Prevalence Rates Of Chronic Diseases Research Articles

Urban living and chronic diseases in the presence of economic growth: Evidence from a long-term study in southeastern China.

High-speed urban development has brought about an increase in per capita income in low- and middle-income countries (LMICs) as well as the high prevalence rate of chronic diseases. Based on a study of chronic diseases from 2011 to 2021 in southeastern China, we used multivariate adjusted logistic regression method to analyze the effect of urban living on the incidence of typical chronic diseases and the trend of such effect with the improvement of public healthcare system. We adopted potential mediating risk factors of urban lifestyles including body mass index (BMI), frequency of dining out, sedentary time, and psychological distress in the adjusted estimation. Baseline results indicate a positive relationship between living in urban areas and the prevalence of type 2 diabetes, hyperlipidemia, and hypertension. Regarding the mediating factors, psychological distress had the highest positive coefficient (Cr) on type 2 diabetes, hyperlipidemia, and hypertension (Cr: 0.4881-0.7084), followed by BMI (Cr: 0.1042-0.1617) and frequency of dining out (Cr: 0.0311-0.0478), and finally, sedentary time (Cr: 0.0103-0.0147). However, regression results on the follow-up survey reveal that trend in the impact of living in urban areas on chronic disease diminished as the level of the healthcare system improved. Additionally, urban living was more positively correlated with the incidence of metabolic disease than with the incidence of cardiovascular disease and cancer. Our findings provide empirical evidence that future urban health planning in LMICs should pay sustained attention to upgrading the level of public health infrastructure covering urban residents as well as rural-to-urban migrants, constructing a long-term dynamic system of chronic disease prevention and control, and regularly monitoring the mental health problems of residents in order to interrupt the process of urban chronic disease prevalence in an early stage.

Can the organization of health resource integration be analyzed in terms of the current state of unmet demand for health services? take the health needs of the elderly in a place in zhejiang province, china, as an example

BackgroundThe aging of the population has made the health problems of the elderly increasingly prominent, and their health needs are increasing. Existing studies on health resource integration approaches are mostly incomplete in assessing the health service capacity from the perspective of the health service provider.ObjectiveThe unmet health needs of the elderly were sampled and analyzed from the perspective of health service demanders. To explore how to build an integrated medical organization structure to better meet the health needs of the elderly.MethodsA whole-group sampling method was used to conduct a questionnaire survey of 1527 older adults in N district of H city, Zhejiang province, China, to cross-sectionally analyze their current status of unmet health needs.ResultsThe survey and analysis found that the needs of the elderly in this community to obtain disease-related knowledge, rational exercise, a healthy diet, and access to health information were not met. There were more patients with chronic diseases, and the top three chronic disease prevalence rates were hypertension (40.2%), dyslipidemia (8.4), and diabetes (7%). Chronic disease co-morbidities accounted for 13.3%.ConclusionThe relatively independently set up health service system at the present stage in China can no longer fully meet the health needs of the elderly, and the health service providers should provide integrated and continuous health services to meet the needs of whole-cycle health management. Therefore, we believe that effectively integrating various health service providers in the region and building an integrated health service organization with general practitioners as the core may be a solution to the current situation of unmet health needs of the elderly.

Self-reported sleep quality and mental health mediate the relationship between chronic diseases and suicidal ideation among Chinese medical students

High prevalence and strong associations of chronic disease, poor sleep quality, poor mental health, and suicidal ideation (SI) have been reported worldwide. However, the underlying mechanism remains unexamined. The participants were 2646 Chinese medical college students with an average age of 20.13 years. Pittsburgh Sleep Quality Index, the Kessler Psychological Distress Scale, and SI was evaluated. The lifetime SI, past 12-month SI, and chronic disease prevalence rates were 10.0%, 8.4%, and 4.6%, respectively. The results of logistic regression analysis in this study found that chronic disease, self-reported poor sleep quality, poor mental health, gender and scholarship were associated with lifetime SI. Similar results were also found for 12-month SI with an exception of region. This result indicated that the effects of chronic diseases on the SI were mediated by self-reported sleep quality and mental health. Physical diseases, sleep-related concerns, and mental health issues need to be addressed through a multidisciplinary team approach and various delivery systems to prevent SI among medical college students.

