Urban-rural disparities in hypertension prevalence, detection, and medication use among Chinese Adults from 1993 to 2011

被引:62
作者
Li, Jiajia [1 ]
Shi, Leiyu [2 ]
Li, Shixue [1 ]
Xu, Lingzhong [1 ]
Qin, Wen [3 ]
Wang, Heng [4 ]
机构
[1] Shandong Univ, Jinan, Peoples R China
[2] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD 21205 USA
[3] Infirm Shandong Univ, Jinan, Peoples R China
[4] Shandong Univ, Hosp 2, Jinan, Peoples R China
基金
中国国家自然科学基金;
关键词
Urban/rural; hukou system; Hypertension; Dynamic trends; China; CARDIOVASCULAR-DISEASE; RISK-FACTORS; AWARENESS; HEALTH; CARE; INEQUALITY; PREVENTION; IMPACT; OLD;
D O I
10.1186/s12939-017-0545-7
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: China has experienced a rapid increase in hypertension over the past decade, especially in rural. Therefore, the aim of this research is to examine the dynamic trends in urban-rural disparities in hypertension prevalence, detection, and medication use among Chinese adults from 1993 to 2011. Methods: Data were extracted from the seven latest waves of the China Health and Nutrition Survey (CHNS). We used the hukou system to distinguish between urban and rural residents. Chi-square tests were performed to examine urban-rural gaps in hypertension prevalence, detection and medication use. Multiple logistic regressions were used to confirm these disparities and to explore whether the urban-rural gaps have narrowed or widened from 1993 to 2011, after controlling for health-related behaviors, BMI, demographic variables and socioeconomic characteristics. Blinder-Oaxaca decomposition technique was also used to calculate the extent to which urban-rural disparities reflect an endowments effect or a coefficients effect. Results: Hypertension prevalence, detection, and medication use among rural adults were significantly lower than urban adults, with the significant level at p < 0.001. The urban-rural gaps in hypertension prevalence and medication use gradually narrowed during the period 1993-2011, whereas the gaps in hypertension detection grew wider. After controlling for confounding variables, urban adults were about 24.5, 49.4, and 89.5% more likely to be hypertensive, detected, and medicated than their rural counterparts (p < 0.01), respectively. The Blinder-Oaxaca decomposition suggested that approximately 22 and 26% of the urban-rural gap in hypertension detection and medication use could be attributed to coefficient difference, respectively. Conclusions: Although hypertension prevalence among rural adults was comparable to that of urban adults, hypertension detection and medication use of rural adults were still suboptimal. Unusually large urban-rural gaps and an expanding trend in hypertension detection deserve the attention of health policymakers and researchers.
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页数:10
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