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The "Medium and Long-term Plan for the Prevention and Control of Chronic Non-communicable Diseases in Shanghai (2018-2030)" was officially released in August 2018.From the perspective of public health, this paper analyzes the background of the plan from the epidemic situation, response and challenges Shanghai City is facing, expounds the comprehensive prevention and control system of chronic diseases including four functional systems, and explains the key preventive and control measures on the different stages of chronic diseases, comparing the evaluation indicators with those of the national plan.This paper will help to better understand the new blueprint for the prevention and control of chronic diseases in Shanghai in the next ten years.
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[Objective]To investigate the influence of healthy walking intervention on risk factors of noncommunicable chronic disease in occupational population, and to explore the suitable mode of exercise intervention for occupational population in Shanghai. [Methods]Before and after healthy walking intervention were compared the changes of body weight, BMI, waist circumference, body fat rate, visceral fat index, over-weight and obesity rate, central obesity rate, blood-pressure controlling rate. [Results]Weight, BMI, waist circumference, body fat percentage, viscera index, SBP and DBP all reduced after100 days of healthy walking, and the results were (1.52 ± 2.75) kg (Z =-21.99, P < 0.01) , (0.55 ±1.03) kg/m2 (Z =-21.64, P<0.01) , (2.10±5.27) cm (Z =-17.62, P<0.01) , (0.31±4.59) ％ (Z=-3.48, P < 0.01) , (0.12 ± 1.99) (Z =-2.70, P < 0.01) , (2.51 ± 10.87) mm Hg (Z =-9.35, P <0.01) and (1.67±8.26) mm Hg (Z =-9.06, P < 0.01). The rate of over-weight and obesity decreased7.86％, the rate of central obesity decreased 6.92％, and the rate of blood-pressure controlling increased2.72％. There were significant difference between the three indicators before and after healthy walking (χ2= 916.48, P< 0.01; χ2= 585.90, P < 0.01; χ2= 366.37, P < 0.01). [Conclusion] Healthy walking could reduce occupational population' s over-weight and obesity rate, central obesity rate, and increase blood-pressure controlling rate. The risk factors of un-communicable chronic disease have improved significantly. Healthy walking plays a positive role in the prevention and control of chronic diseases.
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Non-communicable disease ( NCD) is the major threat to citizens in public health.Under the leadership of local authorities and in accordance with rules and regulations, the Shanghai Municipal Government is undertaking the responsibility of establishing public health system, developing national model city of NCD prevention and control, integrating NCD treatment and prevention approaches, innovating new model of communication, motivating healthy lifestyle, and promoting “Internet +”practice, so as to improve health care management of NCD in all phases.
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Objective To understand the status of community-based management of hypertensive patients aged thirty-five or above in Shanghai . Methods Data from Shanghai Chronic Disease and Risk Factors Surveillance carried out in 2013 were used to analyze the community-based management and treat-ment and control of blood pressure of hypertensive patients aged thirty-five or above in Shanghai .Sample was weighted according to complex sampling scheme and post-stratification to calculate the rates with95 %confidence intervals ( CI) for the subgroups according to different characteristics .The Rao-Scottχ2 test was performed to test for the differences of the rates of the subgroups . Results There were 10 510 hyperten-sion patients were included in the study among which 7 343 patients were aware of their diagnosis , and a total of 3 815 patients had been under management in communities .After being weighted the rate of management of hypertensive patients in communities was 49.74%(95%CI:45.66%-53.83%).There was a significant difference in the proportion of patients receiving management services when comparing different age groups (χ2 =68 .120 , P=0 .002 ) , the rate of management among the patients aged sixty-five or above was 55.49%(95%CI:51.58%-59.32%), while among the patients aged thirty-five to forty-four was only 41.20% (95%CI: 30.73% -52.54%).The rate of management among females was 51.12%(95%CI:47.17%-55.05%), while males was 48.46% (95%CI:43.34%-53.61%), with no statistical significance (χ2 =5.194, P =0.216 ).The rates of management in urban areas , sub-urban areas and rural areas were 47 .66% ( 95%CI: 42 .55%-52 .82%) , 52 .92% ( 95%CI:43.41% -62.24%), 52.84% ( 95%CI: 44.96% -60.58%), respectively, with no statistical significance (χ2 =19 .281 , P =0 .432 ) . The follow-up rate in patients with hypertension under standardized management in communities was 21 .97%( 95%CI: 18 .61% -25 .74%) .There was a significant difference between different genders (χ2 =65.048, P =0.000 ).The rate of females was 27.42%(95%CI:227.7 %-32.61%), which was higher than the rate of males (16.61%,95%CI:13 .02%-209.3 %) .There were no significant differences among different age groups (χ2 =2 .017 , P=0 .834 ) and regions (χ2 =21 .244 , P=0 .111 ) .The treatment rate was 95 .47% ( 95%CI: 94 .08% -96 .54%) .There was a significant difference among different age groups (χ2 =403.46 , P=0 .006 ) .The treatment rate among the patients aged sixty-five or above was 96 .90% ( 95%CI:95 .39%-97 .93%) , while among the patients aged thirty-five to forty-four was 89.31%(95%CI:77.94% -95.19%).There were no significant differences among gender (χ2 =7.983 , P=0.055 ) and regions (χ2 =0.881, P=0 .807 ) .The control rate of hypertensive patients managed in communities was 38 .98% ( 95%CI:35 .55%-42 .51%) , There were no significant differences among different age groups (χ2 =23 .188 ,P=0.103), gender(χ2 =1.050,P =0.468) and regions( χ2 =0.529,P =0.938). Conclusion We should further expand the coverage of the standardized management of hypertension patients in the community , and make personalized intervention plan , so as to improve blood pressure control rates of hypertension patients in the community .
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Objective To explore the application of Framingham Stroke Risk Profile in elderly people. Methods A total of 5 148 people aged 55 years and older who received physical examination in a community were enrolled.Information of their healthy status and risk factors were collected by interview using a questionnaire.Height, weight, waist circumference (WC), and blood pressure as well as fasting plasma glucose ( FPG) , and serum lipid were measured. Results The average 10-year probabilities of stroke in elderly people were 9.79% in men and 6.20% in women ( P <0.05).Besides aging factor, higher risk probability in men might be related to their higher proportions of smoking and atrial fibrillation. In addition to blood pressure and FPG which were variables associated with risk profile, WC/height ratio ( WHR) and serum triglyceride level were associated with increased risk of stroke estimated by stroke risk profile (OR=1.598, 95%CI:1.371~1.864;OR=1.487, 95%CI:1.225~1.783), respectively. Conclusion Besides factors which had been included by risk profile, it is important to pay attention to weight control and triglyceride level.For elderly male, to quit smoking is an important measure that decreases their risk of stroke.