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Objective@#To understand the control attempts of body weight and its related factors among overweight and obese adults in China.@*Methods@#Data was from the 2013 Chinese Chronic Diseases and Risk Factors Surveillance Program, which covered 302 surveillance sites. 179 570 adults, selected through multistage stratified cluster sampling method, were interviewed. Demographic characteristics and weight-control attempts were collected via face-to-face interview. BMI, waist circumstance and blood pressure were individually measured under physical examination. Venous blood samples were obtained and tested for FPG, OGTT-2h, TC, TG, LDL-C and HDL-C. A total of 87 545 overweight and obese patients were included in this study, with the exclusion of 152 patients having the missed critical information. Rates on weight control and attempts were analyzed, using the complex weighting on samples to represent the overall overweight and obese adults in China.@*Results@#The rate of weight-control attempts was 16.3% (95%CI: 14.9%-17.7%). Among all the 12 133 patients who had undergone weight-control measures, the proportions of different attempts were as follows: diet (40.9%, 95%CI: 38.4%-43.3%), combination of diet and physical activity (31.5%, 95%CI: 28.9%-34.0%), physical activity (22.8%, 95%CI: 21.0%-24.6%) and drug control (1.3%, 95%CI: 1.0%-1.7%). Factors as: being female (OR=1.26, 95%CI: 1.15-1.38), at younger age (18-44 years old, OR=1.51, 95%CI: 1.31-1.74), with high education levels (college degree or above, OR=4.52, 95%CI: 3.76-5.43), having high annual income (≥24 000 Yuan, OR=1.94, 95%CI: 1.63-2.30) etc., appeared as favorable factors for taking the measures vs. rural residency (OR=0.63, 95%CI: 0.55- 0.72) as the unfavorable one.@*Conclusion@#The rate of weight-control attempts appeared low among the overweight and obese adults who were affected by factors as age, education and income level. Personalized intervention measures should be carried out for people with different characteristics.
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Objective@#To understand medical treatment seeking behaviors and its influencing factors in employed floating population in China and provide evidence for the development of health service policies for floating population.@*Methods@#Data were from the national chronic disease and risk factor surveillance (floating population part) in 2012. Floating population were selected through multistage clustering sampling stratified by industries in 170 counties and districts from 31 provinces (autonomous regions, municipality directly under the central government) and Xinjiang Production and Construction Corps in the mainland of China. Information on demographic basic information, health status and health seeking behaviors six months before the investigation were collected through face-to-face questionnaire interview. The people aged 18-59 who had physical discomfort in the past six months was analyzed. After complex weighted analysis, multinomial logistic regression model was used to analyze the health seeking behavior and its influencing factors in the employed floating population.@*Results@#A total of 11 134 suitable people aged 18-59 years were included in the study. The number and proportion of the people seeking medical treatment, having self-treatment and having no treatment were 4 950 (44.5%), 3 880 (34.8%) and 2 304 (20.7%), respectively. Multinomial logistic regression analysis showed that women were 1.275 times (95%CI: 1.100-1.477) more likely to seek medical treatment compared with men. The medical treatment seeking rates of floating population in the eastern, central and western areas were 2.153 times (95%CI: 1.669-2.777), 2.310 times (95%CI:1.777-3.002), 2.177 times (95%CI: 1.695-2.796) higher than that of floating population in northeastern area. In terms of seeking treatment, the proportion of the floating population with annual income of more than 25 000 yuan was 1.255 times (95%CI: 1.088-1.448) higher than that of the floating population with annual income of 25 000 yuan or less than 25 000 yuan. The proportion of the floating population with severe physical discomfort within the past six months was 8.076 times (95%CI: 6.091-10.707) higher than that of the floating population without severe physical discomfort and the proportion of the floating population who participated in medical insurance in both original living places and current living places was 1.566 times (95%CI: 1.250-1.961) higher than that of the floating population who did not participate in medical insurance in two places. The incidence ratio of medical care seeking and self-treatment in new generation of floating population was 1.369 (95%CI: 1.157-1.619) and 1.240 (95%CI: 1.042-1.475) compared with old generation of floating population. Compared with the widowed/divorced/separated, the incidence ratio of medical treatment seeking and self-treatment for the married/cohabited was 1.590 (95%CI: 1.057-2.391) and 1.815 (95%CI: 1.209-2.725). The more severe physical discomfort, the higher level medical institutions they chose (P<0.05).@*Conclusions@#The treatment rate in medical institutions of employed floating population was low in China. Gender, generation of floating population, marital status, area, annual income, severity of physical discomfort in past six months and the way to participate in medical insurance were the main factors affecting the medical treatment seeking behaviors of employed floating population.
