Chronic Diseases Rising in Rural North China: A Study

As the population ages, more people are experiencing Chronic Diseases. When someone has two or more of these long-lasting health problems at the same time, it's known as Multimorbidity. The World Health Organization (WHO) recognizes this issue as a growing concern. In recent years, the number of older adults worldwide has been increasing. Between 1990 and 2019, the percentage of people aged 65 years and older grew from 6% to 9%, and it is expected to reach 16% by 2050. In China, as of 2023, there are 297 million people aged 60 and above, making up 21.1% of the total population. This number is expected to exceed 400 million by 2035.

Chronic diseases such as High Blood Pressure, Diabetes, and high cholesterol have seen a rise in China over the past decade. One report stated that diabetes cases increased by 35% during this time. In fact, 36.1% of adults in China now live with multiple chronic conditions. Dealing with multiple health issues often means taking many medications, which can make treatment more complicated and expensive. Rural areas, in particular, face major challenges due to fewer health resources and lower health awareness.

#Research Focus

Currently, most studies about multimorbidity have concentrated on urban settings and older adults. However, there is a lack of research about younger adults and those living in rural areas. This study aims to gather data about chronic diseases among individuals aged 30 and older living in rural North China. The goal is to provide useful insights and suggestions for better management and prevention strategies.

#Research Subjects

The study was carried out from February to December 2023 in North China's rural areas. Researchers used a method where they randomly selected two counties from Shanxi Province and then chose 40 villages from each county. From each village, at least 25 participants were picked based on their gender and age. To qualify, participants had to be at least 30 years old and live permanently in the chosen village. Those excluded were pregnant women, individuals who could not give consent, unwilling individuals, and those who could not provide blood or urine samples. Ethical approval was granted, and all participants signed consent forms. In total, 2,208 adults were part of the study.

#Research Methodology

Each participant completed a questionnaire and went through a physical examination. The questionnaire included questions about personal information, lifestyle choices, and mental health factors. Researchers collected data on gender, age, marital status, education, family size, income, smoking habits, drinking patterns, and physical activity levels.

The physical examination measured height, weight, waist size, and blood pressure, following standard methods for health monitoring. Blood pressure readings were taken multiple times to ensure accuracy. Measurements indicated central obesity if waist sizes exceeded 90 cm for men and 85 cm for women. A blood pressure reading of 130/80 mm Hg or higher was considered high blood pressure. Body mass index (BMI) was classified based on weight measurements.

Participants also reported on 19 chronic diseases. These included high blood pressure, heart disease, arthritis, diabetes, mental health issues, and more.

#Sample Size Calculation

Research showed that in China, around 25.4% of adults had multiple chronic diseases over the past 20 years. Using statistical software, researchers calculated that they needed a minimum of 2,160 participants for their study. By including 2,208 participants, they exceeded this requirement.

#Statistical Analysis

To compile the data, two people entered it independently and checked for accuracy. Researchers utilized software for statistical analysis. They described count data using frequencies and conducted various tests to compare groups. They also created a network graph to visualize how different diseases connected with one another.

#Basic Information

The study included 2,208 adults. Of these, 58.11% were aged 30 to 59, and 52.17% were female. Older participants (age 60 and above) showed lower marriage rates, education levels, family sizes, and incomes compared to the younger group. However, older adults had higher rates of central obesity and high blood pressure. It was found that women had higher literacy and income levels but lower smoking and drinking rates.

#Prevalence of Chronic Diseases

The study found that 66.53% of participants had chronic diseases. The most common health issues were high blood pressure, heart disease, stroke, arthritis, and diabetes. Older adults had a significantly higher rate of chronic diseases compared to younger ones. However, no significant difference in prevalence was found between genders.

#Status of Multimorbidity

The study showed that 32.47% of participants had multimorbidity, which was more common among older individuals than younger ones. Among the participants with multiple health issues, most had two diseases, a quarter had three, and nearly one-fifth had four or more. High blood pressure was the most frequent condition found among those with multiple diseases.

#Analysis of Chronic Disease Patterns

The most common combinations of chronic diseases included high blood pressure with stroke, heart disease, and diabetes. Younger participants most often had high blood pressure combined with digestive issues, stroke, and arthritis. In older adults, the combination of high blood pressure with stroke, heart disease, and diabetes was prevalent.

Men frequently had high blood pressure combined with stroke and heart disease, while women commonly had high blood pressure with arthritis and diabetes.

#Network Analysis

The network graph created showed the relationships between different chronic diseases among the entire population and among specific age and gender groups. The overall population showed a strong connection between diseases. Older adults had a more densely connected network compared to younger participants. Women exhibited a higher density in disease connections than men.

#Conclusion

In 2023, chronic diseases affected 66.53% of individuals aged 30 and older in rural northern China, while 32.47% experienced multimorbidity. High blood pressure was the leading chronic disease, especially among older adults. The study highlights the need for targeted health management strategies based on age and gender. For those aged 30-59 years, attention should be given to high blood pressure and digestive diseases. For individuals aged 60 and above, the focus should be on managing high blood pressure along with conditions such as stroke, heart disease, and diabetes.

This study underscores the seriousness of chronic illnesses and the prevalence of multimorbidity in rural areas. Findings suggest that health management should be tailored to specific demographic groups to effectively address their unique health needs.