Caída de la esperanza de vida en distritos de Madrid en 2020: relación con determinantes sociales

ObjectiveEstimating the decrease in life expectancy (LE) of the population of Madrid and its districts and its relationship with socioeconomic variables in the first year of the COVID-19 pandemic.MethodDeath records were obtained from the Municipal Register of inhabitants (Municipal Statistics Service). Based on Chiang II method, life expectancy at birth and at 65 years of age (LEB and LE65) were calculated, as well as their 95% confidence intervals both for men and women and their gross, net and minimum falls for each district in 2020 over 2019, their correlation with some socioeconomic variables distribution and the existence of multiple linear regression explicative models.ResultsIn 2020, deaths in Madrid increased by 46.1% compared with the previous year, the LEB was 79.31 years in men and 85.25 years in women, meaning a decrease of 3.67 and 2.56 years respectively (4.42% and 2.91%). All districts registered decreases in LE, with the largest decrease in men in Tetuan (4.72 years) and in women in Chamartín (3.91 years). The most affected were the southern districts, especially in men. Immigrant and people over 80 years old rates explained 24% of the drop in LE in men, using linear regression model.ConclusionsThe decrease in LE recorded in Madrid and its districts in 2020 is bigger than in Spain (1.6 years), takes us back to values of 2002 (LE65) and 2008 (LEB), has a sharper fall in the south and is territorially unequally distributed, according to socioeconomic variables and being associated with some of them.     

City deals and health equity in Sydney,Australia

‘City Deals’ are new governance instruments for urban development. Vast evidence exists on the relationship between urban factors and health equity, but little research applies a health equity lens to urban policy-making. This paper does precisely that for the Western Sydney City Deal (WSCD) in Australia. We conducted a critical discourse analysis of publicly available documents and interviews with the WSCD's main architects, applying insights from relevant theories. We find ‘pro-growth’ discourse to encourage economic investment dominates any references to disadvantage. Interviewees maintained the WSCDs fundamental purpose is to rebalance urban investment toward the historically disadvantaged West. However, the WSCD makes limited reference to health and none to equity. Institutionalised governance practices that favour private investments in infrastructure remain the dominant force behind the WSCD. We document how a shift to ‘place-based’ infrastructure has promise for equity but struggles to overcome institutionalised approaches to urban investments.     

城市学龄前儿童运动发育家庭环境量表的初步编制

目的编制城市学龄前儿童家庭运动环境评价量表(Family Environment Scale on Motor Development for Pre-school Urban Children,FESMDPU),为家庭环境与儿童运动发育的关联性研究提供量化工具。方法以HOME和AHEMD-SR量表为蓝本,在确立71个初始条目的基础上,运用临界比、相关分析和探索性因素分析的结果对条目进行删减。结果根据各条目临界比保留全部条目,根据各条目与总分的相关系数删减15个条目,最后通过第1次和第2次探索性因素分析结果删除5个条目,最后共保留51个条目。此外,探索性因素分析提取了户外运动空间、户内运动空间、精细运动玩具、大运动玩具、空间色彩类玩具、温暖/鼓励、日常生活照顾7个因子。结论保留51个条目作为FESMDPU进一步研究的内容,为该量表的应用性研究奠定了基础。     