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Objective@#To estimate the prevalence of MS in elderly people aged ≥60 years and its related factors in China and provide scientific evidence for prevention and control of MS in the elderly.@*Methods@#Data used in this study were obtained from the 2013 Chinese Chronic Diseases and Risk Factor Surveillance Program. A total of 50 497 people aged ≥60 years were selected and interviewed through multistage stratified cluster sampling at 298 surveillance sites in 31 provinces. According to the Chinese MS diagnostic criteria proposed by the Chinese Medical Association Diabetes Branch in 2017, the prevalence rates of different MS forms were compared, and the main related factors were analyzed.@*Results@#The prevalence rate of MS was 36.9% (95%CI: 35.4-38.5). The prevalence rate was higher in urban area than in the rural area, higher in females than in males, higher in eastern area than in western area. The prevalence rate of MS in elderly people aged ≥70 years was lower than that in those aged 60-69 years. The rate in the elderly with higher education and income levels was higher than that in the elderly with lower socioeconomic level. The comparison of the prevalence of the five forms of MS in the elderly showed that hypertension had the highest prevalence rate (72.8%), followed by hyperglycemia (41.7%) and central obesity (37.6%). The prevalence rates of hypertriglyceridemia and low HDL-C were 25.8% and 17.5%. The risk for MS in women was 1.20 times higher than that in men. Age, gender, education level, living area and urban or rural residence were the main factors influencing the prevalence of MS. Smoking, drinking and physical activity levels were correlated with MS.@*Conclusions@#The risk for MS was higher in women than in men in China’s elderly population, and the risk was related to socioeconomic level and life behaviors. It is recommended to carry out lifestyle interventions, such as increasing exercise and having reasonable diet for the elderly patients with MS. Hypertension and diabetes patients also need to be treated with drugs to reduce the risk of cardiovascular disease morbidity and mortality.
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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.
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Objective@#To investigate the status of self-measurement of body weight in overweight and obese adults in China and identify the related factors.@*Methods@#A total of 87 670 adults were enrolled in this study, who were selected through multi stage cluster random sampling from 177 099 residents aged ≥18 years in 302 surveillance areas in China where the fourth chronic non-communicable disease and related factor surveillance project was conducted in 2013. The information about their demographic characteristics and body weight measurement were collected by using questionnaire. Their body height, body weight, waist circumstance and blood pressure were measured respectively through physical examination. Fasting venous blood samples were obtained and assayed for FPG, TC, TG, LDL-C and HDL-C levels. Venous blood samples after 75 g glucose intake were obtained and assayed for OGTT-2h level. The proportion of self-body weight measurement were analyzed after complex sample weighting.@*Results@#The proportion of overweight and obese adults who had self-body weight measurement within 1 week, 1 month and 1 year were 18.9%, 23.0% and 30.2%, respectively. The proportion of those having self-body weight measurement within 1 week was higher in men than in women, and lowest in ≥60 years old group (P<0.05). The proportion of overweight and obese adults who had never measured their body weight was 20.5%, the proportion was higher in women than in men, and highest in ≥60 years old group (P<0.05). Older age (OR=0.73, 95%CI: 0.64-0.82) was risk factor for self-body weight measurement; female (OR=1.11, 95%CI: 1.03-1.19), higher education level (junior college and above OR=3.79, 95%CI: 2.89-4.97), high- income (OR=1.61, 95%CI: 1.31-1.98), dyslipidemia (OR=1.13, 95%CI: 1.04-1.23), diabetes (OR=1.15, 95%CI: 1.03-1.30) were the protective factors for self-body weight measurement.@*Conclusion@#It is necessary to promote self-body weight measurement in overweight and obese adults in China. Targeted health education should be carried out for different groups to encourage regular self-body weight measurement to maintain healthy body weight.