Gambling disorder and chronic diseases in Finland: a nationwide register study

Abstract Background Previous register-based studies on comorbidity have mainly focused on gambling disorder (GD) and psychiatric disorders. However, knowledge on somatic health of persons with GD is also needed. This nationwide register-based study aims to examine the gender-specific prevalence rates of chronic diseases and conditions among the Finnish adults with GD. Methods This study utilizes aggregated data of persons aged 18 and over with GD diagnosis (corresponding to pathological gambling, ICD-10; F63.0) in 2011-2020. The data were retrieved from the Finnish nationwide health registers: Register of Primary Health Care visits and Care Register for Health Care, including specialised outpatient and inpatient health care, and inpatient social care. All diagnostic groups were included. Corresponding figures for the total population with same age range were presented as reference numbers. Results The preliminary results showed that 2,617 persons with the median age of 33.5-36.0 were diagnosed with GD (men n = 1,858; women n = 759). Despite the fact that the prevalence rates of the general population were not age-adjusted, many chronic diseases and conditions were more prevalent among persons with GD compared with the general population. The prevalence rates of psychiatric disorders (87.5% vs 29.2%) and nervous system diseases (23.9% vs 15.2%) were particularly high. Musculoskeletal diseases (61.6% vs 55.8%) and digestive diseases (30.2% vs 27.6%) were also slightly more prevalent. Memory disorders (1.1% vs 5.3%), cardiovascular diseases (25.3% vs 41.0%), and cancer (15.6% vs 24.4%) were less prevalent. Among persons with GD, all comorbid diseases were more prevalent among women than among men. Conclusions Psychiatric disorders and nervous system diseases are exceptionally prevalent in persons with GD. These findings highlight the need for health and social care professionals to recognize that persons with GD may additionally have other disorders that need attention. Key messages • Mental disorders are the most common comorbidity among persons with GD, however, many somatic chronic diseases are also common. • Comorbidities are more common among women with GD than among men with GD.

The positive association between internal migration and hospitalization among the older adults in China: Regional heterogeneity and chronic disease management.

BackgroundPost-retirement migrants are rapidly increasing in China, but the impact of internal migration on hospitalization among older adults remains under-researched. Understanding this impact is essential for health policies development and improvement. This study aims to identify the most vulnerable population, evaluate the association between migration and hospitalization, and discuss potential causes of the association.Methods14,478 older adults were extracted from the 2018 to 2019 Chinese Longitudinal Healthy Longevity Survey (CLHLS) database and divided into four groups according to migration experience and age at migration: non-migrants, pre-adulthood migrants, pre-retirement migrants, and post-retirement migrants. Post-retirement migrants were key research subjects. We employed Pearson's chi-square test to compare group differences in outcome and covariates, and multivariate logistic regression analysis to examine the association between migration and hospitalization by regions and chronic conditions.ResultsSignificant intergroup differences were observed in demographic characteristics, socioeconomic factors, health habits, and health-related factors. Post-retirement migrants displayed following characteristics: female predominance (61.6%; 1,472/2,391), tending toward urban areas (80.9%; 1,935/2,391), and the highest prevalence rate of chronic disease (46.7%; 1,116/2,391). Urban migrants in eastern China were more likely to be hospitalized (OR = 1.65; 95% CI: 1.27–2.15), especially those who were diagnosed with chronic disease (OR = 1.51; 95% CI: 1.04–2.19) or with unconfirmed chronic conditions (OR = 1.98; 95% CI: 1.36–2.89).ConclusionsInternal migration is associated with the hospitalization of post-retirement migrants moving to eastern China. Improved chronic disease management and early interventions might lower the hospitalization. Effective policies should be formulated to reduce the disparity in primary care services across China, thereby facilitating the access of migrants to these services.

