1998-2002年农村城市化工业化进程中1011例院内死亡患者分析

目的研究农村城市化工业化过程中县级医院院内死亡规律. 方法回顾性总结深圳市龙岗中心医院1998-2002年间病案资料. 结果全院死亡1011人;损伤中毒占38.5%,其中机动车辆交通事故占22.1%,骨折占17.7%,颅内和体内损伤占12.8%;循环系统占20%,其中脑出血占10.5%.全院平均病死率2.03%.20～39岁占39.3%,70岁以上占13.5%,不足1个月的占9.5%. 结论在农村城市化工业化过程中,病死人口将会年轻化,各种损伤引起的死亡将成为死亡的主要因素,是医院提高疗效、降低总病死率的关键.     

中国人口老龄化对居民医疗卫生支出的影响研究

在人口老龄化的背景下,如何控制医疗费用、促进健康老龄化已经成为世界性难题。本文通过实证研究分析中国人口老龄化对医疗卫生支出的影响机制,为医疗和养老政策的制定提供参考。面板门槛效应模型的回归结果显示,中国人口老龄化对居民医疗卫生支出的影响与城镇化水平有关。城镇化水平存在双重门槛效应,当城镇化水平低于第二个门槛值,人口老龄化显著地减少了医疗卫生支出;当城镇化水平高于第二个门槛值,人口老龄化对医疗卫生支出的影响机制发生改变,显著地增加了医疗卫生支出。因此,如何在城镇化进程中增进老年人口的社会福祉是控制医疗费用、促进健康老龄化的关键。     

城镇化进程中农村老年人社会支持及影响因素

目的:了解城镇化进程中农村老年人社会支持的状况。方法:采用社会支持评定量表(SSRS)对胶州城镇化进程中200名老年人进行问卷调查。运用SPSS 17.0统计软件对数据进行方差分析。结果:1不同年龄、受教育程度、月均收入、经济来源、子女看望频率的老年人在主观支持方面存在显著差异(F=16.021,9.731,10.811,5.362,21.301;P0.05);2不同年龄、受教育程度、月均收入、经济来源、子女看望频率、有无养老保障、做重大决策时子女的支持情况的老年人在客观支持上存在显著差异(F=3.184,11.137,12.771,6.576,9.663,3.169,17.813;P0.05);3不同年龄、受教育程度、月均收入、经济来源、子女看望频率、有无养老保障的老年人在对社会支持的利用度上存在显著差异(F=7.473,10.348,9.578,9.521,6.112,10.575;P0.05),但是做重大决定时子女的支持情况在老年人对社会支持的利用度上没有差异(P0.05);4不同年龄、受教育程度、月均收入、经济来源、子女看望频率、有无养老保障、做重大决策时子女的支持情况的老年人在社会支持总分上存在显著差异(F=14.529,15.301,16.930,9.227,18.198,12.419,19.990;P0.05)。结论:城镇化进程中农村老年人的社会支持受到年龄、受教育程度、经济状况、有无养老保障,老年人做决定时子女的支持情况等因素的影响。     

城镇化建设中新增城镇居民主观幸福感塑造

城镇化建设不仅是人、财、物由农村向城镇的转移,更是一种生活方式的变革。目前,我国人口城镇化进程缓慢、人居环境较差等问题直接或间接地影响到新增居民的主观幸福感。提出在建设城镇化的过程中,要善于发现问题、积极解决问题,注重居民的主观幸福感的塑造,努力创造出真正让居民感到幸福的城镇。     

城市化对居民区白纹伊蚊孳生地特点影响的研究

目的探讨不同城市化程度居民区白纹伊蚊幼虫的孳生地特点，为控制白纹伊蚊密度提供依据。方法于2004年3月至2005年11月选择城市化程度高的佛山市城区和城市化程度低的揭阳市城中村为调查点，在选定的试验区按随机的原则，每5户选择1户调查其室内外白纹伊蚊幼虫的孳生情况，数据采用SPSS11．0软件进行统计。结果共调查7470户，积水5635处，阳性502处，阳性率6．72％，显示揭阳市城市化程度低的城中村居民区白纹伊蚊的孳生地类型主要为闲置容器（碗、瓶、缸、罐）和贮水容器（池、缸、盆），其阳性构成比分别为64．98％和18．77％，闲置容器的阳性构成比在每年的9月达到最大值为83．67％；佛山市居民区白纹伊蚊的孳生地类型主要为盆景、水生植物和闲置容器，其阳性构成比分别为45．52％和33．79％，闲置容器的阳性构成比每年的7—9月所占比例最大达100％，盆景、水生植物的阳性构成比在2004年、2005年5月所占比例较大，最大值达到75．00％，2005年5月后其所占比例为0。结论不同类型的居民区其白纹伊蚊的孳生地构成有一定的差别，并随着季节的变化而变化，城市化程度高的居民区白纹伊蚊的孳生地主要是盆景、水生植物和闲置容器，城市化低的城中村主要是闲置容器及贮水容器。     

