(Un-) healthy ageing: Geographic inequalities in disability-free life expectancy in England and Wales

Health expectancies are an indicator of healthy ageing that reflect quantity and quality of life. Using limiting long term illness and mortality prevalence, we calculate disability-free life expectancy for small areas in England and Wales between 1991 and 2011 for males and females aged 50–74, the life stage when people may be changing their occupation from main career to retirement or alternative work activities. We find that inequalities in disability-free life expectancy are deeply entrenched, including former coalfield and ex-industrial areas and that areas of persistent (dis-) advantage, worsening or improving deprivation have health change in line with deprivation change. A mixed health picture for rural and coastal areas requires further investigation as do the demographic processes which underpin these area level health differences.     

上海市居民期望寿命与健康期望寿命的差异分析

目的:分析不同年龄、性别的上海市居民期望寿命和健康期望寿命的差异。方法:分析比较上海市和全球长寿国家/地区期望寿命的变化趋势;利用全球疾病负担研究建立的疾病和健康结局的失能权重,应用Sullivan法测算上海市居民健康期望寿命,并分析不同年龄、性别人群的健康寿命损失。结果:近40年,上海市期望寿命增长了10.86岁,2...     

中国大陆地区健康期望寿命研究现状调查

目的 通过对中国大陆地区已发表的健康期望寿命文献进行计量分析,了解国内健康期望寿命研究现况,为国家卫生行政部门制定相关政策提供参考。方法 采用文献计量法对纳入文献从时间、地区、类型、健康期望寿命研究结果等方面进行描述性统计分析。结果 51篇已发表的文献中,2016年发表文献最多,占比17.6%。从地区上看,全国性研究最多,占比23.5%,其次为东部沿海地区,占比43.1%;直辖市发表文献较多于一般省份。从研究的人群看,60岁以上老年人的自评自理健康期望寿命研究相对较多,占比54.9%。从健康期望寿命的计算结果上看,大部分研究女性健康期望寿命高于男性。结论 中国大陆地区健康期望寿命研究处于初步阶段,对老年人群健康较为重视,且存在区域差异,经济较发达的东部地区,尤其是直辖市开展的研究较多。不同研究间的可比性较差,需建立统一的计算方法,增强不同地区间的可比性,以及同一地区不同年份的纵向可比性。     

上海市某区老年人健康期望寿命分析

目的：计算上海市静安区60岁以上老年人的健康期望寿命,分析10年间老年人健康期望寿命的损害。方法：采用随机整群抽样的方法在2011年选择3049位老年人进行调查,采用Sullivan法计算健康期望寿命。结果：2011年该地区60岁组老年人的期望寿命和健康期望寿命分别为26．30岁和18．94岁,各年龄组的女性期望寿命均高于男性,但各年龄组的男性健康期望寿命均高于女性。疾病是影响老年人的生活质量的主要因素,其中脑血管病导致的健康期望寿命损失率最大为60．9％。结论：为了提高老年人的健康期望寿命,应加强防治慢性非传染性疾病和女性老年人的保健服务。     

中国流动老人的健康期望寿命研究

目的 了解流动老人的健康期望寿命,包括自评健康期望寿命和生活自理期望寿命, 并探索其影响因素。方法 利用2015年流动人口动态监测调查中的老年人数据,采用Sullivan法分析流动老人的自评健康期望寿命和生活自理期望寿命,logistic回归分析其影响因素。结果 60～64岁流动老人的自评健康期望寿命约为17.7岁,生活自理期望寿命约为20.6岁。女性的健康期望寿命比男性高,但是健康期望寿命损失率也比男性高。慢性病会对老年人的健康产生重要的负面影响, 家庭收入高、教育水平高、流动范围大、参加健康体检、有伴侣、本地朋友多、锻炼时间长都是流动老人健康的保护因素。结论 流动老人健康状况整体较好,相关部门需要提升流动老人卫生服务的利用率,加强对流动老人的慢病管理,鼓励老年人养成健康的生活方式。对高龄女性、社会经济地位低、无伴侣、少数民族的流动老人应给予重点关注。     

