Disease burden of stroke and its economic impact on household economic status among Han, Naxi and Bai rural residents in Yunnan province

  Objective  To examine disease burden of stroke and its impact on household economic status among Han, Naxi and Bai rural residents in Yunnan province for providing evidences to the prevention and treatment of stroke in different ethnic populations.

  Methods  Using stratified multistage random sampling, we conducted a face-to-face questionnaire survey among 7 534 Han, Naxi, and Bai permanent residents aged ≥ 35 years and over recruited in three counties (a non-national autonomous county, a Naxi and a Bai autonomous county) in Yunnan province from January 2018 through February 2019. Disability-adjusted life years (DALY) was used to estimate stroke-related disease burden among the participants and the incidence of catastrophic health expenditure and poverty due to stroke were adopted to evaluate the impact of stroke on household economic status.

  Results  The prevalence of stroke for the residents of Han (n = 2 502), Naxi (n = 2 531), and Bai (n = 2 501) were 4.2%, 1.8%, and 6.2%, respectively, and the prevalence was significantly higher among the Bai residents than that among the Han and Naxi residents (both P < 0.001). For the 1 000 Han, Naxi and Bai residents, the years of life lost (YLL) attributed to stroke were 17.10, 24.75 and 11.79; the years lived with disability (YLD) were 10.84, 4.64 and 16.00; and the DALY were 27.94, 29.39 and 27.79, respectively. Among the Han, Naxi, and Bai families with stroke patients, the incidence of catastrophic health expenditure was 32.08%, 22.73%, and 25.16% and that of poverty was 33.96%, 20.45% and 18.71%, respectively, with a significant difference in the stroke-related poverty incidence among the Han, Naxi and Bai families (χ² = 8.375, P = 0.015).

  Conclusion  The disease burden of stroke is heavy and the burden exerts an obvious impact on economic status of the families with stroke patients among rural Han, Naxi and Bai residents in Yunnan province; the results suggest that effective and specific measures should be taken among the residents of different nationalities to reduce the disease burden and its economic impact.