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。

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.