1990-2015年中国分省期望寿命和健康期望寿命分析

目的 分析中国及各省期望寿命和健康期望寿命现状及其变化情况。方法 利用2015年全球疾病负担研究结果,对2015年中国居民与全球主要国家期望寿命和健康期望寿命进行比较;分析全国及各省期望寿命和健康期望寿命的差异和1990-2015年全国及各省期望寿命和健康期望寿命的变化幅度。结果 2015年中国居民的期望寿命为76.2岁,健康期望寿命为68.0岁,分别比全球平均水平高出4.4岁和5.2岁。2015年中国人均期望寿命和健康期望寿命,女性均高于男性。我国期望寿命和健康期望寿命较高的省份有上海、北京、香港、澳门、浙江、江苏、天津和广东等东部发达省份,较低的省份有西藏、青海、贵州、新疆和云南等西部省份。1990-2015年,中国居民期望寿命和健康期望寿命均呈上升趋势,期望寿命增加了9.5岁,健康期望寿命增加了8.4岁。全国及各省期望寿命增加的岁数均高于健康期望寿命增加的岁数。结论 1990-2015年中国居民的期望寿命和健康期望寿命有了较大程度的提高,但各省之间差异较大。     

Sudden Increases in Listeriosis Rates in England and Wales, 2001 and 2003

The monthly incidence of listeriosis infections in England and Wales had 2 sudden increases during April 2001 (41%) and March 2003 (48%). Although no causative association is demonstrated, these increases correspond to key dates relating to the onset and aftermath of the 2001 foot and mouth disease outbreak in the United Kingdom.     

Social gradient in life expectancy and health expectancy in Denmark

Summary Objectives: Health status of a population can be evaluated by health expectancy expressed as average lifetime in various states of health. The purpose of the study was to compare health expectancy in population groups at high, medium and low educational levels.Methods: Health interview data were combined with life table figures using Sullivans method.Results: Life expectancy was 4.3 years longer for 30-year-old men with a high educational level than for those with a low level. At age 30, the proportion of expected lifetime in self-rated good health was 67.7%, 76.1% and 82.3% for men with a low, medium and high educational level, respectively. Among women, life expectancy differed by 2.7 years between low and high educational level, and the proportion of expected lifetime in self-rated good health was 62.5% at the low and 80.5% at the high educational level.Conclusions: Educational level and life expectancy are clearly related. The social gradient in terms of health expectancy is even greater than that in terms of life expectancy.     

Regional differences in healthy life expectancy in The Netherlands

BACKGROUND: Healthy life expectancy has mainly been studied at the level of healthcare systems rather than at regional level within healthcare systems. In this article, healthy life expectancy at birth and at 65 years of age for men and women in the Netherlands has been described, and factors related to these regional variations have been explored. METHODS: Ecological study of 27 healthcare regions (hospital catchment areas). Life expectancy and healthy life expectancy were calculated using 1995 mortality data and pooled health interview survey data (1992-1997) from Statistics Netherlands. RESULTS: Healthy life expectancy shows a regional pattern, slightly different from that found in life expectancy and self-reported health. The regional distribution of male and female healthy life expectancy is different, especially at 65 years. Healthy life expectancy of women aged 65 years is independent of their total life expectancy. Social conditions and lifestyle differences between regions are negatively associated with healthy life expectancy in Dutch regions. Healthcare supply variables show no clear relationship. CONCLUSION: Although the Netherlands is a small, homogeneous country, substantial differences were found in healthy life expectancy.     

健康期望寿命的影响因素研究进展

目的 分析健康期望寿命（HLE）的影响因素。方法 检索7个中英文数据库截至2022年5月7日收录的近三年相关文献。筛选纳入有关HLE影响因素的原始研究,影响因素包括疾病与伤害及其影响因素。本研究基于健康决定因素的生态学模型将疾病与伤害的影响因素分为5个层次：个人特质、个体的行为与生活方式、社会社区网络、生活和工作条件、宏观上的社会经济、文化和环境状态。梳理研究地区、HLE指标、研究人群、影响因素、数据来源和结果等内容,应用证据图谱对不同HLE指标和两个维度影响因素的报告文献频次进行可视化展示,并进一步提取四大权威医学英文期刊和中文核心期刊的实证研究进行对比分析。结果 共纳入90篇文献,其中在中国开展的文献研究占28.9%（26篇）。报告疾病与伤害的文献53篇,全部涉及非传染性疾病,且占比最大（58.9%）。报告健康决定因素77篇,涉及生态学模型5个层次,所有文献会同时报告多层次。其中个人特质的文献数最多,共53篇（58.9%）;个体的行为与生活方式47篇（52.2%）;社会社区网络10篇（11.1%）;生活与工作条件35篇（38.9%）;宏观上的社会经济、文化、环境状态8篇（8.9%）。提取四大权威医学英文期刊和中文核心期刊近三年发表的HLE影响因素的相关文献21篇,其中涉及非传染性疾病和个人特质的文献最多,分别有11篇（52.3%）和12篇（57.1%）。非传染性疾病是全球伤残调整寿命年贡献的最主要因素,个体的行为与生活方式为最易被改变因素。结论 近三年HLE影响因素研究主要集中于对非传染性疾病与个人特质的研究;未来应当深入探讨个体的行为与生活方式和职业环境因素。     