农村城市化进程中乡村医师的管理和发展

上海市宝山区在农村城市化进程中以乡村医师管理和发展的实践研究，分析了乡村医师的现状与问题，提出了农村城市化进程中乡村医师管理与发展的若干对策。     

Quantification of Urbanization in Relation to Chronic Diseases in Developing Countries: A Systematic Review

During and beyond the twentieth century, urbanization has represented a major demographic shift particularly in the developed world. The rapid urbanization experienced in the developing world brings increased mortality from lifestyle diseases such as cancer and cardiovascular disease. We set out to understand how urbanization has been measured in studies which examined chronic disease as an outcome. Following a pilot search of PUBMED, a full search strategy was developed to identify papers reporting the effect of urbanization in relation to chronic disease in the developing world. Full searches were conducted in MEDLINE, EMBASE, CINAHL, and GLOBAL HEALTH. Of the 868 titles identified in the initial search, nine studies met the final inclusion criteria. Five of these studies used demographic measures (such as population density) at an area level to measure urbanization. Four studies used more complicated summary measures of individual and area level data (such as distance from a city, occupation, home and land ownership) to define urbanization. The papers reviewed were limited by using simple area level summary measures (e.g., urban rural dichotomy) or having to rely on preexisting data at the individual level. Further work is needed to develop a measure of urbanization that treats urbanization as a process and which is sensitive enough to track changes in “urbanicity” and subsequent emergence of chronic disease risk factors and mortality. Electronic supplementary material    The online version of this article doi: contains supplementary material, which is available to authorized users.     

Epidemiological Transition and the Double Burden of Disease in Accra,Ghana

It has long been recognized that as societies modernize, they experience significant changes in their patterns of health and disease. Despite rapid modernization across the globe, there are relatively few detailed case studies of changes in health and disease within specific countries especially for sub-Saharan African countries. This paper presents evidence to illustrate the nature and speed of the epidemiological transition in Accra, Ghana’s capital city. As the most urbanized and modernized Ghanaian city, and as the national center of multidisciplinary research since becoming state capital in 1877, Accra constitutes an important case study for understanding the epidemiological transition in African cities. We review multidisciplinary research on culture, development, health, and disease in Accra since the late nineteenth century, as well as relevant work on Ghana’s socio-economic and demographic changes and burden of chronic disease. Our review indicates that the epidemiological transition in Accra reflects a protracted polarized model. A “protracted” double burden of infectious and chronic disease constitutes major causes of morbidity and mortality. This double burden is polarized across social class. While wealthy communities experience higher risk of chronic diseases, poor communities experience higher risk of infectious diseases and a double burden of infectious and chronic diseases. Urbanization, urban poverty and globalization are key factors in the transition. We explore the structures and processes of these factors and consider the implications for the epidemiological transition in other African cities.     

Urbanization and the likelihood of a cesarean section

Objective

This study examines the association between the likelihood of cesarean section (CS) and the degree of urbanization in Taiwan, exploring possible explanations for the difference.

Study design

The database used in this study was the Taiwan 2004 National Health Insurance Research Database. A total of 200,207 singleton deliveries fulfilled our criteria and were included in our study. The urbanization level of cities/towns where parturients resided at the time of delivery was stratified into seven categories. A multilevel logistic regression model was applied to examine the relative likelihood of CS by urbanization level after adjusting for parturient, physician and hospital characteristics.

Results

There was an upward trend in the CS rate with advancing urbanization level; the CS rates for urbanization level 1 (most urbanized) through 7 (least urbanized) were 33.7, 32.3, 30.4, 30.2 29.7, 29.5, and 28.6%, respectively. Compared with participants living at the highest urbanization level, the adjusted odds of a CS were 0.91 (95% CI = 0.85–0.98, p = 0.014), 0.84 (95% CI = 0.78–0.91, p < 0.001), 0.83 (95% CI = 0.68–0.88, p < 0.001), 0.79 (95% CI = 0.72–0.86, p < 0.001), and 0.70 (95% CI = 0.62–0.80, p < 0.001) times, respectively, for those living in cities/towns ranked from the third highest to the lowest levels of urbanization.

Conclusions

We conclude that higher urbanization levels were associated with higher odds of CS. Highly urbanized communities could therefore be targeted for policy intervention aimed at reducing the unnecessary CS rate.