Health Inequalities in the Elderly with Different Socioeconomic Status in China

This study aims to examine socioeconomic inequalities in health status and health service of the elderly in China to provide basis for health promotion. The data of China Health and Retirement Longitudinal Study (CHRLS) in the year 2015 was used. Adults aged 60 and over (n=8001) were included in the analytic sample. Socioeconomic status (SES) of the elderly was assessed by annual per capita consumption expenditure, education, and regional and rural/ urban status. Health status was measured by self-rated health, activities of daily living (ADL), the prevalence rate of chronic diseases and the 1-month prevalence rate; while health service was measured by the utilization of both outpatient service and inpatient service. Overall, the elderly with higher economic level had better health status and higher ADL disability rate, but lower prevalence rate of chronic diseases, 1-month outpatient visit rate and annual hospitalization rate. The elderly with lower education level had higher self-rated "poor" health, ADL disability rate, 1-month prevalence rate and 1-month non-visit rate. The elderly in eastern region or urban areas had better health status than those in central and western regions or rural areas. However, for health service utilization, the elderly in western region used both outpatient and inpatient services more frequently. The rural elderly had higher 1-month outpatient visit rate, while the urban elderly had higher annual hospitalization rate. Socioeconomic inequalities in health existed in Chinese elderly. To promote health equity among the elderly, the government should improve health insurance and medical assistance policies, optimize health resources allocation, and narrow economic gaps between western and eastern regions, and between rural and urban areas.

Determination of the Incidence and Prevalence Rates of Chronic Diseases among Old age at Al-Russafa District in Baghdad City

Objectives: To evaluate the incidence and prevalence rates of chronic diseases among old age at Al-Russafa District in Baghdad City. Methodology: A descriptive design, using the evaluation approach, is employed to determine of the incidence and prevalence rates of chronic diseases among old age at al-Russafa District in Baghdad City from October10th 2021 to April 2nd 2022. A non-probability, convenient sample of (672214) old age, is selected for the purpose of the study. All subjects have signed consent form to present their agreement for participation in the study. The confidentiality of the data is also safeguard and they will be securely maintained during and after conducting the study. A questionnaire is constructed for the purpose of the study through review of related literature. It is consisted of (3) main parts; old age demographic characteristics, old age chronic diseases and the incidence and the prevalence of old age chronic diseases. Content validity is determined for the study instrument through panel of experts and internal consistency reliability is obtained for the study instrument through split-half technique and the computation of Cronbach alpha correlation coefficient in a pilot study. Data are gathered through the use of the study instrument as mean of data collection and analyzed through the application of descriptive statistical data analysis and inferential statistical data analysis approaches. Results: The study results depict that old age chronic diseases are accounted for cardiovascular and chronic respiratory diseases at Al-Russafa District in Baghdad City. Males old age have been prominently at greater risk to the incidence and the prevalence of such diseases more than females at Al-Russafa District in Baghdad City. Conclusion: The study concludes that high incidence rates are accounted for chronic respiratory diseases, cardiovascular diseases, arterial hypertension, kidney diseases, diabetes mellitus and arthritis at Al-Russafa District in Baghdad City and high prevalence rates are accounted for chronic respiratory diseases, cardiovascular diseases, arterial hypertension, kidney diseases and diabetes mellitus at Al-Russafa District in Baghdad City. Recommendations: The study recommends that screening and early detection programs should be planned and implemented on regular base for the finding of such subpopulation-based health problems. Further and nation-wide research can be conducted on large scale sample size and different settings. Keywords: Determination, Incidence Rate, Prevalence Rate, Chronic Diseases, Old age

