The Impacts of Regional Regulatory Policies on the Prevention and Control of Chronic Diseases in China: A Mediation Analysis.

Huihui Huangfu,Zhi Hu,Chengyue Li,Qinwen Yu,Zheng Chen,Qunhong Shen,Anning Ma,Peiwu Shi,Li Li,Panshi Wang,Tianqiang Xu,Chuan Pu,Zhaohui Gong,Lingzhong Xu,Qingyu Zhou,Hua Wang,Mo Hao,Zhaoyang Zhang,Chao Hao

doi:10.3390/healthcare9081058

Abstract

Regional regulatory policies (RPs) are a major factor in the prevention and control of chronic diseases (PCCDs) through the implementation of various measures. This study aimed to explore the impacts of RPs on PCCDs, with a focus on the mediating roles of community service. The soundness of the regulatory mechanism (SORM) was used to measure the soundness of RPs based on 1095 policy documents (updated as of 2015). Coverage provided by community service institutions (CSIs) and community health centres (CHCs) was used to represent community service coverage derived from the China Statistical Yearbook (2015), while the number of chronic diseases (NCDs) was used to measure the effects of PCCDs based on data taken from the 2015 China Health and Retirement Longitudinal Study survey. To assess the relationship between SORM, NCDs and community service, a negative binomial regression model and mediation analysis with bootstrapping were conducted. Results revealed that there was a negative correlation between SORM and NCDs. CSIs had a major effect on the relationship between RPs and PCCDs, while CHCs had a partial mediating effect. RPs can effectively prevent and control chronic diseases. Increased effort should also be aimed at strengthening the roles of CSIs and CHCs.

Highlights

The prevalence of chronic noncommunicable diseases constitutes a threat to human life, health, and sustainable development [1]
The soundness of the regulatory mechanism (SORM) was 9.70%, indicating substantial room for improvement in regard to the regulatory policies (RPs) aimed at chronic disease
This study examined the relationship between RPs and prevention and control of chronic diseases (PCCDs), with a focus on the mediating roles of the coverage of community service institutions (CSIs) and community health centres (CHCs)

Summary

Introduction

The prevalence of chronic noncommunicable diseases constitutes a threat to human life, health, and sustainable development [1]. Chronic diseases have become the top risk factors for health, accounting for more than 80% of the 10.3 million annual deaths and 68.6% of the overall economic burden in China [2] In this context, several factors have seriously threatened people’s health, affecting social harmony and the credibility of the Chinese governments, including low awareness rates, long latency, high incidence rates, long clinical courses, high mortality rates, and low control rates [2,3]. Several factors have seriously threatened people’s health, affecting social harmony and the credibility of the Chinese governments, including low awareness rates, long latency, high incidence rates, long clinical courses, high mortality rates, and low control rates [2,3] These issues demonstrate the need for increased attention on chronic disease, to reduce the risk of illness while improving the overall quality of life. Regulatory policies (RPs) can improve the rate of service coverage by promoting the implementation of prevention measures [5], thereby constituting a major source of control for PCCDs

Objectives

Results

Discussion

Conclusion