Yang Juan, Liu Shan, Li Fei, Meng Haodong, Qiao Hui, Xie Yongxin
School of Public Health, Ningxia Medical University, Yinchuan, China.
Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China.
Front Public Health. 2025 Jun 23;13:1599656. doi: 10.3389/fpubh.2025.1599656. eCollection 2025.
With the acceleration of the aging process, the health shock on the middle-aged and older adults people has become a key issue that urgently needs to be solved. Health shock refers to the long-term fluctuating effect on the future level of family health welfare due to the uncertainty of the health status of family members in the short term. The occurrence of health shocks is related to many factors, among which chronic comorbidity is an important factor affecting the occurrence of health shocks in the middle-aged and older adults people. The purpose of this study was to explore the developmental trajectories and interactions of chronic comorbidities and health shocks in rural residents in the southern mountainous areas of Ningxia.
On the basis of health follow-up data from rural middle-aged and older adults people in Ningxia in 2009, 2015, 2019 and 2022, the dynamic associations between chronic comorbidities and health shocks in rural residents in mountainous areas of southern Ningxia were analyzed via the latent growth model (LGM) and cross-lagged model (CLM).
The unconditional latent growth model (ULGM) revealed that chronic comorbidities ( = 26.807, < 0.001) and health shocks ( = 64.296, < 0.001) are increasing in the 14-year period from 2009 to 2022. The parallel latent growth model (PLGM) revealed that the initial level of health shock had a significant positive predictive effect on both the initial level and the rate of change of chronic comorbidities. The change rate of health shocks had a significant positive predictive effect on the initial level of chronic comorbidities and a relatively significant negative predictive effect on the rate of change of chronic comorbidities. The initial level of chronic comorbidities had a significant positive predictive effect on the initial level of health shock and a significant negative predictive effect on the change rate of health shock. The change rate of chronic comorbidity has no significant predictive effect on the initial level and change rate of health shock. The results of the cross-lagged model (CLM) indicate a bidirectional causal association between chronic comorbidities and health shocks.
Based on a 14-year tracking data study, this research found that both chronic comorbidities and health shocks were on the rise, and there was a dynamic interaction and bidirectional causal relationship between the two, which could predict each other's development trends. Based on the empirical results, it is recommended to strengthen the monitoring and management chronic comorbidities to reduce the risk of health shocks. Meanwhile, it is also necessary to closely monitor health shock events, and accordingly optimize the management strategies for chronic comorbidities, thereby reducing the incidence of health shocks among the middle-aged and older adults population, improving the quality of life and health, and promoting the realization of the goal of healthy aging.
随着老龄化进程的加速,中老年人群的健康冲击已成为亟待解决的关键问题。健康冲击是指由于家庭成员短期健康状况的不确定性对家庭未来健康福利水平产生的长期波动影响。健康冲击的发生与多种因素相关,其中慢性共病是影响中老年人群健康冲击发生的重要因素。本研究旨在探讨宁夏南部山区农村居民慢性共病与健康冲击的发展轨迹及相互作用。
基于2009年、2015年、2019年和2022年宁夏农村中老年人群的健康随访数据,通过潜在增长模型(LGM)和交叉滞后模型(CLM)分析宁夏南部山区农村居民慢性共病与健康冲击之间的动态关联。
无条件潜在增长模型(ULGM)显示,在2009年至2022年的14年期间,慢性共病(χ² = 26.807,P < 0.001)和健康冲击(χ² = 64.296,P < 0.001)均呈上升趋势。平行潜在增长模型(PLGM)显示,健康冲击的初始水平对慢性共病的初始水平和变化率均有显著的正向预测作用。健康冲击的变化率对慢性共病的初始水平有显著的正向预测作用,但对慢性共病的变化率有相对显著的负向预测作用;慢性共病的初始水平对健康冲击的初始水平有显著的正向预测作用,但对健康冲击变化率有显著负向预测作用;慢性共病的变化率对健康冲击的初始水平和变化率均无显著预测作用。交叉滞后模型(CLM)结果表明慢性共病与健康冲击之间存在双向因果关联。
基于14年追踪数据研究,本研究发现慢性共病和健康冲击均呈上升趋势,二者之间存在动态相互作用和双向因果关系,能够相互预测对方的发展趋势。基于实证结果,建议加强慢性共病的监测与管理,以降低健康冲击风险。同时,也有必要密切监测健康冲击事件,并据此优化慢性共病管理策略,从而降低中老年人群健康冲击的发生率,提高生活质量与健康水平,促进健康老龄化目标的实现。