Population Health Unit, Finnish Institute for Health and Welfare, Finland.
Scand J Public Health. 2023 Aug;51(6):829-834. doi: 10.1177/14034948211061014. Epub 2021 Dec 14.
Information on the future development of prevalences of risk factors and health indicators is needed to prepare for the forthcoming burden of disease in the population and to allocate resources properly for prevention. We aim to present how multiple imputation can be used flexibly to project future prevalences.
The proposed approach uses data on repeated cross-sectional surveys from different years. We create future samples with age and sex distributions corresponding to the official national population forecasts. Then, the risk factors are simulated using multiple imputation by chained equations. Finally, the imputations are pooled to obtain the prevalences of interest. Covariates, such as sociodemographic variables as well as their possible interactions and non-linear terms, can be included in the modelling. The future development of these covariates is also projected simultaneously. We apply the procedure to data from five Finnish health examination surveys conducted between 1997 and 2017, and project the prevalences of obesity, smoking and hypertension to 2020 and 2025.
The prevalence of obesity is projected to increase to 24% for both men and women in 2025. The prevalences of hypertension and smoking are expected to continue decreasing, and the differences between men and women are projected to remain so that men will have higher prevalences.
为了应对即将到来的人口疾病负担，为预防工作合理分配资源，我们需要了解未来风险因素和健康指标的发展趋势。我们旨在介绍如何灵活运用多重插补来预测未来的流行率。
本研究采用了来自不同年份的重复横断面调查数据。我们根据官方的全国人口预测结果，创建了具有相应年龄和性别分布的未来样本。然后，使用链式方程的多重插补模拟风险因素。最后，将插补值汇总以获得感兴趣的流行率。可以在模型中纳入协变量，如社会人口统计学变量及其可能的交互作用和非线性项。同时还可以预测这些协变量的未来发展趋势。我们将该方法应用于 1997 年至 2017 年间进行的五次芬兰健康检查调查数据，并预测肥胖、吸烟和高血压在 2020 年和 2025 年的流行率。
预计到 2025 年，男性和女性的肥胖流行率将分别上升至 24%。高血压和吸烟的流行率预计将继续下降，男性和女性之间的差异预计将保持不变，即男性的患病率更高。