Relationship Between Severity of Comorbidities and Self-Perceptions of Aging

An older adult with negative self-perceptions of aging (SPA) can lead to lower self-rated health and a higher risk of mortality. To stay a positive SPA, keep a healthier status is very important. However, evidence also proved that health conditions, like a physical limitation, could predict the level of SPA. Older adults usually have a higher prevalence rate of chronic diseases than the younger population, which can adversely impact them. The purpose of this study is to determine the relationship between the severity of comorbidities and the change of SPA during a time. I examined data in 7,034 people from the 2012 wave Health and Retirement Study (HRS) and followed the respondents who have answer the SPA scale in the leave-behind questionnaire in 2016. The generalized estimating equation was used to analyze the relationship between the severity of comorbidities and SPA in different waves. To measure the severity of comorbidities, a reduced index of the comorbidities severity scale (CmSS) was created to collect the health condition from HRS. Results statistical model shows that an individual with more severity of comorbidities may have a more negative SPA. However, the relationship does not follow through with the times. These findings enhance the previous study that there are relationships between severity of comorbidities and SPA. The benefit of this study is to use a different measurement to identify the severity of comorbidities and extend to more in-depth research.

Surveillance analysis and microbiological profiles of nosocomial infections in a palliative care center

Objective: The growing geriatric population and increasing prevalence rates of chronic diseases increase the need for palliative care globally. Despite the wide availability of palliative care units in several countries, they have been founded in our country recently. This study aimed to contribute to the development of appropriate treatment protocols by determining the causes of hospitalizations, comorbidities, infection rates, and causative microorganisms in a palliative care center.
 Material and Method: A total of 457 patients admitted to palliative care were evaluated. Blood cultures were taken from the patients suspected to have developed nosocomial infections. Samples for cultures were taken from the foci that were thought to be the origin of infection. Identification of isolates was performed using automated systems and standard manual methods. The numbers of patients and patient days, and the numbers and rates of nosocomial infections were retrieved from the infection control unit data records and were analyzed. The rates and incidences of nosocomial infections in our hospital and the palliative care unit were calculated. 
 Results: Of the patients, 51% were men and 49% were women. The mean age was 72±12.6 years. Nosocomial infection rates were 6.3% in 2019, 9.1% in 2020, and 3.3% in the first six months of 2021. Urinary system infections ranked first with a rate of 58.6%. The most common cause of hospital admissions was malignancy with a rate of 25.9%. The most commonly isolated microorganism was Klebsiella spp with a rate of 27.5%.
 Conclusion: Palliative care is a multidisciplinary practice requiring strong coordination and collaboration. Palliative care aims to improve symptoms and the quality of life of patients. Our study has contributed to developing practical solutions by documenting prognostic factors, infections, causative microorganisms, and issues experienced in palliative care patients.

A New Measure of Community Health: Findings From the Healthy Aging Data Reports.

The purpose of this study was to develop a multidimensional measure of community healthy aging that is more nuanced than existing measures. The social-ecological framework guided this analysis of the latent structure of community prevalence rates of chronic diseases and functional impairments. The sample was 471 communities in Massachusetts (n = 319) and New Hampshire (n = 152). Data were drawn from publicly available healthy aging data reports for both states. Community prevalence rates for 45 chronic conditions, rates of mortality, and Medicare service utilization were estimated with the 2014-2015 Centers for Medicare & Medicaid Services (CMS) Medicare Beneficiary Summary Files and used in factor analyses to explore the latent structure of community healthy aging. Results revealed a multidimensional structure composed of 4 latent population health components: serious complex chronic disease, indolent chronic disease, physical disability, and psychological disability. We found that while lower community socioeconomic status is a major determinant of all 4 components of population health, it is predictably associated with higher levels of serious complex chronic disease and physical disability and yet surprisingly with lower levels of indolent chronic disease and psychological disability. The 4-dimensional model provides a more nuanced measure of community healthy aging than mortality rate, and it identifies community health disparities that otherwise may go undetected. Understanding the multiple levels that influence community healthy aging may reveal new interventions or programs to improve it and allow policymakers or other stakeholders to more accurately tailor interventions to match the conditions of need.