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Objective@#To identify the definition of heat wave based on mortality risk assessment in different regions of China.@*Methods@#Daily mortality (from China Information System for Disease Control and Prevention) and meteorological data (from National Meteorological Information Center in China) from 66 counties with a population of over 200 000 were collected from 2006-2011. With the consideration of climate type and administrative division, China was classified as seven regions. Firstly, distributed lag non-linear model (DLNM) was used to estimate community-specific effects of temperature on non-accidental mortality. Secondly, a multivariate meta-analysis was applied to pool the estimates of community-specific effects to explore the region-specific temperature threshold and the duration for definition of heat wave.@*Results@#We defined regional heat wave of Northeast, North, Northwest, East, Central and Southwest China as being two or more consecutive days with daily mean temperature higher than or equal to the P64, P71, P85, P67, P75 and P77 of warm season (May to October) temperature, respectively, while the thresholds of temperature were 21.6, 23.7, 24.3, 25.7, 28.0 and 25.3 ℃. The heat wave in South China was defined as five or more consecutive days with daily mean temperature higher than or equal to the P93 (30.4 ℃) of warm season (May to October) temperature.@*Conclusion@#The region-specific definition of heat wave developed in our study may provide local government with the guidance of establishment and implementation of early heat-health response systems to address the negative health outcomes due to heat wave.
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Objective To study the relationship between blood pressure level and major risk factors for cardiovascular diseases in adults in China.Methods A total of 179 347 adults aged ≥18 years were recruited from 298 surveillance points in 31 provinces in China in 2013 through complex multistage stratified sampling.The survey included face to face interview and physical examination to collect information about risk factors,such as smoking,drinking,diet pattern,physical activity,overweight or obesity,and the prevalence of hypertension.The blood pressure was classified into 6 levels (ideal blood pressure,normal blood pressure,normal high blood pressure and hypertension phase Ⅰ,Ⅱ and Ⅲ).The relationship between the prevalence or co-prevalence of risk factors for cardiovascular disease and blood pressure was analyzed.Results The adults with ideal blood pressure,normal blood pressure,normal high pressure,hypertension phase Ⅰ,Ⅱ and Ⅲ accounted for 36.14％,22.77％,16.22％,16.43％,5.97％ and 2.48％,respectively.Among them,the blood pressure was higher in men,people in Han ethnic group and those married,and the blood pressure was higher in those with older age,lower income level and lower education level,the differences were all significant (P＜0.05).Whether taking antihypertensive drug or not,co-prevalence of risk factors influenced the blood pressure levels of both sexes (P＜0.05),and the blood pressure levels of those taking no antihypertensive drug was influenced more by the co-prevalence of risk factors.Finally,multiple logistic analysis showed that the risks for high blood pressure in adults with 1,2 and ≥3 risk factors were 1.36,1.79 and 2.38 times higher,respectively,than that of the adults without risk factor.Conclusion The more the risk factors for cardiovascular disease in adults,the higher their blood pressure were.It is necessary to conduct comprehensive behavior intervention targeting ≥ 2 risk factors for the better control of blood pressure in general population.
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Objective To explore the relations between the prevalence of multiple chronic diseases and cigarette smoking behavior in the Chinese adults.Methods Based on the results from the 2013 Chronic Disease Risk Factor Surveillance (NCD Surveillance),176 534 Chinese residents aged 18 years and above,covering 298 counties (districts) in 31 provinces,was randomly recruited,using the multi-stage stratified clustering sampling method.Information on demographics,cigarette smoking (status,quantity and period) was obtained through face-to-face interviews and questionnaires.Anthropometric data and blood samples were collected and properly stored for analysis.Results In total,175 386 adults were included for statistical analyses,with 42.7％ as males and 57.3％ as females.The prevalence rates of hypertension,high total cholesterol and high triglycerides were 30.4％,7.2％ and 18.0％ in male smokers,35.6％,14.0％,10.3％ and 15.9％ in female smokers respectively,which were all higher than those in the respective non-smokers.Male smokers were found under lower risk on hypertension,but 19％ higher on total glycerides when compared with non-smokers of the same sex (OR=1.19,95％CI:1.10-1.30),when multiple risk factors were under control.Male current smokers with more than 20 cigarettes per day have 41％ (OR=1.41,95％CI:1.28-1.55) higher risk of high TG than non-smokers.Female smokers presented 40％ (OR=1.40,95％CI:1.15-1.70) higher risk in high glycerides than the non-smokers.Specifically,women smoking longer than 20 years have 60％(OR=l.60,95％ CI:1.31-1.95) higher risk of high TG than women smoking less than 20 years.Conclusions Prevalence rates of certain chronic diseases were seen higher in smokers of both genders.People with longer history of smoking or being heavier smokers,appeared at advanced risk on developing chronic diseases.