Culture and Curriculum in England and Wales: Tensions and Dilemmas for Early Childhood Specialists

This paper deals with the vulnerable position of nursery education in Britain of the 1990s, given the changing nature of the family in society and more particularly in view of its weakly articulated justification in the face of government intervention in education.     

健康期望寿命指标的应用与发展

随着人群期望寿命的增长和传统指标在反映健康水平上有所缺陷,因此健康期望寿命应运而生,该指标综合了生命的长度和质量,更全面地反应了人群的健康水平。此文梳理了健康期望寿命的提出和发展、指标群分类、常用测算方法、国内外应用实例以及国内研究现状,提出建立全国统一的测算方法,并充分利用健康大数据资源,全面评估人群健康期望寿命。     

哈密市老年人日常活动能力及健康期望寿命研究

目的 了解哈密市（伊区两县）≥60岁老年人日常活动能力及健康期望寿命,分析ADL的影响因素。方法 通过多阶段抽样抽取调查对象,收集≥60岁老年人的人口学特征、慢病患病情况以及日常活动能力情况。不同人群ADL依赖率的比较采用χ2检验,ADL影响因素筛选采用二分类Logistic回归分析。结果 共抽样调查880人,哈密市60岁及以上老年人ADL依赖率为13.18%。男性60岁及以上老年人ADL依赖率为10.21%,女性为16.59%;不同性别、民族、文化程度、婚姻状况、户籍类型、社会医疗保险,是否患有慢性病、是否吸烟,是否饮酒,是否进行体育锻炼分组的≥60岁老年人ADL依赖率有统计学差异（P＜0.05）;二分类Logistic回归分析显示,民族为哈萨克族、文盲、丧偶、患有慢性病的老年人ADL依赖率更高,参加体育锻炼的老年人ADL依赖率更低。哈密市60～64岁组老年人期望寿命为25.58岁,期望寿命随年龄增加而呈现下降趋势。60～64岁组老年人健康期望寿命为20.17岁,ADL依赖健康期望寿命为5.41岁。结论 在老年人健康问题中,应更加关注易发生ADL损失的高危人群,重点关注独居,丧偶老年人。鼓励老年人多参加体育锻炼或社区活动,增强身体健康。     

健康期望寿命的指标定义和测算方法研究进展

目的 健康期望寿命（HLE）将预期寿命与健康水平相结合,是各国衡量国民寿命长度和质量的重要综合性指标。本研究采用概括性综述梳理全球HLE的指标定义和测算方法以及实证研究,以期为决策者遴选和发展适合中国国情的HLE指标和算法提供借鉴和参考。方法 检索7个中英文文献数据库,检索时限为建库至2022年5月7日;同时,手动检索综述性文献及其参考文献。纳入HLE指标及测算方法相关的系统评价和实证研究,提取并汇总研究地区、研究类型、研究人群、HLE指标、测算方法、测算数据源和近5年实证研究等内容,梳理HLE的指标定义演变、不同指标适用范围、定义健康的量表,以及HLE的测算方法,总结不同指标测算方法的实证研究结果。研究遵循概括性综述规范实施步骤,文章撰写参考PRSIMA-ScR声明。结果 共纳入文献84篇,其中13篇综述评价,17篇为HLE指标定义的原始研究,10篇为指标测算方法的原始研究,44篇为近5年开展的实证研究。HLE的相关指标多达20种,定义健康的量表各有侧重;不同学者提出10种指标测算方法,根据指标的健康定义、是否设置权重和数据类型而不同。近5年最常用的指标是无残疾期望寿命和不区分具体类型的HLE。对于HLE的测算,横断面数据多使用沙利文法、纵向数据多采用多状态寿命表法。结论 HLE的定义和测算方法多样,尚无公认的最优方法。总结全球范围内的HLE概念、健康评价技术和测算方法以及实证研究,可为我国HLE指标测算的本土化提供借鉴和参考。     