城乡脑血管疾病致残人群服务需求满足的差异性调查研究

背景　近年来,残疾人群服务受到广泛关注。一方面,由于残疾人口规模庞大,导致相当一部分残疾人群的服务需求得不到满足;另一方面,随着经济的快速发展,城乡差异逐渐加大。脑血管疾病是全球人口第二大常见死因,其发病率和致残率均很高。在我国,仅脑卒中这一类脑血管疾病造成的经济负担每年高达400亿元。目的　了解脑血管疾病致残人群的服务需求满足度现状及城乡差异,为相关政策制定提供参考。方法　使用2006年第二次全国残疾人抽样调查数据,选取脑血管疾病致残人群作为研究对象,样本总量为12 583例,统计性别、年龄、婚姻状况、受教育程度、民族、户人均家庭收入、残疾等级、居住地情况。服务包括13项,分为第Ⅰ类为健康服务、第Ⅱ类为基本生存服务、第Ⅲ类为自我提升及发展服务、第Ⅳ类为环境支持性服务,评价脑血管疾病致残人群不同服务的需求、利用、满足情况。结果　12 583例受试者中,乡村7 697例（61.2%）,城镇4 886例（38.8%）。乡村第Ⅰ、Ⅱ、Ⅲ、Ⅳ类的需求率分别为94.6%、75.4%、1.6%、22.2%,利用率分别为52.5%、13.0%、0.4%、8.8%,满足度分别为44.7%、11.7%、0.1%、2.8%;城镇第Ⅰ、Ⅱ、Ⅲ、Ⅳ类服务的需求率分别为94.3%、46.7%、1.4%、31.5%,利用率分别为72.8%、7.9%、0.3%、14.8%,满足度分别为62.8%、6.3%、0.1%、6.2%。乡村第Ⅱ类服务需求率、利用率、满足度均高于城镇,第Ⅳ类服务需求率、第Ⅰ、Ⅳ类服务利用率和满足度均低于城镇（P<0.05）。二元Logistic回归分析结果显示,居住地为城镇是第Ⅰ、Ⅳ类服务满足的有利因素〔OR=1.665,95%CI（1.527,1.816）,P<0.001;OR=2.040,95%CI（1.646,2.528）,P<0.001〕,居住地为城镇是第Ⅱ类服务满足的危险因素〔OR=0.769,95%CI（0.662,0.894）,P=0.001〕。结论　城镇脑血管疾病致残人群健康服务、环境支持性服务方面需求、满足度均高于乡村,应进一步缩小城乡差距,加强对乡村脑血管疾病残疾人群健康服务的满足。     

第三次中国城市儿童哮喘流行病学调查

目的 了解我国城市儿童哮喘的患病率、发病规律及诊治情况.方法 于2009年9月至2010年8月在全国27个省或自治区,4个直辖市等共43座城市,开展0 ～ 14岁城区儿童哮喘流行病学调查.采用分层随机整群抽样方法,在各城市确定调查学校、幼儿园和社区.使用统一初筛问卷对儿童进行筛查,筛查出的可疑哮喘儿童由临床医生通过现场问诊、体检、查阅患儿病历及以往相关辅助检查结果等,明确其是否患有哮喘.对已确诊哮喘患儿做进一步问卷调查,了解其哮喘诊治情况及伴发过敏性疾病情况.所有数据使用Epi-Info软件进行双录入,使用SPSS软件进行统计分析.结果 共完成463 982名儿童的初筛,诊断哮喘13 992例,其中典型哮喘12 634例(90.3％),咳嗽变异性哮喘1358例(9.7％).确诊患者中既往已诊断哮喘9605例(68.6％),新诊断病例4387例(31.4％).我国城区0～14岁儿童哮喘总患病率为3.02％ (95％ CI:2.97％ ～ 3.06％),其中典型哮喘患病率为2.72％ (95％ CI:2.68％ ～ 2.77％),咳嗽变异性哮喘患病率为0.29％ (95％ CI:0.28％~0.31％).近2年(2009和2010年)哮喘现患率为2.32％ (95％ CI:2.28％~ 2.37％).男性儿童哮喘患病率明显高于女性[3.51％(8495/241811)和2.29％(5089/222 160),x2 =608.7,P＜0.01].以学龄前儿童(3～5岁)患病率最高(4.15％),明显高于学龄儿童(6～14岁)(2.82％)和婴幼儿(0～2岁)(1.77％).不同地区以华东地区最高(4.23％),东北地区最低(2.00％).不同城市以上海最高(7.57％),拉萨最低(0.48％).在确诊的哮喘患儿中45.2％(6321例)有家族过敏史,72.5％(10 143例)有个人过敏史,50.1％(7010例)伴有过敏性鼻炎.哮喘发作最常见诱因为呼吸道感染和天气变化(或接触冷空气),分别达87.9％(12 299例)和51.5％(7204例).哮喘患儿58.7％(8209例)曾使用过吸入激素,71.4％ (9986例)曾使用过支气管舒张剂,抗生素的使用率为75.1％(10 504例).5岁以上哮喘儿童中,峰流速仪的使用率为14.3％(1449/10 145).结论 我国主要城市城区儿童哮喘总患病率为3.02％,2年现患率为2.32％,不同性别、不同年龄、不同地域和不同城市儿童哮喘患病率存在明显差异,仍有近1/3患儿未得到及时和准确诊断,哮喘的用药和管理状况亟待改进.     