The analysis of health condition of individuals aged 40 years and older and going in for sports

The attitude to high physical loads on organism in the middle and older age groups is ambiguous, from optimistic to completely pessimistic, associated with possibility of development pathological processes because of high physical activity. The purpose of the study is to evaluate health status of people aged 40 years and older involved in sports. The health data was obtained through interviewing athletes aged 40 years and older competing in track and field events at distances of 10 kilometers or more. In total, 1800 questionnaires were distributed, and 1649 completed questionnaires were returned. The analysis of health status was implemented on the basis of self-rated health and objective characteristics (medical care appealability, acute diseases incidence, chronic diseases availability, fact of medication intake). The very high level of health self-rate was established in individuals involved in sports, that persisted along age increasing. No gender differences were revealed (4.00-4.07 for males and 3.89-4.08 for females). According to survey results, less than half of male respondents consulted physician during a year. The level of appealability was stable in all age groups surveyed. The average rate of acute diseases per year in athletes of older age groups did not exceed 1.16 diseases per year and was slightly higher in females. With age, the indicator tended to decrease in males and to increase in females. The prevalence rate of chronic diseases was low in both males and females and with age it tended to increase in males and remained almost stable in females. The rate of regular medication intake was lower than rate of chronic diseases, this difference was especially significant in females. According to respondents, sport activities, despite heavy loads and age, contribute to organism health enhancement. This opinion was specific for more than 90% of athletes, regardless of their gender. In the oldest age group (60 years and older) 94.3% of respondents expressed reported that their health improved after starting running. However, sufficient number of athletes are concerned about potential risk of training that is the reason to organize system of medical monitoring of athletes, especially in older age groups.

Health Status of Primary School Children Studying in Dynamic Postures

Background: The innovative form of organizing schooling in the mode of dynamic postures providing for alternation of standing and sitting postures at each lesson is implemented in order to prevent detrimental health effects of the long-term stationary sitting posture, reduce static and educational fatigue, preserve and strengthen health in educational institutions. Our objective was to assess the health status of primary school children studying in dynamic postures. Materials and methods: We assessed the health status of 174 pupils aged 7–10 in the first to third grades of primary school studying in the mode of dynamic postures. The health data was obtained from their personal medical records. The assessment was carried out in accordance with the comprehensive methodology for assessing health of children and adolescents based on the 10th revision of the International Statistical Classification of Diseases and Related Health Problems. Physical development was measured using regression scales. Results: We established that visual impairment (137.9‰) and musculoskeletal disorders (109.2‰) ranked highest in the structure of functional disorders (FD) among the first to third graders. The prevalence of functional disorders of the circulatory and respiratory system was 86.2‰ and 80.5‰, respectively. Musculoskeletal conditions dominated in the structure of chronic diseases (63.0%), the prevalence being 293.1‰. These were followed by diseases of the skin and subcutaneous tissue and gastrointestinal diseases with the prevalence rate of 46.0‰ each. The total prevalence of functional abnormalities among the primary school first to third graders was 500.0‰ while the prevalence rate of chronic diseases was 465.5‰. Normal physical development was observed in 82.9% of the subjects. Overweight and obesity were detected in 11% and 0.6% of the children, respectively, while underweight, small and big height were measured in 3.1%, 1.8%, and 0.6% of the children, respectively. Conclusions: The comparative data analysis helped establish lower disease prevalence rates among the children studying in dynamic postures compared to those studying in the seated position. Our findings may serve as a scientific substantiation of efficiency of using the dynamic posture regime in order to maintain and improve health of schoolchildren.

