基于多水平模型分析农村地区不同居住方式老年人健康状况及其影响因素

目的 调查分析四川省某市农村地区不同居住方式老年人两周患病和慢性病患病现状及其影响因素，为促进农村地区老年人健康水平和制定相关政策提供参考和依据。方法 利用该市农村地区2015年居民家庭健康入户调查数据，选取7 280名60岁及以上老年人为研究对象。采用单因素分析比较不同居住方式老年人的两周患病率和慢性病患病率；采用多水平模型分析(家庭和个体)分析两周患病率和慢性病率患病的影响因素。 结果 该地区农村老年人的居住方式以与老伴居住为主（57.0%），其次为独居（15.4%）。居住方式对老年人健康状况有显著影响，独居老人两周患病率和慢性病患病率最高，分别为48.0%和70.0%。多水平模型结果显示，老年人健康状况在家庭水平存在聚集性，家庭水平的居住方式和经济条件，个体水平的年龄、抑郁、吸烟、饮酒、锻炼是影响老年人两周患病率和慢性病患病率的主要因素。结论 与其他居住方式老人相比，独居老人的健康状况更差。家庭经济条件、年龄、抑郁、吸烟、饮酒、日常锻炼与老年人两周患病和慢性病患病相关。

Health Determinants of Rural Elderly Populations with Different Living Arrangements: a Multilevel Model

Objective To determine the health and its determinants of rural elderly populations in a city in Sichuan province. Methods Data were extracted from a 2015 household survey, containing 7 280 rural participants aged over 60 years. The prevalence of two-week morbidity and chronic conditions were compared among those with different living arrangements. Multilevel models were established to determine the family and individual factors associated with the health status of the respondents. Results Most respondents (57.0%) lived with a spouse, compared with 15.4% who lived alone. Those who lived alone had higher prevalence of two-week morbidity (48.0%) and chronic conditions (70.0%). The multilevel model indicated a familial clustering effect. Living arrangements and household income were associated with the prevalence of two-week morbidity and chronic conditions, after controlling for variations in age, depression, smoking, drinking, and exercise at the individual level. Conclusion The rural elderly people who live alone have poor health status. Household income, age, depression, smoking, drinking and physical exercise are associated with two-week morbidity and chronic conditions.