Increasing social inequality in life expectancy in Denmark

Background: The purpose of the study was to determine trendsin social inequality in mortality and life expectancy in Denmark.Methods: The study was based on register data on educationallevel and mortality during the period 1981–2005 and comprisedall deaths among Danes aged 30–60. Sex- and age-specificdeath rates for each of three levels of education were calculatedand age-standardized to allow comparisons over time and betweengroups. As data obtained since 1996 included ages up to 74,partial life expectancy (i.e. expected lifetime of 30-year-oldsbefore the age of 75) was calculated for the period 1996–2005.Results: Between 1981 and 2005, the difference in death ratesbetween people aged 30–60 with low and high educationallevel increased by two-thirds for men and was doubled for women.During the period 1996–2005, the gap in partial life expectancyfrom age 30 to 75 between people with low and high educationallevel increased by 0.3 years. Conclusion: During the past 25years, the social gap in mortality has widened in Denmark. Inparticular, women with a low educational level have been leftbehind.     

郑州市≥65岁老年人健康预期寿命及影响因素

目的了解河南省郑州市≥65岁老年人健康预期寿命及其影响因素,为老年人口卫生服务提供科学依据。方法采用自行设计调查表和日常生活能力(activity of daily life,ADL)量表对在河南省郑州市7个社区和11所养老院整群抽取的2 622名≥65岁老年人进行问卷调查。结果郑州市2009年65岁～、70岁～、75岁～、80岁～、85岁～和≥90岁老年人预期寿命分别为19.38,15.81,12.47,9.50,7.38和6.40岁,男性各年龄组的预期寿命均低于女性;健康预期寿命分别为11.31,7.71,4.71,2.51,1.31和0.73岁,男性65岁～、85岁～和≥90岁年龄组健康预期寿命均低于女性,70岁～、75岁～和80岁～年龄组健康预期寿命均高于女性;健康预期寿命与预期寿命比值分别为0.584,0.488,0.378,0.264,0.178和0.114,健康预期寿命与预期寿命比值除≥90岁年龄组为女性高于男性外,其他各年龄组均为男性高于女性;多因素非条件Logistic回归分析结果表明,年龄、听视力障碍、心脑血管疾病、糖尿病和老年痴呆症是郑州市≥65岁老年人健康预期寿命的危险因素;受教育程度...     

Economic growth and health progress in England and Wales: 160 years of a changing relation

Using data for England and Wales during the years 1840-2000, a negative relation is found between economic growth--measured by the rate of growth of gross domestic product (GDP)--and health progress--as indexed by the annual increase in life expectancy at birth (LEB). That is, the lower is the rate of growth of the economy, the greater is the annual increase in LEB for both males and females. This effect is much stronger, however, in 1900-1950 than in 1950-2000, and is very weak in the 19th century. It appears basically at lag zero, though some short-lag effects of the same negative sign are found. In the other direction of causality, there are very small effects of the change in LEB on economic growth. These results add to an emerging consensus that in the context of long-term declining trends, mortality oscillates procyclically during the business cycle, declining faster in recessions. Therefore, LEB increases faster during recessions than during expansions. The investigation also shows how the relation between economic growth and health progress changed in England and Wales during the study period. No evidence of cointegration between income--as indexed by GDP or GDP per capita--and health--as indexed by LEB--is found.     

2015—2019年陕西省居民健康期望寿命的发展

目的 本文旨在衡量陕西省2015—2019年人群死亡率的发展、估算健康期望寿命及不健康年数。方法 利用2015—2019年陕西省全员人口库和住院病案首页,利用Joinpoint连接点回归趋势分析年龄别死亡率发展情况,沙利文法测算健康期望寿命。结果 陕西省2015—2019年0岁组婴儿死亡率年平均下降34.1%（95%CI:- 43.5%～- 23.2%, P = 0.003）,陕北地区年均变化幅度大于陕南和关中地区。陕西省5年内健康期望寿命由67.85岁提高到69.76岁,各地级市均有不同程度的改善。不健康年数随着年份的增加而增长,全省由6.80岁提升至7.43岁,不健康年数2019年环比增长速度下降1.62%。结论 陕西5年来健康期望寿命逐年提高,虽然不健康年数有所增加,但环比增长速度有所减缓,各地级市间健康水平存在差异,应针对性地差异化地方政策促进健康。