Analysis of healthy life expectancy and related socioeconomic influencing factors among the middle-aged and elderly in China, the United States, and the European Union / 中华流行病学杂志

Objective: To calculate and compare the healthy life expectancy (HLE) of the middle-aged and elderly in China, the United States, and developing and developed countries in the European Union(EU) and analyze the impact of socioeconomic factors on HLE in different countries or regions. Methods: Four surveys from 2010 to 2019 were brought into the research. The data were collected from the China Health and Retirement Longitudinal Study, Health and Retirement Study, and the Survey of Health, Ageing and Retirement in Europe. Developed and developing countries in the EU were divided into two groups for calculation. Education level, total family wealth, and work retirement status were selected to measure socioeconomic status, and activities of daily living were used as health status indicators. We used the multi-state life cycle table method to calculate the transition probability between different health states and estimate life expectancy and HLE. Results: A total of 69 544 samples were included in the study. In terms of age, the middle-aged and elderly in the United States and developed countries of the EU have higher HLE in all age groups. In terms of gender, only Chinese women have lower HLE than men. Regarding socioeconomic factors, the middle-aged and elderly with higher education levels and total family wealth level have higher HLE. In China, working seniors have higher HLE, while for USA women and developed countries of the EU, retired or unemployed seniors have higher HLE. Conclusions: Demographic and socioeconomic factors impact HLE in different countries or regions. China should pay more attention to the health of women and the middle-aged and elderly retired with lower education and less total family wealth.

Research progress on clinical quality disparity and effects for quality improvement in patients with acute coronary syndromes / 上海预防医学

The United Nations Sustainable Development Goal proposes to achieve universal health coverage by 2030， and the key element is that everyone can enjoy high-quality healthcare services. Cardiovascular diseases， predominantly acute coronary syndromes， have become the largest disease burden on global health. However， the quality of healthcare services for acute coronary syndromes varies significantly across the populations and regions. This study aimed to investigate the difference in the quality of acute coronary syndrome services in multiple countries， regions， hospitals， and patient populations， and then determine the impact of quality improvement initiatives on quality disparity， which may facilitate further improving the equity of clinical service quality for acute coronary syndromes and promoting health equity and universal health coverage.