A preliminary effect analysis of family doctor and medical insurance payment coordination reform in Changning District of Shanghai, China

BackgroundChangning District of Shanghai pioneered in implementing Family Doctor and Medical Insurance Payment Coordination Reform. The survey aimed to assess the effect of the reform to provide a decision-making basis for ensuring the “gatekeeper” role of the family doctor.MethodsA cross-sectional survey was conducted using a self-designed questionnaire in Changning District of Shanghai during January and February in 2014. Multi-stage random cluster was applied and 3040 residents were selected. Comparisons were made with statistically test between the contracted and non-contracted residents in four policy targeted dimensions, doctor-visiting behavior, health management and status, medical cost control and satisfaction.ResultsCompared with the non-contracted residents, the contracted residents (72.9%) presented a higher prevalence rate of chronic diseases (32.6%), a higher proportion (51.9%) in first-contact in the community health service center and a higher proportion to refer to specialists as well (P < 0.001).The result showed that the average annual medical expense were significantly higher than non-contracted residents (P < 0.001), however, the difference disappeared after age, medical insurance and other socio-demographic variables were controlled. In terms of self-management of non-communicable diseases and complication prevention, the blood pressure control rate and blood glucose control rate for the contracted group were also higher than the counterparts, reaching up to 85.6 and 72.7% respectively.ConclusionThe preliminary analysis indicated that the contracted residents performed better in orderly doctor visiting behavior, health management behavior, health status and satisfaction. Follow up survey is necessary to further analyze the policy effect.

Study of the prevalence and disease burden of chronic disease in the elderly in China

Objective: To understand the prevalence and disease burden of major chronic diseases in the elderly in China and provide scientific basis for the prevention and control of chronic diseases and for the rational allocation of health resources. Methods: We analyzed the prevalence of chronic diseases in residents aged ≥60 years in China by using national and provincial surveillance data of chronic diseases and related risk factors in China. We conducted the analysis on the burden of chronic diseases in the elderly in China by using the data of global burden of disease. Results: The prevalence rates of hypertension, diabetes and hypercholesterolemia were 58.3%, 19.4% and 10.5% respectively in residents aged ≥60 years in China. Up to 75.8% of the residents aged ≥60 years had at least one chronic disease. The prevalence rate was higher in women than in men, higher in urban area than in rural area. With the increase of age, the prevalence rate of chronic diseases also increased. The top three chronic diseases with heavy disease burden in residents aged ≥70 years were stroke, myocardial infarction, cancer and chronic obstructive pulmonary disease. Conclusion: The prevalence of major chronic diseases in the elderly is high with three quarters of the elderly suffering from at least one chronic disease, and the burden of chronic diseases is increasing.

Socioeconomic Status and Morbidity Rate Inequality in China: Based on NHSS and CHARLS Data.

Previous studies have shown there are no consistent and robust associations between socioeconomic status and morbidity rates. This study focuses on the relationship between the socioeconomic status and the morbidity rates in China, which helps to add new evidence for the fragmentary relationship between socioeconomic status and morbidity rates. The National Health Services Survey (NHSS) and China Health and Retirement Longitudinal Study (CHARLS) data are used to examine whether the association holds in both all-age cohorts and in older only cohorts. Three morbidity outcomes (two-week incidence rate, the prevalence of chronic diseases, and the number of sick days per thousand people) and two socioeconomic status indicators (income and education) are mainly examined. The results indicate that there are quadratic relationships between income per capita and morbidities. This non-linear correlation is similar to the patterns in European countries. Meanwhile, there is no association between education years and the morbidity in China, i.e., either two-week incidence rate or prevalence rate of chronic diseases has no statistically significant relationship with the education level in China.