The Valencian Community Healthy Cities Network: assessment of the implementation process

In 1986 WHO-Euro began to develop the Healthy Cities projectwhich was later extended to Spain, in this paper the factorsrelated to the initial development of the Healthy Cities Projectin the member towns and cities of the Valencian Community HealthyCities Network, and the level of their development will be described. The project began in 1987 and the Network, at the time of thisstudy (March 1991), was made up of 48 towns and cities. Theinstrument used to assess the process of the project developmentwas a questionnaire administered by personal interview withthe three people responsible for the project in each city: theMayor, Health Councillor and Health Officer. A score was establishedto measure the level of development of the project in each citywhich included performance of the health diagnosis and plan,the existence of intersectoral committees and the creation ofchannels of community participation. A large proportion of the cities (72%) have carried out theHealth Diagnosis; 26% of the cities have intersectoral committeesand community participation is as yet in the initial stages.Political parties' support of their city's membership in theNetwork, has been almost unanimous with only three exceptions.Resources allocated to the project are not yet constant, althoughthere is important support from different levels, and on thepart of local and autonomous institutions. Differences can beobserved in the level of development of the cities which makeup the Network, related partly to length of time of membership,to the size of the city and to other factors difficult to assess.     

河南省城市学龄儿童感觉统合失调现状

目的了解河南省城市学龄儿童感觉统合失调状况,为学龄儿童心理健康教育提供参考资料。方法随机整群抽取河南省5个地市6所小学的一～五年级城市学生3588名,采用北京医科大学精神卫生研究所编制的《儿童感觉统合能力发展评定量表》进行测评。结果儿童感觉统合失调率为37.60%,以轻度感觉统合失调为主。其中男童为41.72%,女童为33.59%,男童感觉统合失调率高于女童（χ2=25.26,P=0.0001）。结论河南省城市学龄儿童感觉统合失调率较高,应根据各地情况开展有针对性的心理健康教育。     

广州市城区284名小学生血脂水平与体脂含量关系分析

目的了解广州市小学生血脂水平分布现况,分析血脂水平与体脂含量的关系,为开展心脑血管疾病的早期预防提供基础资料。方法抽取广州市2所全日制小学一～五年级各2个班,每班再抽取15名学生,进行血脂检测及体格检查。利用酶法对学生进行血清总胆固醇(TC)和三酰甘油(TG)测定,匀相测定法测定高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C);采用生物电阻抗法(BIA)测量体脂含量。结果广州市284名受检小学生血脂异常率为30.3%,肥胖小学生的血脂异常率明显高于非肥胖组学生(χ2=21.91,P<0.01);TC,TG,LDL-C和HDL-C分别与体脂含量(PBF)呈中、高度相关。结论体脂含量对预测血脂异常有一定的价值。肥胖儿童定期检查血脂,对早期发现血脂紊乱、进行早期干预有重要的现实意义。     

基于人群日死亡数的五城市环境温度阈值分析

目的 对5个城市的环境温度与日死亡人数变化之间的关系进行分析,确定环境温度阈值以及当环境温度高于阈值温度时日死亡人数的变化与温度升高之间的关系.方法 运用R统计软件中分段回归模型软件包进行统计分析,用最大似然法进行迭代运算以确定环境温度阈值,对环境温度高于阈值时的死亡人数变化与温度进行回归分析,以贝叶斯信息准则(bayes information criterion,BIC)对模型进行检验.结果 北京市朝阳区、哈尔滨市、重庆市渝中区、福州市3个区及汕头市金平区的全死因死亡危险的阈值温度(℃)分别为(25.63±0.809)、(23.24±1.114)、(29.29±2.886)、(36.06±0.281)和(31.28±1.016),对应的环境温度高于阈值温度时,每升高1 ℃死亡人数增加的百分比(95% CI)分别为0.99(0.46～1.52)、1.12(0.24～2.00)、0.17(-0.34～0.68)、21.70(11.99～32.26)和2.79(1.05～4.57).结论 北京市和哈尔滨市的环境温度阈值相差不大,其在环境温度高于阈值时每升高1 ℃死亡率增加的百分数也比较接近.中部城市重庆的阈值温度在30 ℃左右,但当环境温度高于阈值时其死亡率增加的百分数却相对较低.福州市和汕头市都是南方沿海城市,其纬度都较其他几个城市低,而且容易受热带风暴影响,所以其阈值温度相对较高,而且当环境温度高于阈值时死亡率增加的百分数也相对较大.