| Objective:By measuring the self-rated healthy life expectancy and active life expectancy of people aged over 60 years in Jiangxi Province with gender and urban-rural dimensions,we explored the differences in gender and urban-rural dimensions and analyzed the influencing factors of self-rated and active health conditions.This study is to provide a reference for relevant government departments to formulate policies to improve the quality of life and health of the population.Methods:Based on the mortality data of children under 5 years old and the data of the 6th National Health Service Survey of Jiangxi Province,we employed the model life table method and Sullivan method to measure the self-rated and active healthy life expectancy of people over 60 years old in Jiangxi Province.In addition,we compared the healthy life expectancy in different populations by gender and urban-rural dimensions and analyzed the effects of mortality rate and health rate by age groups on the differences in healthy life expectancy of different populations using the decomposition method.The Binary Logistic regression model was used to analyze the influencing factors with self-rated health and active health as the dependent variables.Results:1.The survey covered 2731 elderly population over 60 years old.In this survey,2713 questionnaires were effectively answered,and the effective questionnaire recovery rate was 99.3%.For the population participating in the survey,the average age was 70.06±7.75 years old,the majority was in the range of 60～69 years old,and there were relatively fewer senior citizens.The populations included 1308 males and1405 females.Among the population,1492 were urban residents and 1221 were rural residents.The distribution of demographic characteristics of the elderly in this survey was basically in line with the distribution ratio of the elderly in Jiangxi Province.Among the elderly citizens who participated in the survey,81.05% of them were self-rated healthy and 90.20% of them could take care of themselves in life.For both self-rated and active health status,the healthy rate for male population was higher than that for female population in general,the healthy rate for urban residents was higher than that for rural residents in general,and the health rate tended to decrease with the increase of age.2.The self-rated healthy life expectancy of male population over 60 years old in Jiangxi Province was 15.81 years,and the life expectancy was 19.13 years.The ratio of self-rated healthy life expectancy to life expectancy was 0.83.The self-rated healthy life expectancy of female population over 60 years old was 16.98 years,and life expectancy was 22.03 years.The ratio of self-rated healthy life expectancy was0.77.The self-rated healthy life expectancy between the male and female population above 60 years old was statistically significant.The ratio of self-rated healthy expectancy to life expectancy decreased with the increase of age.The active life expectancy of male population over 60 years old in Jiangxi Province was 17.15 years with the ratio of healthy life expectancy to life expectancy as 0.90.The active life expectancy of female population over 60 years old was 19.06 years with the ratio of active life expectancy to life expectancy as 0.87.The active life expectancy between the male and female population over 60 years old was statistically significant.The ratio of active life expectancy to life expectancy decreased with the increase of age.This trend was consistent with the self-rated healthy life expectancy.3.In urban area,the self-rated(active)healthy life expectancy of men over 60 years old was 17.50(18.26)years,the life expectancy was 20.07 years,and the ratio between the former and later was 0.87(0.91)while the corresponding indicators for women were respectively18.99(20.09)years,23.10 years,0.82(0.87).In the rural area,the self-rated(active)healthy life expectancy of men over 60 years old was 13.51(16.62)years,the life expectancy was 18.96 years and the ratio between the former and later was 0.71(0.88);the corresponding indicators for females were 15.26(18.64)years,21.84 years,0.70(0.85).The differences in self-rated(active)healthy life expectancy of populations over 60 years old by both gender and urban-rural dimensions were statistically significant.Regardless of the self-rated(active)or the corresponding ratio to life expectancy,urban populations were larger than rural people.4.According to the decomposition of the difference in healthy life expectancy,the difference between the genders(female-male)mainly came from the mortality rate,and the difference in health rate reduced this health life expectancy difference.For the same sex,the difference in self-rated healthy life expectancy between urban and rural elderly(urban-rural)mainly came from the self-rated health rate.For the difference in active life expectancy,the contributions of mortality and active rate were similar.5.Influencing factors of self-rated and active health: smoking,alcohol consumption,hypertension,diabetes,other chronic diseases(chronic diseases other than hypertension and diabetes),vision status,need for care,average weekly exercise,anxiety or depression,memory decline or dementia,and employment status are the 11 factors related to self-rated health;age,average weekly physical exercise,anxiety or depression,vision status,memory decline or dementia,diabetes,other chronic diseases,alcohol consumption,health checkups,and employment status are the 10 factors related to active health.Conclusion:The healthy life expectancy of people over 60 years old in Jiangxi province is high but it is still lower than that of developed regions nationwide.Women over 60 years old,especially those in rural areas,are at a disadvantage status in terms of health compared to other groups.The effects of age,disease status,psychological status,health behavior and employment status are related to self-rated and active health.The government and related departments should combine the factors associated with self-rated and active health,and formulate policies to improve the health and life quality of the elderly population by targeting key groups to maximize health equity. |
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