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Objective To study the relationship between blood pressure level and major risk factors for cardiovascular diseases in adults in China.Methods A total of 179 347 adults aged ≥18 years were recruited from 298 surveillance points in 31 provinces in China in 2013 through complex multistage stratified sampling.The survey included face to face interview and physical examination to collect information about risk factors,such as smoking,drinking,diet pattern,physical activity,overweight or obesity,and the prevalence of hypertension.The blood pressure was classified into 6 levels (ideal blood pressure,normal blood pressure,normal high blood pressure and hypertension phase Ⅰ,Ⅱ and Ⅲ).The relationship between the prevalence or co-prevalence of risk factors for cardiovascular disease and blood pressure was analyzed.Results The adults with ideal blood pressure,normal blood pressure,normal high pressure,hypertension phase Ⅰ,Ⅱ and Ⅲ accounted for 36.14％,22.77％,16.22％,16.43％,5.97％ and 2.48％,respectively.Among them,the blood pressure was higher in men,people in Han ethnic group and those married,and the blood pressure was higher in those with older age,lower income level and lower education level,the differences were all significant (P＜0.05).Whether taking antihypertensive drug or not,co-prevalence of risk factors influenced the blood pressure levels of both sexes (P＜0.05),and the blood pressure levels of those taking no antihypertensive drug was influenced more by the co-prevalence of risk factors.Finally,multiple logistic analysis showed that the risks for high blood pressure in adults with 1,2 and ≥3 risk factors were 1.36,1.79 and 2.38 times higher,respectively,than that of the adults without risk factor.Conclusion The more the risk factors for cardiovascular disease in adults,the higher their blood pressure were.It is necessary to conduct comprehensive behavior intervention targeting ≥ 2 risk factors for the better control of blood pressure in general population.
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Objective To explore the relations between the prevalence of multiple chronic diseases and cigarette smoking behavior in the Chinese adults.Methods Based on the results from the 2013 Chronic Disease Risk Factor Surveillance (NCD Surveillance),176 534 Chinese residents aged 18 years and above,covering 298 counties (districts) in 31 provinces,was randomly recruited,using the multi-stage stratified clustering sampling method.Information on demographics,cigarette smoking (status,quantity and period) was obtained through face-to-face interviews and questionnaires.Anthropometric data and blood samples were collected and properly stored for analysis.Results In total,175 386 adults were included for statistical analyses,with 42.7％ as males and 57.3％ as females.The prevalence rates of hypertension,high total cholesterol and high triglycerides were 30.4％,7.2％ and 18.0％ in male smokers,35.6％,14.0％,10.3％ and 15.9％ in female smokers respectively,which were all higher than those in the respective non-smokers.Male smokers were found under lower risk on hypertension,but 19％ higher on total glycerides when compared with non-smokers of the same sex (OR=1.19,95％CI:1.10-1.30),when multiple risk factors were under control.Male current smokers with more than 20 cigarettes per day have 41％ (OR=1.41,95％CI:1.28-1.55) higher risk of high TG than non-smokers.Female smokers presented 40％ (OR=1.40,95％CI:1.15-1.70) higher risk in high glycerides than the non-smokers.Specifically,women smoking longer than 20 years have 60％(OR=l.60,95％ CI:1.31-1.95) higher risk of high TG than women smoking less than 20 years.Conclusions Prevalence rates of certain chronic diseases were seen higher in smokers of both genders.People with longer history of smoking or being heavier smokers,appeared at advanced risk on developing chronic diseases.
