北京市老年人慢性病社会决定因素研究

目的：研究北京市老年人慢性病在不同社会阶层人群中的患病差异。方法：利用北京大学公共卫生学院2013年对北京市老年人进行的入户调查数据库，获取1717名具有北京代表性的60岁及以上人口的入户调查信息。以收入、受教育程度、职业和户口等社会经济地位指标对社会阶层进行度量，采用Logistic回归模型，分析北京市老年人慢性病患病在不同社会阶层人群间的分布。结果：非农业户口人群、收入位于中间和最高人群、小学组和大专及以上组慢性病患病风险较低。退休前从事农林牧渔业水利业生产人员慢性病患病风险较高。收入次低20％组同时患3种以上慢性病风险较高。结论：慢性病防控策略的制定应充分考虑社会分层等健康社会决定因素，而不仅仅是针对慢性病的直接病因。北京市老年人的慢性病防控工作应当重点关注农业户口、低收入和受教育程度较低人群。

Analysis on social determinants of chronic disease of the elderly in Beijing

Objective: This paper investigates the difference of chronic disease in different social class of the elderly in Beijing. Method: Date of a representative sample included 1717 residents aged 60 and above are drawn from Beijing elderly household survey 2013 conducted by Peking university school of public health. With income, education, occupation and residence household as indicators of social class, logistic regression model is used for analyzing the difference of chronic disease prevalence among different socio-economic status. Result: The non-agricultural household group, middle and highest income group, the least and highest groups of education have a lower probability and the farming, forestry, animal husbandry and fishing water production personnel before retired have a higher risk of suffering from chronic disease. In terms of multiple chronic diseases, second lowest 20% income group tie to higher risk of suffering three or more chronic conditions simultaneously. Conclusion: Strategies development of chronic disease prevention and control should take full account of social determinants of health such as the social stratification, not just for the direct cause of chronic diseases. Agricultural household, low-income and low-education group of people should be priorities in Beijing elderly chronic disease prevention and control.