Prevalence and influencing factors of suboptimal health among urban middle-aged and elderly residents in China
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摘要:
目的 了解城市中老年居民亚健康状况及其影响因素,为促进城市中老年居民健康提供参考依据。 方法 于2017年12月 — 2018年10月采用多阶段分层随机抽样方法在四川省、黑龙江省、甘肃省、天津市和广东省抽取3600名 ≥ 45岁城市中老年居民进行亚健康状况问卷调查,并应用多因素非条件logistic回归模型分析其亚健康状况的主要影响因素。 结果 最终纳入分析的3476名城市中老年居民的总体亚健康检出率为66.51 %,其中生理亚健康、心理亚健康和社会亚健康的检出率分别为67.17 %、63.98 %和69.45 %;多因素非条件logistic回归分析结果显示,受二手烟影响程度大、有不良饮食习惯和近半年经历过应激事件为城市中老年居民亚健康状态的危险因素;在婚、家庭人均月收入2500~7500元、按时早睡、高挫商和自我健康关注度高为城市中老年居民亚健康状态的保护因素。 结论 城市中老年居民亚健康检出率较高,婚姻状况、家庭人均月收入、受二手烟影响程度、有无不良饮食习惯、是否按时早睡、挫商程度、自我健康关注度和近半年是否经历过生活应激事件是城市中老年居民亚健康状态的主要影响因素。 Abstract:Objective To examine the prevalence and influencing factors of suboptimal health among urban middle-aged and elderly residents and to provide evidence for health promotion in the population. Methods Using stratified multistage random sampling, we recruited 3 600 urban permanent residents aged 45 years and above in five provinces across China and carried out a survey with Sub-Health Measurement Scale Version 1.0 and a self-designed questionnaire during December 2017 – October 2018. Unconditional multivariate logistic regression was adopted to explore influencing factors of suboptimal health status of the participants. Results Among 3476 participants completing the survey, the detection rate of general suboptimal health was 66.51% and the detection rate of physical, mental, and social suboptimal health status were 67.17%, 63.98%, and 69.45%, respectively. The results of unconditional multivariate logistic regression analysis revealed that with higher exposure to second-hand smoke, having unhealthy dietary behavior, and experiencing stress event during past six months were risk factors for suboptimal health; while, being married, with a monthly household income of 2 500 – 7 500 RMB yuan per capita, going to bed early and on time, with high adversity quotient, and paying a close attention to self-health were protective factors against suboptimal health. Conclusion Among urban permanent residents aged 45 years and above in China, the detection rate of suboptimal health status was relatively high, and mainly influenced by marital status, monthly household income per capita, second-hand smoke exposure, unhealthy eating habits, sleeping on time, adversity quotient, attention to self-health and recent stressful life event. -
Key words:
- suboptimal health /
- influencing factor /
- middle-aged and elderly residents /
- urban area
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表 1 城市中老年居民5种状态检出情况
项目 疾病(例) 轻度亚健康(人) 中度亚健康(人) 重度亚健康(人) 健康(人) 总体 618 583 1242 487 546 生理 631 492 1347 496 510 心理 554 475 1257 492 698 社会 575 551 1376 487 487 表 2 不同特征城市中老年居民亚健康状况比较
特征 调查人数 亚健康检出人数 亚健康检出率(%) χ2 值 P 值 性别 男性 1406 1142 81.22 0.192 0.661 女性 1452 1170 80.58 年龄(岁) 45~54 1250 1036 82.88 6.029 0.049 55~64 776 611 78.74 ≥ 65 832 665 79.93 文化程度 高中及以下 1942 1603 82.54 11.489 0.003 大专/本科 881 684 77.64 硕士及以上 35 25 71.43 婚姻状况 非在婚 375 330 88.00 14.096 <0.001 在婚 2483 1982 79.82 家庭人均月收入(元) <2500 826 713 86.32 22.775 <0.001 2500~7500 1854 1463 78.91 >7500 178 136 76.40 有无医疗保险 无 239 196 82.00 0.209 0.648 有 2619 2116 80.79 受二手烟影响程度 小 1477 1149 77.79 19.043 <0.001 大 1381 1163 84.21 有无不良饮食习惯 无 1657 1284 77.49 29.604 <0.001 有 1201 1028 85.60 是否按时早睡 否 1317 1118 84.89 25.214 <0.001 是 1541 1194 77.48 睡眠时间(h/d) <5 58 50 86.21 17.417 <0.001 5~7 728 625 85.85 >7 2072 1637 79.01 是否独生子女 否 2434 1968 80.85 0.018 0.893 是 424 344 81.13 家庭结构 核心家庭 1430 1176 82.24 8.102 0.017 大家庭 1215 955 78.60 其他家庭 213 181 84.98 挫商程度 低 1548 1374 88.76 135.141 <0.001 高 1310 938 71.60 自我健康关注度 低 1532 1331 86.88 76.512 <0.001 高 1326 981 73.98 近半年是否经历过应激事件 无 1577 1185 75.14 75.350 <0.001 有 1281 1127 87.98 表 3 城市中老年居民亚健康状态影响因素多因素非条件logistic回归分析
因素 参照组 β $S_{\bar x}$ Wald χ2 值 P 值 OR 值 95 % CI 婚姻状况 在婚 非在婚 – 0.766 0.175 19.081 <0.001 0.465 0.330~0.655 家庭人均月收入(元) 2500~7500 <2500 – 0.363 0.123 8.702 0.003 0.696 0.547~0.885 >7500 – 0.385 0.217 3.138 0.076 0.681 0.445~1.042 受二手烟影响程度 大 小 0.314 0.103 9.211 0.002 1.369 1.118~1.676 有无不良饮食习惯 有 无 0.302 0.109 7.670 0.006 1.353 1.092~1.676 是否按时早睡 是 否 – 0.249 0.107 5.398 0.020 0.780 0.632~0.962 挫商程度 高 低 – 1.028 0.106 93.358 <0.001 0.358 0.291~0.441 自我健康关注度 高 低 – 0.602 0.105 32.875 <0.001 0.548 0.446~0.673 近半年是否经历过应激事件 有 无 0.811 0.110 53.953 <0.001 2.249 1.812~2.793 -
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