云南省农村居民2011年和2021年5种常见慢性病疾病负担的变化研究

Background?Chronic diseases have become a major public health problem affecting the health of the populationand the number of patients with chronic diseases in China continues to increaseas well as the increasing number of deaths due to chronic disease by yearand the increasing burden of disease on patients gradually. Understanding the changes in the burden of chronic diseases is of great importance for the prevention and control of chronic diseases. Howeverthere is a lack of research on the changes in the burden of common chronic diseases in rural Yunnan Province. Objective?To examine the changes in the disease burden of five common chronic diseaseshypertensioncoronary heart diseaseCHDstrokeasthmaand chronic obstructive pulmonary diseaseCOPDamong rural residents in Yunnan Province in 2011 and 2021. Methods A repeated cross-sectional design was used to select 8 400 and 7 700 rural residents aged ≥ 35 years in Yunnan Province using multistage stratified random sampling method in 2011 and 2021 as the research subjectsrespectively. Data were collected from on-site questionnaires and physical examinations of study participantsas well as data on the causes of death of five common chronic diseases. Principal component analysis was used to construct a socioeconomic statusSEPindicator by selecting three variables including education levelannual household income per capita and accessibility to medical servicesthe coefficients of the variables were used to calculate the SEP composite scoreand the SEP was classified into four grades of lowmediumlowmedium-high and high based on the quartiles of the SEP composite score. Disability-adjusted life yearDALYwas used to measure the magnitude of the disease burden for five chronic diseases. Results?Compared with 2011the overall prevalence of hypertension25.14% vs. 41.57%stroke1.03% vs. 2.52%and COPD9.23% vs. 12.60%in rural Yunnan Province in 2021 increasedP<0.05as well as the prevalence for malesfemalesand participants with all SEP gradesP<0.05 the overall prevalence of CHD2.02% vs. 2.30%and asthma1.36% vs. 1.61%did not change significantlyP>0.05 while an increase was found in the prevalence of CHD among males and those with high SEP gradeand in the prevalence of asthma among males and those with medium-high SEP gradeP<0.05. In 2021the prevalence of all 5 chronic diseases was higher in males than in femalesP<0.05and there was a decreasing trend in the prevalence of COPD by different grades of SEP in 2021χ2 trend=6.801P<0.001. In additionan increase was found in DALY?per 1 000 population of CHD10.45 vs. 18.18stroke12.80 vs. 23.20asthma4.54 vs. 9.10and COPD35.99 vs. 49.07while a decrease was found in DALY?per 1 000 population of hypertension1.38 vs. 1.26. COPD presents higher DALY?per 1 000 population and years of life disabilityYLDper 1 000 populationwhile stroke presents higher years of life lostYLLper 1 000 population among the five chronic diseases. Conclusion?The prevalence and disease burden of five common chronic diseases among rural residents in Yunnan Province in 2021 were mainly higher than 2011and the disease burden of COPD was the heaviest in 2021with males and those with low SEP grade being the key populations for future prevention and control of chronic diseases. Targeted prevention and control strategies should be adopted to reduce its harm to the health of population.