Examining Inequality in the Public Health Workforce Distribution in the Centers for Disease Control and Prevention (CDCs) System in China, 2008-2017 / 生物医学与环境科学（英文）

Objective@#Allocation of human resources to address inequalities in the public health system has increasingly attracted societal and political attention. Using the Centers for Disease Control and Prevention (CDCs) system of China as an example, we evaluated inequality in the public health workforce distribution across different regions in China between 2008 and 2017, with the aim of providing information for policymakers to support resource allocation and address growing health inequities.@*Methods@#We used three standard public health workforce inequality indices - Gini coefficient, Theil L, and Theil T - and spatial autocorrelation analysis to explore spatial clusters of the workforce in different provinces, visualized with geographical tools.@*Results@#The aggregate workforce-to-population ratio decreased from 1.47 to 1.42 per 10,000 population from 2008 to 2017, and was consistently lower than the National Health Commission's (NHC) recommended critical shortage threshold of 1.75. The workforce distribution inequality indices varied by regional socioeconomic and health system development. Geographic clustering of CDCs workforce distribution was evident, with H-H and L-L clusters in western China and the Guangdong-Fujian region, respectively.@*Conclusions@#Our study addressed key issues for government and policymakers in allocation of public health human resources. There is an urgent need for careful identification of analytic questions that will help carry out public health functions in the new era, alongside policy implications for an equitable distribution of the public health workforce focusing on the western region and low-low cluster areas.

Association between Selenium in Soil and Diabetes in Chinese Residents Aged 35-74 Years: Results from the 2010 National Survey of Chronic Diseases and Behavioral Risk Factors Surveillance / 生物医学与环境科学（英文）

Objective@#To explore the association between soil selenium levels and the risk of diabetes in Chinese adults aged 35-74 years.@*Methods@#Data for this study were derived from the China Chronic Diseases and Behavioral Risk Factors Surveillance 2010 survey. Selenium concentrations in soil were obtained from the Atlas of Soil Environmental Background Values in China. A two-level binary logistic regression model was used to determine the association between soil selenium concentrations and the risk of diabetes, with participants nested within districts/counties.@*Results@#A total of 69,332 participants aged 35-74 years, from 158 districts/counties were included in the analysis. Concentrations of selenium in soil varied greatly across the 158 districts/counties, with a median concentration of 0.219 mg/kg ( : 0.185-0.248). The results showed that both Quartile 1 (0.119-0.185 mg/kg) and Quartile 4 (0.249-0.344 mg/kg) groups were positively associated with diabetes compared to a soil selenium concentration of 0.186-0.219 mg/kg (Quartile 2), crude odds ratios ( s) (95% ) were 1.227 (1.003-1.502) and 1.280 (1.048-1.563). The values were 0.045 and 0.013, for Quartile 1 and Quartile 4 groups, respectively. After adjusting for all confounding factors of interest, the Quartile 1 group became non-significant, and the Quartile 4 group had an adjusted (95% ) of 1.203 (1.018-1.421) relative to the reference group (Quartile 2), the values was 0.030. No significant results were seen for the Quartile 3 group (0.220-0.248 mg/kg) compared to the reference group.@*Conclusion@#Excessive selenium concentrations in soil could increase the risk of diabetes among Chinese adults aged 35-74 years.

Ovary cancer mortality in China 2004 - 2005: results from the Third National Retrospective Sampling Survey of Death Causes / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the distribution characteristics and trend of ovary cancer mortality based on results of the Third National Retrospective Sampling Survey of Death Causes.</p><p><b>METHODS</b>Data of National Retrospective Sampling Survey for the years of 2004 - 2005 from 158 counties/cities/districts was used for the settings. A total of 69,690,241 person-year for female between 2004 and 2005 including 23,598,822 person-year in urban and 46,091,419 person-year in rural were respectively included in the study. Furthermore, the areas of east, middle, and west were divided into the subsets. And also the areas of urban and rural areas were divided into the subsets. The crude death rate and age-specific death rate and the age-standardized death rate by Chinese population of 1982 (CASR) and by world population of 1960 (WASR) were calculated. The historical comparison with the sampling survey of 1990 - 1992 (second time) was conducted, and the global comparison with some selected countries was performed.</p><p><b>RESULTS</b>The crude death rate for ovary cancer was 1.45/100 000 (1008/69 690 241) between 2004 and 2005, which was ranked the 12th and accounted for 1.45% (1008/69 667) of all sites of cancers. The CASR was 0.97/100 000 and the WASR was 1.26/100 000. The crude death rate of ovary cancer were 2.67/100 000 (630/23 598 822) and 0.82/100 000 (378/46 091 419) in urban and rural areas respectively, with the CASR of 1.62/100 000 and 0.59/100 000 in urban and rural areas respectively. Compared with the data from the second time (0.06/100 000 for crude death rate, 0.53/100 000 for CASR and 0.75% for proportion), the crude death rate increased by 141.07% and the CASR increased by 83.02%. The proportion of mortality was increased by 92.92%, which ranked from the 17th to the 12th. In the urban areas, the CASR of ovary cancer increased by 31.71% (1.23/100 000 vs 1.62/100 000), while by 118.52% in rural areas (0.27/100 000 vs 0.59/100 000) with an increasing trend more remarkable in rural than in urban.</p><p><b>CONCLUSION</b>Ovary cancer is not the leading site of cancer death-cause in China, its morality is higher in urban than in rural. It is necessary to pay more attention to ovary cancer in China.</p>