Guo Jing, Li Jiasen, Huang Kehui, Huang Ning, Feng Xing Lin
Department of Health Policy and Management, School of Public Health, Peking University, Beijing, People's Republic of China.
Arch Public Health. 2021 Aug 30;79(1):157. doi: 10.1186/s13690-021-00678-1.
Non-communicable diseases (NCDs) have become a priority public health issue. The aim of this study was to examine whether socio-economic inequalities exist in chronic disease management among Chinese adults, and whether the relationship between SES and chronic disease management mediated by social capital.
We used combined data from China Health and Retirement Longitudinal Study (CHARLS). A total of 19,291 subjects, including 14,905 subjects from 2011 survey, 2036 subjects from 2013, and 2350 subjects from 2015 was included in this study.
Subjects living in urban setting, with higher education attainment and economic status were more likely to have annual health checks, and to be diagnosed for those with hypertension, diabetes and dyslipidemia (all P < 0.05). Social participation could mediate the association between social economic status (SES) and annual health checks, diagnosis of hypertension and dyslipidemia, and health education of hypertension. Health checks could mediate the association between social participation and the diagnosis of hypertension, diabetes and dyslipidemia. The proportions of mediation were 17.5, 23.9 and 8.9%, respectively. There were no mediating effects observed from cognitive social capital variable-perceived helpfulness.
It is necessary to deeply reform our social security system and enhance the social capital construction to promote those low SES people's physical health.
非传染性疾病已成为公共卫生领域的一个优先问题。本研究旨在探讨中国成年人在慢性病管理方面是否存在社会经济不平等，以及社会经济地位与慢性病管理之间的关系是否由社会资本介导。
我们使用了中国健康与养老追踪调查（CHARLS）的合并数据。本研究共纳入19291名受试者，包括2011年调查的14905名受试者、2013年的2036名受试者和2015年的2350名受试者。
居住在城市、具有较高教育程度和经济地位的受试者更有可能进行年度健康检查，并且更有可能被诊断患有高血压、糖尿病和血脂异常（所有P<0.05）。社会参与可以介导社会经济地位（SES）与年度健康检查、高血压和血脂异常诊断以及高血压健康教育之间的关联。健康检查可以介导社会参与与高血压、糖尿病和血脂异常诊断之间的关联。中介比例分别为17.5%、23.9%和8.9%。从认知社会资本变量——感知帮助性方面未观察到中介效应。
有必要深入改革我国社会保障制度，加强社会资本建设，以促进低社会经济地位人群的身体健康。
