目的 分析2020―2050年中国老年人口健康预期寿命(health expectancy, HE)及其性别差异的变化趋势，为中国人口长寿和健康之间的关系及其性别差异在未来的发展趋势提供证据和线索。方法 基于2010年人口普查数据和1987年、2006年全国残疾人抽样调查数据，使用多状态人口预测模型(population-development-environment Analysis, PDE)和流行病学计算方法预测了死亡率和残疾率。使用Sullivan方法估计了2020―2050年50岁及以上人口分性别、年龄的无残疾预期寿命(disability-free life expectancy, DFLE)和伴随残疾预期寿命(life expectancy with disability, LwD)。结果 中国老年人口的预期寿命(life expectancy, LE)在2020―2050年持续上升。其中，女性中LE的上升由LwD的上升所主导，而男性中DFLE的贡献略高。在75岁以下的女性和65岁以下的男性中呈现“功能残障扩张”且男性中更不明显；整个研究期间，80岁及以上女性的余寿中会有超过一半的时间伴随残疾度过，占比高于男性。女性的DFLE高于男性，绝对性别差异整体上随时期缩小，但在高龄老人中相对保持稳定；女性DLFE的占比低于男性，在2040年之后相对差异开始缩小，且在高龄老人中更明显。结论 未来中国老年人口的功能状况可能会不断恶化。虽然在2040年之后DFLE的相对性别差异开始缩小，但这建立在LwD占比较高的情况下。在重点关注女性高龄老年人的功能状况的同时，应尽快建立起完备的长期照护体系。

Objectives This study aimed to investigate the associations between individual-level SES, area-level SES, and their interaction with dementia in China. Methods This study used data from the Second China National Sample Survey on Disability and restricted our finalized analysis to 688,507 participants aged 50 years or older. Dementia was ascertained according to the International Statistical Classification of Diseases, Tenth Revision. Multilevel logistic regression models were fitted to examine the associations between individual-level SES, area-level SES, and their interaction with dementia. Results Participants with higher individual SES were less likely to develop dementia; the risk of dementia decreased by 18% for each standard deviation increase in individual SES (OR=0.82, 95% CI=0.77, 0.88). Advantaged areas were associated with an increased risk of dementia in Chinese adults by 1.52 (95% CI=1.43, 1.62). Analysis of the combination between individual-level SES and area-level SES revealed that as the level of area SES increased, the risk of dementia in lower SES people was significantly higher than in higher SES people (OR=1.09, 95% CI=1.04,1.14). Discussion This study found that people with lower SES living in high-SES areas had a higher risk of dementia than people with lower SES living in low-SES areas. Significant socioeconomic differences in the risk of dementia exist in China, and more attention should be given to low-SES populations living in high-SES areas.

中国正处于人口老龄化迅速发展的阶段,同时仍处于健康模式的转变过程中,疾病谱和死亡谱蕴藏着庞大且复杂的人口健康安全风险,为我国公共卫生带来巨大的挑战。本文从制度优化的角度提出要建立适应我国国情与需求的"人口健康报告制度",并从人口经济学视角对其进行成本与收益分析,结果发现健康报告制度的提出是人口健康监测的进一步发展,也是当前公共卫生制度与服务体系发展处于"制度均衡"向"制度非均衡"的转折以及进行制度创新和优化的重要体现,其直接收益包括经济上成本的节约以及人群覆盖产生的数据与信息收益,间接收益包括通过健康报告制度产生的人群健康效益,即人群健康水平的提高。

Background Disabilities caused by perinatal asphyxia will burden child health and well-being. To date, our understanding about the situation and risk factors of perinatal asphyxia-induced disabilities among Chinese children is still limited. Objectives To evaluate the prevalence and socio-demographic risk factors of disabilities caused by perinatal asphyxia among Chinese children in 2006 and compare disability trajectories across different socio-demographic status. Methods Cross-sectional data came from the 2006 China National Survey on Disability which includes a total of 616,940 children aged 0– 17 years old was employed in the investigation. Perinatal asphyxia-induced disabilities were identified by following the guidance in consensus manuals. Population-weighted numbers and prevalence rates were investigated, and multivariable logistic regression was performed to evaluate associations between disabilities and socio-demographic factors. Adjusted predictions at representative values were computed to compare the disability trajectories relative to significant socio-demographic variables. Results The prevalence rate of disabilities caused by perinatal asphyxia was 7.70 per 10,000 children (95% CI: 7.01– 8.39). Male (OR 1.81, 95% CI: 1.47– 2.23) and low family income (OR: 1.73, 95% CI: 1.21– 2.49) have higher and the increase of per additional year of age (OR: 0.89, 95% CI: 0.88– 0.91) has lower probability of being disabilities caused by perinatal asphyxia. Further disability trajectories showed that differences in probability between gender and family income group were more evident before age 7 and weakened with increasing age. Conclusions Our results showed that both demographic and socioeconomic characteristics are risk factors for disabilities caused by perinatal asphyxia. Of these, gender and family income have much higher impact than other factors on the prevalence rate of disabilities caused by perinatal asphyxia at infants and young children. Multiple society sectors should increase their effort to bring about fundamental social change to prevent disabilities caused by perinatal asphyxia, especially concerning younger children and their families.

