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减少超重和肥胖对健康不平等的影响评估。

A health inequality impact assessment from reduction in overweight and obesity.

机构信息

Department of Public Health, University of Copenhagen, Faculty of Health Sciences, Section of Social Medicine, CSS, Øster Farimagsgade 5, Postbox 2099, DK-1014, Copenhagen K, Denmark.

Danish Centre for Health Economics (DaCHE), University of Southern Denmark, Odense, Denmark.

出版信息

BMC Public Health. 2020 Nov 30;20(1):1823. doi: 10.1186/s12889-020-09831-x.

Abstract

BACKGROUND

In recent years, social differences in overweight and obesity (OWOB) have become more pronounced. Health impact assessments provide population-level scenario evaluations of changes in disease prevalence and risk factors. The objective of this study was to simulate the health effects of reducing the prevalence of overweight and obesity in populations with short and medium education.

METHODS

The DYNAMO-HIA tool was used to conduct a health inequality impact assessment of the future reduced disease prevalence (ischemic heart disease (IHD), diabetes, stroke, and multi-morbidity) and changes in life expectancy for the 2040-population of Copenhagen, Denmark (n = 742,130). We simulated an equalized weight scenario where the prevalence of OWOB in the population with short and medium education was reduced to the levels of the population with long education.

RESULTS

A higher proportion of the population with short and medium education were OWOB relative to the population with long education. They also had a higher prevalence of cardiometabolic diseases. In the equalized weight scenario, the prevalence of diabetes in the population with short education was reduced by 8-10% for men and 12-13% for women. Life expectancy increased by one year among women with short education. Only small changes in prevalence and life expectancy related to stroke and IHD were observed.

CONCLUSION

Reducing the prevalence of OWOB in populations with short and medium education will reduce the future prevalence of cardiometabolic diseases, increase life expectancy, and reduce the social inequality in health. These simulations serve as reference points for public health debates.

摘要

背景

近年来,超重和肥胖(OWOB)在不同社会群体间的差异变得更加明显。健康影响评估为人群疾病流行率和风险因素变化提供了基于人口水平的情景评估。本研究的目的是模拟降低中低教育人群超重和肥胖流行率对健康的影响。

方法

使用 DYNAMO-HIA 工具对丹麦哥本哈根 2040 年人口(n=742130)未来疾病流行率(缺血性心脏病(IHD)、糖尿病、中风和多种疾病)降低和预期寿命变化的健康不平等影响进行评估。我们模拟了一个均衡体重的情景,即将中低教育人群的 OWOB 流行率降低到高教育人群的水平。

结果

与高教育人群相比,中低教育人群中 OWOB 的比例更高,且他们患心血管代谢疾病的流行率也更高。在均衡体重的情景下,中低教育男性的糖尿病流行率降低了 8-10%,女性降低了 12-13%。中低教育女性的预期寿命增加了一年。仅观察到与中风和 IHD 相关的患病率和预期寿命的微小变化。

结论

降低中低教育人群中 OWOB 的流行率将降低未来心血管代谢疾病的流行率,提高预期寿命,并减少健康方面的社会不平等。这些模拟结果为公共卫生辩论提供了参考点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1742/7706236/cbd45ddc5fd4/12889_2020_9831_Fig1_HTML.jpg

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