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Objective@#To evaluate the provincial representativeness of China Non-communicable and Chronic Disease Risk Factor Surveillance System, 2013.@*Methods@#The Sixth National Population Census data which was collected by National Bureau of Statistics of People's Republic of China was used to calculate proportion of population who aged 65 and above, mortality rate, the proportion of non-agriculture population, the illiteracy rate and urbanization rate in order to evaluate the surveillance system in each province. The Mann-Whitney U test was used to determine the statistically differences between the surveillance system and corresponding general population.@*Results@#Among the 298 disease surveillance points (DSPs) in China Non-communicable and Chronic Disease Risk Factor Surveillance System, there were 111, 85, and 102 DSPs located in the east, middle, and west area of China, which covering 13.90%, 11.48%, and 12.28% of the total population, respectively. The surveillance system covered 169 million of the population of China, accounting for 12.70% of Chinese population. The number of DSPs by provinces ranges from 6 (Hainan, Qinghai, and Ningxia) to 14 (Shandong, Guangdong and Henan). It indicated that mortality rate (DSP: 0.238%; Province: 0.482%) and the illiteracy rate (DSP: 15.54%; Province: 26.22%) among DSPs in Tibet were significantly lower than the provincial level, on the other hand, the proportion of non-agriculture population among DSPs (40.6%) was significantly higher than the provincial level (18.8%). The urbanization rate among Jiangxi DSPs (43.4%) was significantly lower than the provincial level (59.9%). The proportion of non-agriculture population among Shandong DSPs (32.8%) was significantly higher than the provincial level (24.2%), however, the illiteracy rate among Shandong DSPs (3.86%) was significantly lower than the provincial level (5.25%). Other than the provinces mentioned above, there was no statistical differences (P>0.05) among proportions of population who aged 65 and above, mortality rates, the proportions of non-agriculture population, the illiteracy rates and urbanization rate between provincial surveillance system and corresponding area.@*Conclusion@#Other than 3 provinces, in general, China Non-communicable and Chronic Disease Risk Factor Surveillance System had provincial representativeness.
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Objective@#To investigate the geographical variation of prediabetes in adults in different regions of China, and to analyze the related factors of prediabetes.@*Methods@#Data was obtained from China Chronic Disease and Related Risk Factor Surveillance in 2013. The surveillance adopted multiple-stage stratified cluster random sampling method, which sampled 177 099 residents aged above 18 years old among 298 surveillance points in 31 provinces of Chinese Mainland. Questionnaire interview was used to obtain demographic variables, personal living style, and socio-economical information. Physical examination was conducted and fasting venous blood sample and (oral glucose tolerance test-2 hours, OGTT-2 h) venous blood sample were obtained from the participants. A total of 171 567 residents aged 18 and above were included in the analysis. The prevalence of prediabetes was analyzed by provinces and by China's geographical regions, after complex weighting. Multilevel logistic models were established to explore the related factors of prediabetes on the area level and individual level.@*Results@#The prevalence of prediabetes among residents aged 18 and above was 16.6% (95%CI: 15.6%-17.6%) in China. The prevalence of prediabetes was the highest (18.3%) in the south China and lowest (13.1%) in the northwest area. The difference of the prevalence in different areas were not statistically significant (P=0.510). If categorized the prevalence of prediabetes into 5 groups by quintile, Hainan, Jilin, Shandong, Anhui, Hunan and Chongqing were in the highest group of prevalence of prediabetes (18.6%-22.7%), and Tibet, Qinghai, Gansu, Ningxia, Guizhou, and Jiangxi were in the lowest group (7.6%-12.6%). The variance of prevalence of prediabetes on the county level (MOR: 1.60 (95%CI:1.53-1.67)) was more diverse than the province level (MOR: 1.21(95%CI:1.08-1.29)) and higher than the street level (1.23 (95%CI:1.14-1.30)). Several factors increased risk of pre-diabetes, including smoking, hazardous drinking and harmful drinking, drinking in the past 30 days, overweight, obesity, central obesity, sugary drink intake, hypertension, high total cholesterol, high triglycerides, high blood low-density lipoprotein cholesterol, low blood high-density lipoprotein cholesterol (all P<0.05). After adjusted the above variables, 92.5% of variance of prediabetes prevalence conld be explained on the provincial level.@*Conclusion@#The geographical distribution of prediabetes in adults in China differed by geographic areas, and it significantly varied on the county level. The related variables included demographic variables, personal behavior, and geographic related variables.
