我国老年人健康自评状况相关社会经济因素的系统评价
A Systematic Review on the Relevance between Socioeconomic Factors and Self-Rated Health among Chinese Elders
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摘要:
目的 评价社会健康功能和经济状况与我国老年人健康自评的相关性及其人群归因危险度。 方法 检索 1960-2009年 4月发表的有关社会健康功能和经济状况对我国老年人健康自评影响的中文和英文文献。计算有关因素的合并比值比(odds ratio, OR)值及其 95%可信区间(confidence interval, CI); 结合人群暴露率, 估计人群归因危险度。 结果 共纳入 4篇横断面研究。与我国老年人健康自评较差密切相关的社会健康功能主要是生活不满意OR 2.98,95% CI(1.82, 4.87), 家庭关系不和谐OR 2.71, 95% CI(2.10, 3.51), 没有人关心OR 1.68, 95% CI(1.16, 2.43);其经济状况主要是收支不平衡OR 2.02, 95% CI(1.19, 3.43), 支付医疗费用困难OR 1.94, 95% CI(1.41, 2.68), 家庭月收入少于 100元OR 1.77, 95% CI(1.46, 2.15); 其人群归因危险度分别为 24.19%、19.65%和 14.18%。对我国老年人健康自评影响最大的前三位经济状况依次为支付医疗费用困难、家庭月收入少于 100元及收入不是来自自己, 其人群归因危险度分别为 24.83%、18.42%和 18.05%。 结论 积极防治老年人慢性病和提倡老年人参加社会活动是社区保健和卫生行政部门的工作重点。但由于纳入的研究较少, 论证强度较低, 目前尚缺乏高质量证据证明各种影响因素与老年人健康自评的相关性。 Abstract:Objective To assess the relevance between social functions/economic situations and self-rated health (SRH) and to estimate the population attributable risk proportion (PARP) among Chinese elders. Methods Articles of interest were systematically and comprehensively identified through searches of English and Chinese databases (Jan 1960-July 2009). Combined odds ratio (OR) and 95% confidence interval (CI) of relevant risk factors were calculated. Based on these combined OR values and the population exposure rate, PAPR was estimated. Results Four cross-sectional studies were included and analyzed. The main social functions associated with poor self-rated health among Chinese elders were unpleasant lifeOR 2.98, 95% CI (1.82, 4.87), disharmonious familyOR 2.71, 95% CI (2.10, 3.51), and lack of careOR 1.68, 95% CI (1.16, 2.43), for which the PAPR were 24.19%, 19.65% and 14.18% respectively. Their economic conditions were overdraft OR 2.02, 95% CI (1.19, 3.43), difficult to pay medical expensesOR 1.94, 95% CI (1.41, 2.68), and monthly family income less than 100 YuanOR 1.77, 95% CI (1.46, 2.15). The top three economic conditions associated with self-rated health in Chinese elders were difficult to pay medical expenses, monthly family income less than 100 Yuan and no self-earned income, for which the PAPR were 24.83%, 18.42% and 18.05% respectively. Conclusion The control and prevention of chronic disease for the elders and encouraging them to participate in social activities are still what the community health care centers and administrations focusing on. However, the relevance between socioeconomic factors and self-rated health remains in suspense due to the lack of studies and evidence.
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