准确认识和把握我国老年人认知障碍的变化趋势和影响趋势变化的关键因素,对于相关规划和政策的制定至关重要。本研究采用中国老年健康影响因素跟踪调查在2002— 2019年间的六轮数据,分析了我国65— 105岁老年人认知障碍患病率的变化趋势,重点探索了教育水平提高对认知障碍趋势的影响及其性别差异。结果显示,在控制人口年龄结构的影响后,我国老年人认知障碍患病率呈现明显的下降趋势,认知障碍标准化患病率从2002年的14 3%下降到2017— 2019年的10.2%,下降了28.7%;老年人受教育水平的提高是这一下降趋势的主要影响因素,可解释下降62%的原因,且这一影响存在显著的性别差异。研究结果提示,通过早期...

本文利用2016— 19年全国残疾人人口基础数据库持证残疾人数据,研究持证残疾老年人群体全国、城乡以及省份等不同层次的贫困状况和特征,并从城乡和地域上进行分解。结果表明:(1)全国范围内残疾老年人经济贫困率下降明显,至2019年,绝对贫困发生率仅6.5%,但边缘贫困问题开始凸显,且具有较明显城乡和区域差异。(2)农村残疾老年人多维贫困程度较城市更为严重,趋势整体向好,农村改善速度快于城市。(3)西部地区残疾老年人贫困状况依然相对更为严峻,具有较高的边缘贫困率及程度较深的多维贫困。东部地区整体经济发展水平虽较高,但部分省市开始出现城市边缘贫困加剧与多维贫困加深的现象,还可能面临城乡残疾老年人多维贫...

我国残疾人口规模大、残疾种类和致残原因复杂,给个人、家庭和公共卫生体系造成巨大经济负担。残疾防控具有重要的社会和经济效益,但目前仍然缺乏对残疾防控经济效果的科学评估。本研究利用第二次全国残疾人抽样调查数据,基于经济负担视角,在残疾规模的预测和残疾家庭收入损失的研究结果基础上,对残疾防控经济效益中"家庭收入补偿"进行了评估。研究表明,残疾防控根据不同方案,在2050年将产生1. 41-1. 92万亿元人民币/年的收益,累计产生15. 14-21. 73万亿元人民币收益。残疾防控力度越大,所产生的家庭收入补偿越高,预期经济效益越大。本研究首次对残疾防控的经济效益评估的思路和方法进行探索,虽然家庭收...

残疾统计是认识和掌握残疾人状况的基本方式和手段,也是促进残疾预防、康复和精准服务,推动残疾人社会保障体系建设、脱贫攻坚、提升机会均等的实证基石,对社会、经济和人口政策的制定和实施具有极为重要的意义。本文对改革开放以来中国残疾统计和信息化事业的发展历史进行了梳理,对我国残疾统计数据和残疾基本信息进行介绍,论述了我国在国际残疾统计领域发挥的重要作用,指出我国残疾统计事业未来应从完善制度、建设思路、优化统计方法细节、突出统计内容重点等方面加强建设,以迎接新时期残疾人工作的挑战。

随着死亡率的降低,人们越来越关注增加的预期寿命是否在健康状态中度过。相应地,学者们提出了疾病扩张、疾病压缩和动态平衡三种假说。这对于判断人口健康发展趋势以及制定医疗和社会服务规划都具有重要的理论和现实意义。阐述三种假说的依据和理论机制、分析已有文献的验证结果,并探讨未来的理论研究方向。认为三种假说在不同特征的人群中都得到了一定程度的验证,而研究人口健康在三种假说状态间转换的前提条件,并通过公共卫生和医疗手段实现疾病压缩将有利于提高生命质量、实现全民健康。

Background Type D personality and medication nonadherence have been shown to be associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease, myocardial infarction, and heart failure. However, the relationship between type D personality and medication adherence in patients with Type 2 Diabetes Mellitus (T2DM) remains unknown. This study aims to examine whether type D personality was associated with medication adherence in patients with T2DM. Design and Settings A follow-up study was conducted in general hospital of the People's Liberation Army in Beijing. Methods 412 T2DM patients (205 females), who were recruited by circular systematic random sampling, provided demographic and baseline data about medical information and completed measures of Type D personality. Then, 330 patients went on to complete a self-report measure of medication adherence at the sixth month after baseline data collection. Chi-square test, t tests, and hierarchical multiple regression analyses were conducted, as needed. Results Patients with type D personality were significantly more likely to have poor medication adherence (p$<$0.001). Type D personality predicts poor medication adherence before and after controlling for covariates when it was analyzed as a categorical variable. However, the dimensional construct of type D personality was not associated with medication adherence when analyzed as a continuous variable. Conclusion Although, as a dimensional construct, type D personality may not reflect the components of the personality associated with poor medication adherence in patients with T2DM, screening for type D personality may help to identify those who are at higher risk of poor medication adherence. Interventions, aiming to improve medication adherence, should be launched for these high-risk patients.

新中国成立以来,我国外贸发展战略大致上经历了进口替代、混合结构、激进的出口导向以及强调可持续发展的外贸战略等多种模式。这些模式的选择对推动中国经济发展起到了决定性的主导作用,对外贸易一度成为拉动经济增长三驾马车中最为强势的力量。但我们在分析外贸发展战略时,主要都是从世界经济形势和中国整体经济发展水平出发,而较少考虑中国内部存在的差异性。实际上,"非均衡"已经成为中国当前经济社会发展的最显著特征。忽略这些差异的存在,会影响我们做出科学决策。本文力图通过对"外贸依存度"、"外贸对区域经济增长的贡献率"、"区域内进出口总量分布"以及"出口产品结构"等一系列重要指标的测算,阐明目前中国区域间外贸发展水...