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Objective@#To investigate the prevalence of hypercholesterolemia among Chinese adults in different geographic areas, and to analyze the related factors.@*Methods@#China Chronic and Non-Communicable Disease and Risk Factor Surveillance was conducted in 2013, based on 298 counties/districts in 31 provinces of Chinese mainland. The adults aged 18 years old were randomly selected using multi-stage stratified clustering sampling method. Information on chronic disease and risk factors was collected using face-to-face questionnaire interview and physical measurement. Blood samples were collected by local staffs. Serum total cholesterol (TC) was determined using standard method in a central laboratory. After excluding 565 participants missing key variables and 1 558 participants with abnormal TC values, a total of 174 976 participants were included. Weighted prevalence of hypercholesterolemia was calculated. Hypercholesterolemia related individual or geographic determinants were defined using multilevel logistic regression.@*Results@#The prevalence of hypercholesterolemia in Chinese adults age 18 years old and above was 6.9% (95%CI: 6.4%-7.3%), ranged from 3.0% (95%CI: 2.5%-3.4%) in the northwest of China to 14.2% (95%CI: 12.9%-15.5%) in the south (χ2=183.42, P<0.001). The prevalence of hypercholesterolemia was higher in 6 provinces including Tianjin, Liaoning, Fujian, Guangdong, Guangxi, and Hainan (≥9.0%), but lower in 7 provinces including Shanxi, Shannxi, Gansu, Qinghai, Ningxia, Xinjiang, and Tibet (<3.9%). There was a 1.27 fold variation in hypercholesterolemia prevalence by provincial level, and 72.5% of the geographical variation in hypercholesterolemia prevalence was account for by area-level determinants. With multilevel logistic analysis, the individual risk factors associated with hypercholesterolemia included aging, higher education level or annual household income per capita, regular drinking, too much red meal intake, inactivity, overweight or obesity. For geographic factors, residents living at south China, counties/districts with higher urbanization rates, higher education level or lower standardized death rates were more likely to have hypercholesterolemia (all P<0.05).@*Conclusion@#The prevalence of hypercholesterolemia was high in Chinese adults, it was different between regions and related with characteristics of population, individual behaviors and geographical regions.
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Objective To investigate the prevalence and co-prevalence of tobacco use,excessive alcohol use,insufficient intake of vegetable and fruit,physical inactivity,and overweight or obesity in floating population and influencing factors in China,2012.Methods Data from the 2012 China Chronic Disease Risk Factor Survey in Floating Population in China were used.In this survey,48 704 people aged 18-59 years in floating population were selected through stratified multistage clustering sampling in 170 counties and districts from 31 province (autonomous regions and municipalities) and Xinjiang Production and Construction Corps.The gender specific prevalence and co-prevalence of five risk factors were estimated,and the rank sum test was used for result comparison.Results Among the people surveyed,27.4％ had one risk factor,37.1％ had two risk factors,28.5％ had ≥3 risk factors.The prevalence or co-prevalence of risk factors were positively correlated with age (P＜0.05),income level (P＜0.05) and migration time (P＜0.05),and negatively correlated with educational level (P＜0.05).People who were males,in Han ethnic group,engaged in construction and from other provinces were more likely to have more risk factors (P＜0.05).Conclusion The prevalence and co-prevalence of tobacco use,excessive alcohol use,insufficient intake of vegetable and fruit,physical inactivity and overweight or obesity were high in floating population in China,suggesting that it is necessary to strengthen the comprehensive behavior intervention in floating population.
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Objective To understand the passive smoking exposure level and related risk awareness in adults in China in 2013.Methods A face-to-face questionnaire survey was conducted in 179 570 adults selected through multistage cluster sampling from Chinese chronic disease and risk factors surveillance sample population (2013) in 302 surveillance sites.The effective sample size was 176 179 adults.After comprehensive weighting of the samples,the passive smoking exposure level and the awareness rate of related risks were analyzed.Results The passive smoking exposure rate was 52.8％ (95％CI:51.2％-54.4％) and the rate decreased with age (x2=515.8,P＜0.000 1).The exposure rate was highest in persons engaged in commercial services (61.6％,95％CI:58.6％-64.5％).The awareness rate of related risks was 67.9％ (95％CI:65.8％-69.9％).The awareness rate was higher in urban area (77.0％,95％CI:75.0％-79.1％) than in rural area (60.0％,95％CI:57.7％-62.4％),in males (69.8％,95％CI:67.8％-71.7％) than in females (65.9％,95％CI:63.7％-68.1％).The awareness rate of three related diseases in urban residents (49.8％,95％CI:47.3％-52.4％) were higher than that in rural residents (37.9％,95％CI:35.4％-40.5％);the awareness rate of passive smoking related lung cancer was highest (88.5％,95％CI:87.5％-89.5％),followed by lung disease in children (70.0％,95％ CI:68.1％-71.9％),the awareness rate of passive smoking related heart disease was lowest (46.8％,95％CI:44.6％-49.1％).Conclusion The passive smoking exposure level is relatively high in adults in China,and the awareness rate of passive smoking exposure risks,especially heart disease,is low.
