihood of receiving medication and are major contributors to inequality.
CONCLUSION
In China, policies and strategies regarding diabetes prevention and control should further focus on associated socioeconomic factors and major contributors to reduce diabetes prevalence, improve diabetes treatment and management, and alleviate current inequality in the prevalence and treatment of diabetes among middle-aged and elderly adults.
背景
在中国，由于人口老龄化，糖尿病的患病率在近几十年来显著增加。虽然许多研究已经研究了全球糖尿病的患病率，但对于中年和老年人中糖尿病患病率和治疗的不平等现象分析较少。
目的
本研究评估了中国中年和老年人糖尿病患病率和药物治疗的影响因素和不平等。
方法
数据来自中国健康与退休纵向研究，这是一项针对中年和老年人（即 45 岁及以上）的全国代表性家庭调查。使用逻辑回归模型和集中指数来估计社会经济因素与糖尿病患病率和治疗的不平等。
结果
中国中年和老年人自我报告的糖尿病患病率为 8.4%；城市地区明显高于农村地区。城市地区贫困人口和农村地区富人中均存在患病率的集中现象。总体而言，糖尿病患者接受抗糖尿病药物治疗的比例为 64.3%；城市地区明显高于农村地区，表明城市地区对糖尿病治疗的认识要好于农村地区。城乡富裕人群接受抗糖尿病药物治疗的比例不成比例地集中。社会经济因素显著影响糖尿病的患病率以及接受药物治疗的可能性，是不平等的主要原因。
结论
在中国，糖尿病预防和控制的政策和策略应进一步关注相关的社会经济因素和主要贡献者，以降低糖尿病的患病率，改善糖尿病的治疗和管理，并减轻中年和老年人中糖尿病患病率和治疗的不平等现象。
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