Jiao Chen, Leng Anli, Nicholas Stephen, Maitland Elizabeth, Wang Jian, Zhao Qinfeng, Xu Lizheng, Gong Chaofan
Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China.
Int J Environ Res Public Health. 2020 Nov 28;17(23):8855. doi: 10.3390/ijerph17238855.
(1) Background: The association between multimorbidity and mental health is well established. However, the role of gender in different populations remains unclear. Currently, China is facing an increased prevalence of multimorbidity, especially in its disease-causing poverty population. The present study explores the gender-based differences in the relationship between multimorbidity and mental health using data from the rural, disease-causing poverty, older-age population in Shandong province, China, as a case study. (2) Methods: The data were obtained from the survey on the health and welfare of disease-causing poverty households in rural Shandong province. We identified 936 rural participants who were over 60 years old from disease-causing poverty households. The mental health status was measured using the Kessler Psychological Distress Scale (K10) instrument. Using a multivariable linear regression model, including the interaction of gender and multimorbidity, gender differences in the association between multimorbidity and mental health were explored. (3) Results: Multimorbidity was a serious health problem in rural, disease-causing poverty, older-age households, with the prevalence of multimorbidity estimated as 40% for women and 35.4% for men. There was a strong association between multimorbidity and mental health, which was moderated by gender. Women had higher K10 scores than men, and the mean K10 score was highest in women with three or more chronic diseases. Compared with men, women with multimorbidity had a higher risk of mental health problems. (4) Conclusions: The prevalence of multimorbidity in older-age rural disease-causing poverty subpopulations is a severe public health problem in China. The association between multimorbidity and mental health differed by gender, where multimorbid women suffered an increased mental health risk compared with men. Gender differences should be addressed when delivering effective physical and mental healthcare support to disease-causing poverty, older-age, rural households.
（1）背景：多种疾病并存与心理健康之间的关联已得到充分证实。然而，性别在不同人群中所起的作用仍不明确。当前，中国多种疾病并存的患病率呈上升趋势，尤其是在因病致贫人群中。本研究以中国山东省农村因病致贫老年人群的数据为例，探讨多种疾病并存与心理健康关系中的性别差异。（2）方法：数据来源于山东省农村因病致贫家庭健康与福利调查。我们从因病致贫家庭中识别出936名60岁以上的农村参与者。使用凯斯勒心理困扰量表（K10）工具测量心理健康状况。采用多变量线性回归模型，包括性别与多种疾病并存的交互作用，探讨多种疾病并存与心理健康关联中的性别差异。（3）结果：多种疾病并存是农村因病致贫老年家庭中的一个严重健康问题，女性多种疾病并存的患病率估计为40%，男性为35.4%。多种疾病并存与心理健康之间存在密切关联，且受性别影响。女性的K10得分高于男性，患有三种或更多慢性病的女性平均K10得分最高。与男性相比，患有多种疾病的女性出现心理健康问题的风险更高。（4）结论：农村老年因病致贫亚人群中多种疾病并存的患病率是中国一个严重的公共卫生问题。多种疾病并存与心理健康的关联因性别而异，患有多种疾病的女性与男性相比心理健康风险增加。在为因病致贫的农村老年家庭提供有效的身心医疗支持时，应考虑性别差异。