Improving Chronic diseases management through integration, in Jeddah, Saudi Arabia

Introduction: Prevalence rates of chronic diseases are increasing in Saudi Arabia, contributing almost 60% of all premature deaths in 2016, estimated to rise to 73% by 2020. Of these, diabetes and hypertension are most common with prevalence rates of 23% and 26% respectively. In Jeddah region, at 30% diabetes prevalence is the highest regionally in Saudi Arabia. A key failing of the Jeddah approach to chronic disease management is the disconnect between primary care and secondary/tertiary services. In an attempt to improve care, Jeddah Department of Health Affairs commenced integration of primary and secondary chronic disease care. We discuss progress on the new integrated approach for diabetes management. Short description of practice change implemented A multi-phase integration of chronic disease management through improved co-ordination between primary and secondary care providers and shared case management. Phase 1 aims to improve referral systems and access to specialist care teams for primary care physicians. Aim and theory of change: To improve health outcomes for patients with diabetes in Jeddah through the improvement of case management by providing primary care physicians with specialist support and access to patient information. The is aimed at encouraging shared responsibility, establishing relationships between primary healthcare professionals and related specialties, and taking specialist care closer to the patient. Targeted population and stakeholders: The programme targets the 4000 people living with diabetes in Jeddah, includes primary and secondary care providers, and other stakeholders in the local community. Timeline: Implementation started in May 2017, and it is anticipated that full phase 1 integration will be achieved by December 2018. Highlights: The targeted outcomes access to care, improved patient’s satisfaction, self-management and clinical outcomes with resultant improvements in quality of life and reduced mortality/morbidity. There would also be reduction in emergency department use and readmissions. Comments on sustainability: The current effort sits within a wider national reform programme providing new integrated care models. The aim is to ensure this programme aligns with the national approach. However, the planned changes are poorly understood by local leaders and health care workers, with this consequent lack of local ownership a major barrier for sustainability. Comments on transferability: The current programme sits within the larger national model of care currently being piloted. Formative and (independent) summative evaluations have been built into the approach to allow for transferability through identification of success factors and key learnings. Conclusions: This integrated system has the potential to provide an enabling environment for the improvement of diabetes management. Primary care physicians now function as part of a wider team, with improved access to specialist services. Discussions: Whilst there has been improved interaction with specialists, integration of patient records is still not implemented, and use of shared guidelines and protocols have yet to be addressed. This will be key for the next phase. Lessons learned: Effective integration needs adequate preparation and stakeholder buy-in before the implementation stage. The approach is being amended to empower local stakeholders to own and improve care management.

Variation in the rate of well-controlled status of chronic disease by income level in Korea: 2010 to 2015.

Although it is known that the prevalence rates of chronic diseases depend on income level, annual changes of the control rate have not been evaluated. In this cross-sectional study, we analyzed the variation in rate of well-controlled status of chronic diseases based on the annual income level using data from national nutrition surveys conducted between 2010 and 2015.Prevalence and controlled rate of hypertension, diabetes mellitus, and chronic kidney disease were analyzed in relation to annual income levels, using data from the Korea National Health and Nutrition Examination Survey (KNHANES), obtained from 2010 to 2015. We also analyzed the incidence of use of necessary medical care services and the reasons cited for not using these services.The data of 28,759 persons were analyzed. The average age increased, and sex ratio remained unchanged over the study period. Although the prevalence rates of diabetes increased, that of increased glycated hemoglobin gradually decreased. A significant change has been shown recently on the prevalence rates of hypertension patients. The prevalence rates of chronic kidney disease stayed unchanged during the course of the study period. The incidence of controlled chronic disease status increased with the income level, and over time during the study, in the case of diabetes and chronic kidney disease. However, while controlled hypertension status rate increased from year to year, there was no trend of increase with increased income level. The incidence of participants not using hospital services declined with increasing income level, but the rate of economic causes being cited as reasons for not using hospital services increased over time and showed no change among income levels. Results of regression analysis of prevalence rates of chronic diseases by income level showed that lower income groups tended to have higher odds ratios for chronic diseases.Our results suggest that the incidence rate of well-controlled chronic disease status remains low in lower income groups. These results imply that financial status may play an important role in the management of chronic diseases.