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Objective To estimate the effect of daily diurnal temperature range (DTR) on mortality in different areas in China.Methods A time series study using the data collected from 66 areas in China was conducted,and Meta-analysis was used to analyze the estimates of associations between DTR and daily mortality.Modifying effects of extremely low and high DTR-mortality relationship by season and socioeconomic status (SES) were also evaluated respectively.Cumulative excess risk (CER) was used as an index to evaluate the effects.Results The information about 1 260 913 registered deaths were collected between 1 January 2006 and 31 December 2011,we found the relationship between extreme DTR and mortality was non-linear in all regions and the exposure-response curve was J-shaped.In central and south areas of China,the result indicated the obvious acute effect of extremely high DTR,and the mortality effect in central area (CER=5.1％,95％CI:2.4％-7.9％) was significant higher than that in south area (CER=4.5％,95％CI:1.7％-7.3％).Regarding to the modification of seasons,the cumulative mortality effect of DTR in cold season (CER=5.8％,95％CI:2.5％-9.2％) was higher than that in hot season (CER=3.1％,95％CI:1.1％-5.1％).Generally,deaths among the elderly (≥75 years) were associated more strongly with extremely high DTR.Conclusions The mortality effects of extremely DTR in different areas and seasons showed different characteristics,that in central area and in cold season it was significantly stronger.After modified by season and SES,DTRs were the greatest threat to vulnerable population,especially to the elderly (≥75 years).Therefore,more attention should be paid to vulnerable groups and protection measures should be taken according to the local and seasonal conditions.
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Objective To investigate the prevalence and co-prevalence of tobacco use,excessive alcohol use,insufficient intake of vegetable and fruit,physical inactivity,and overweight or obesity in floating population and influencing factors in China,2012.Methods Data from the 2012 China Chronic Disease Risk Factor Survey in Floating Population in China were used.In this survey,48 704 people aged 18-59 years in floating population were selected through stratified multistage clustering sampling in 170 counties and districts from 31 province (autonomous regions and municipalities) and Xinjiang Production and Construction Corps.The gender specific prevalence and co-prevalence of five risk factors were estimated,and the rank sum test was used for result comparison.Results Among the people surveyed,27.4％ had one risk factor,37.1％ had two risk factors,28.5％ had ≥3 risk factors.The prevalence or co-prevalence of risk factors were positively correlated with age (P＜0.05),income level (P＜0.05) and migration time (P＜0.05),and negatively correlated with educational level (P＜0.05).People who were males,in Han ethnic group,engaged in construction and from other provinces were more likely to have more risk factors (P＜0.05).Conclusion The prevalence and co-prevalence of tobacco use,excessive alcohol use,insufficient intake of vegetable and fruit,physical inactivity and overweight or obesity were high in floating population in China,suggesting that it is necessary to strengthen the comprehensive behavior intervention in floating population.
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Objective To understand the passive smoking exposure level and related risk awareness in adults in China in 2013.Methods A face-to-face questionnaire survey was conducted in 179 570 adults selected through multistage cluster sampling from Chinese chronic disease and risk factors surveillance sample population (2013) in 302 surveillance sites.The effective sample size was 176 179 adults.After comprehensive weighting of the samples,the passive smoking exposure level and the awareness rate of related risks were analyzed.Results The passive smoking exposure rate was 52.8％ (95％CI:51.2％-54.4％) and the rate decreased with age (x2=515.8,P＜0.000 1).The exposure rate was highest in persons engaged in commercial services (61.6％,95％CI:58.6％-64.5％).The awareness rate of related risks was 67.9％ (95％CI:65.8％-69.9％).The awareness rate was higher in urban area (77.0％,95％CI:75.0％-79.1％) than in rural area (60.0％,95％CI:57.7％-62.4％),in males (69.8％,95％CI:67.8％-71.7％) than in females (65.9％,95％CI:63.7％-68.1％).The awareness rate of three related diseases in urban residents (49.8％,95％CI:47.3％-52.4％) were higher than that in rural residents (37.9％,95％CI:35.4％-40.5％);the awareness rate of passive smoking related lung cancer was highest (88.5％,95％CI:87.5％-89.5％),followed by lung disease in children (70.0％,95％ CI:68.1％-71.9％),the awareness rate of passive smoking related heart disease was lowest (46.8％,95％CI:44.6％-49.1％).Conclusion The passive smoking exposure level is relatively high in adults in China,and the awareness rate of passive smoking exposure risks,especially heart disease,is low.
