Changes in the Burden of Five Common Chronic Diseases among Rural Residents in Yunnan Province in 2011 and 2021

Abstract

Background Chronic diseases have become a major public health problem affecting the health of the population, and the number of patients with chronic diseases in China continues to increase, as well as the increasing number of deaths due to chronic disease by year, and the increasing burden of disease on patients gradually. Understanding the changes in the burden of chronic diseases is of great importance for the prevention and control of chronic diseases. However, there is a lack of research on the changes in the burden of common chronic diseases in rural Yunnan Province. Objective To examine the changes in the disease burden of five common chronic diseases [hypertension, coronary heart disease (CHD), stroke, asthma, and chronic obstructive pulmonary disease (COPD) ] among rural residents in Yunnan Province in 2011 and 2021. Methods A repeated cross-sectional design was used to select 8 400 and 7 700 rural residents aged≥35 years in Yunnan Province using multistage stratified random sampling method in 2011 and 2021 as the research subjects, respectively. Data were collected from on-site questionnaires and physical examinations of study participants, as well as data on the causes of death of five common chronic diseases. Principal component analysis was used to construct a socioeconomic position (SEP) indicator by selecting three variables including education level, annual household income per capita and accessibility to medical services, the coefficients of the variables were used to calculate the SEP composite score, and the SEP was classified into four grades of low, medium-low, medium-high and high based on the quartiles of the SEP composite score. Disability-adjusted life year (DALY) was used to measure the magnitude of the disease burden for five chronic diseases. Results Compared with 2011, the overall prevalence of hypertension (25.14% vs. 41.57%), stroke (1.03% vs. 2.52%), and COPD (9.23% vs. 12.60%) in rural Yunnan Province in 2021 increased (P<0.05), as well as the prevalence for males, females, and participants with all SEP grades (P<0.05) ; the overall prevalence of CHD (2.02% vs. 2.30%) and asthma (1.36% vs. 1.61%) did not change significantly (P>0.05), while an increase was found in the prevalence of CHD among males and those with high SEP grade, and in the prevalence of asthma among males and those with medium-high SEP grade (P<0.05). In 2021, the prevalence of all 5 chronic diseases was higher in males than in females (P<0.05), and there was a decreasing trend in the prevalence of COPD by different grades of SEP in 2021 (χ2trend=6.801, P<0.001). In addition, an increase was found in DALY per 1 000 population of CHD (10.45 vs. 18.18), stroke (12.80 vs. 23.20), asthma (4.54 vs. 9.10), and COPD (35.99 vs. 49.07), while a decrease was found in DALY per 1 000 population of hypertension (1.38 vs. 1.26). COPD presents higher DALY per 1 000 population and years of life disability (YLD) per 1 000 population, while stroke presents higher years of life lost (YLL) per 1 000 population among the five chronic diseases. Conclusion The prevalence and disease burden of five common chronic diseases among rural residents in Yunnan Province in 2021 were mainly higher than 2011, and the disease burden of COPD was the heaviest in 2021, with males and those with low SEP grade being the key populations for future prevention and control of chronic diseases. Targeted prevention and control strategies should be adopted to reduce its harm to the health of population.

Keywords

• chronic disease|burden of illness|socioeconomic position|disability adjusted life year|yunnan province|rural areas