Volozh O, Deev A, Solodkaya E, Abina J, Kalyuste T, Kaup R, Goldsteine G, Olferiev A
Institute of Cardiology, Tallinn, Estonia.
Public Health. 1998 Sep;112(5):303-8. doi: 10.1038/sj.ph.1900484.
To construct a complex indicator, the Health Index, for the determination of the general health profile of the population and to assess the time trends of the latter in the male population of Tallinn, the capital of Estonia.
Three epidemiological studies of cardiovascular diseases (CVD) risk factor involving independent random samples of the male population of Tallinn aged 30-59 y were carried out in 1981/82 (survey I), in 1984/85 (survey II) and in 1992/94 (survey III), the total number of participants was 5019. The screening procedure included standard epidemiological methods. The cohorts of the surveys I and II were followed up for 11 y on average; 457 deaths of cases were registered during that period. For the assessment of the general health profile of the population the Health Index was constructed on the basis of mortality follow-up data of the above mentioned two cohorts by means of the survival analysis methods using SAS (Statistical Analysis System). 20 variables were tested, 11 of them were selected as statistically significant for the prediction of total mortality: systolic blood pressure, heart rate, coronary heart disease (CHD) status (P < 0.0001), total cholesterol (TC), TC2, body mass index (BMI), BMI2, education, smoking, alcohol consumption (P < 0.01), marital status (P < 0.05). The predictive ability of the Health Index for CHD, CVD and total mortality was confirmed by analysing the age-adjusted relative risks according to the deciles of the Health Index.
The Health Index was used to determine the general health profile of the male population of Tallinn aged 30-59 y at surveys I, II and III and for the assessment of its time trends between the three surveys (1981/82-1992/94). We have established an improvement of the health profile in the studied population from survey I to survey II and a further improvement for those aged over 40 y from the surveys II and III.
The Health Index should be regarded as a valuable tool for the assessment of health trends in the population. The mortality decline expected in this study was confirmed by observed mortality trends in the Estonian male population.
构建一个综合指标——健康指数，用于确定人群的总体健康状况，并评估爱沙尼亚首都塔林男性人群中该指标随时间的变化趋势。
在1981/82年（调查I）、1984/85年（调查II）和1992/94年（调查III）对塔林30 - 59岁男性人群的独立随机样本进行了三项心血管疾病（CVD）危险因素的流行病学研究，参与者总数为5019人。筛查程序包括标准的流行病学方法。调查I和II的队列平均随访了11年；在此期间登记了457例死亡病例。为了评估人群的总体健康状况，基于上述两个队列的死亡率随访数据，使用SAS（统计分析系统）的生存分析方法构建了健康指数。测试了20个变量，其中11个被选为对总死亡率预测具有统计学意义的变量：收缩压、心率、冠心病（CHD）状态（P < 0.0001）、总胆固醇（TC）、TC2、体重指数（BMI）、BMI2、教育程度、吸烟、饮酒量（P < 0.01）、婚姻状况（P < 0.05）。通过根据健康指数的十分位数分析年龄调整后的相对风险，证实了健康指数对冠心病、心血管疾病和总死亡率的预测能力。
健康指数用于确定调查I、II和III时塔林30 - 59岁男性人群的总体健康状况，并评估三次调查（1981/82 - 1992/94）之间其随时间的变化趋势。我们发现，从调查I到调查II，研究人群的健康状况有所改善，40岁以上人群从调查II到调查III进一步改善。
健康指数应被视为评估人群健康趋势的有价值工具。本研究中预期的死亡率下降得到了爱沙尼亚男性人群观察到的死亡率趋势的证实。