Migrant elders in Hainan, China, report better health and lower depression than local-born elderly residents

Background: The number of migrant elders is increasing due to ageing of the global population and increasing life expectancy. There is accumulating evidence of the impact of internal or international migration on health.Aim: To compare the health and depression of local and migrant elders in Hainan province.Subjects and methods: Health and depression were assessed by the Self-Rated Health Measurement Scale Version 1.0 (SRHMS V1.0) and the Geriatric Depression Scale (GDS), respectively. The relationship between health and depression was investigated, along with the three sub-scales of SRHMS and the potential independent variables.Results: In total, 564 valid questionnaires were returned. Migrant elders were younger, had higher education levels and monthly income, and lower prevalence rates of chronic diseases than the local elders. The SRHMS scores were significantly higher, while the GDS scores were statistically lower in the migrant elders than the locals. Depression was negatively correlated with health (r = –0.674, p = 0.0000). Moreover, the three sub-scales of SRHMS were correlated with age, birth place, marital status, chronic diseases, GDS and/or educational level.Conclusion: Migrant elders self-reported better health and lower depression compared to the local elders. Differences in age, education, monthly income and chronic diseases might be influencing factors.

Empathy as Tool for Studying Chronic Disease Medicine Package Design for Chinese Elderly

Background The elderly population expanded gradually in modern Asian society as a special community. China’s first blue book shows the high prevalence rate of chronic diseases in the elderly. Daily prescription medicines for chronic diseases, which differ from OTC (over-the-counter) medicines, are not required to be packaged or labelled under the mandatory prescription drug requirement in China. Existing package design need to be improved since there have been frequent reports of misuse and poisoning related to elderly users misusing the medicine due to unclear design. Empathic design offers a new vision for designers to meet the real needs of users by observing their behavior in a natural environment. The literature review shows extensive literature focusing on NPD (new product design) from the perspective of empathy. However, most of these studies were conducted in a Western social context. There is a dearth of research specifically addressing the Asian elderly. The main aim of this study was to develop a new empathic design process for identifying the problems in chronic disease medicine package for Chinese aging users, via the case studies from a design perspective. Methods This paper follows Leonard & Rayport’s empathic design process and is divided into two stages: problem identification（SPI）and problem solving(SPS). Moreover, a new SPI was developed using case studies to identify the problems in chronic disease medicine package. The KANO questionnaire, a half-opened interview and Contextual Inquiry (CI) were the main methods of data collection and analysis. Results The problems revealed in the questionnaire, interview, and CI were summarized and compared. The data shows that the interview found some hidden problems that the questionnaire could not done. Moreover, for the CI, the observation without pre-set questions filled the vacancy of knowledge brought on by the questionnaire and interview. The indirect methods in empathic design such as the empathic probe pack were not very effective for the subject, the elderly people did not respond positively when the researcher showed it to them. Conclusion A new 3-step SPI, which was effective in identifying the problems for Asian elderly users, was developed using case studies： pre-observation, observation and analysis of the collected data.

Making the dietary guidelines for Americans “for Americans”: The critical role of data analyses

The purpose of this paper is to describe the critical role that data analyses played in the development of the 2015–2020 Dietary Guidelines for Americans. In abbreviation, the five overarching Guidelines of the 2015–2020 Dietary Guidelines are to follow a healthy eating pattern across the life span; focus on variety, nutrient density, and amount; limit calories from added sugars and saturated fats and reduce sodium intake; shift to healthier food and beverage choices; and support healthy eating patterns for all. Key Recommendations provide further guidance. Four approaches were used to review the evidence: (1) original systematic reviews; (2) high-quality existing reports, comprised primarily of systematic reviews; (3) data analyses; and (4) food pattern modeling analyses. National databases and analyses by Federal agencies were critical to answer questions about chronic disease prevalence rates, food and nutrient intakes of the U.S. population, and nutrient content of foods. They were also essential to support food pattern modeling used to describe the types and amounts of foods to eat to help meet nutrient needs while taking into consideration current intakes and scientific research. Data analyses contributed substantially to development of the Dietary Guidelines and will continue to be essential in updating Federal nutrition policy.