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Objective To estimate the effect of daily diurnal temperature range (DTR) on mortality in different areas in China.Methods A time series study using the data collected from 66 areas in China was conducted,and Meta-analysis was used to analyze the estimates of associations between DTR and daily mortality.Modifying effects of extremely low and high DTR-mortality relationship by season and socioeconomic status (SES) were also evaluated respectively.Cumulative excess risk (CER) was used as an index to evaluate the effects.Results The information about 1 260 913 registered deaths were collected between 1 January 2006 and 31 December 2011,we found the relationship between extreme DTR and mortality was non-linear in all regions and the exposure-response curve was J-shaped.In central and south areas of China,the result indicated the obvious acute effect of extremely high DTR,and the mortality effect in central area (CER=5.1％,95％CI:2.4％-7.9％) was significant higher than that in south area (CER=4.5％,95％CI:1.7％-7.3％).Regarding to the modification of seasons,the cumulative mortality effect of DTR in cold season (CER=5.8％,95％CI:2.5％-9.2％) was higher than that in hot season (CER=3.1％,95％CI:1.1％-5.1％).Generally,deaths among the elderly (≥75 years) were associated more strongly with extremely high DTR.Conclusions The mortality effects of extremely DTR in different areas and seasons showed different characteristics,that in central area and in cold season it was significantly stronger.After modified by season and SES,DTRs were the greatest threat to vulnerable population,especially to the elderly (≥75 years).Therefore,more attention should be paid to vulnerable groups and protection measures should be taken according to the local and seasonal conditions.
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Objective To investigate the community-based management of diabetes patients aged ≥35 years in China.Methods The subjects from 2013-2014 Chronic Non-communicable Disease and Risk Factor Surveillance in China were used in this study,those who were aged ≥35 years and diagnosed by doctors in hospitals at community level or above were selected through clustering sampling.Questionnaire was used to collect the data of subjects' general information,health status,the treatment and the control of blood glucose.Blood samples were taken from the subjects to detect the fasting blood glucose level and blood glucose level at 2 hours after oral administration of glucosum anhydricum.The subjects were weighted according to complex sampling scheme to calculated the different rates and 95％CI.The Rao-scott x2 test was performed to test the differences in rates between the subgroups.Results The survey indicated that among the 10 056 diabetes patients aged ≥35 years and diagnosed with diabetes,4 609 received management service in communities.After being weighted,the management rate of diabetes patients was 45.0％ (95％ CI:40.8％-49.2％).Females (46.9％,95％CI:42.8％-51.0％) had higher management rate than males (43.0％,95％CI:38.1％-47.9％).The management rate was higher in rural area (50.4％,95％CI:46.3％-54.5％) than in urban area (41.6％,95％CI:35.5％-47.6％).There was a significant age specific difference in the proportion of patients receiving management services (x2=21.0,P＜0.01),the rate of management was highest in the patients aged ≥65 years (49.2％,95％CI:43.6％-54.7％),but lowest in the patients aged 35-44 years (35.2％,95％CI:27.9％-42.4％).The overall standardized management rate of diabetes patients in communities was 16.7％ (95％ CI:13.7％-19.7％).The proportion of urban patients receiving standardized management service (19.7％,95％CI:15.3％-24.1％) was higher than that of rural patients (12.8％,95％ CI:9.8％-15.8％).The overall treatment rate of diabetes patients in communities was 95.8％ (95％CI:94.8％-96.9％).The treatment rate was higher in females (97.0％,95％CI:96.0％-98.0％) than that in males (94.5％,95％CI:92.7％-96.4％).The control rate of blood glucose in diabetes patients receiving management in communities was 34.6％ (95％CI:31.5％-37.6％),and the highest blood glucose control rate was in the patients aged ≥65 years (38.2％,95％ CI:33.4％-43.0％),while the lowest blood glucose control rate was in the patients aged 45-54 years (34.4％,95％CI:26.7％-42.0％).Conclusions Both the standardized management rate and blood glucose control rate were low in the diabetes patients aged ≥35 years in China.It is necessary to strengthen the allocation of medical resources in communities and standardized diabetes management.