The spectrum of chronic diseases and influential factors of immigrants moving water source area of South-to-North Water Diversion Project
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摘要:
目的 了解南水北调中线工程水源区内外迁移民慢性病患病情况，疾病谱及其影响因素。 方法 通过多阶段分层整群抽样方法，选取湖北省十堰市丹江口库区内迁的307名移民和外迁的676名移民，采用一般资料及健康状况调查表进行调查。 结果 内迁移民慢性病患病率为51.8%，患病率居于前5位的慢性病依次为腰腿疼、高血压、胃炎、心脏病和糖尿病；外迁移民慢性病患病率为65.1%，患病率居于前5位的慢性病依次为腰腿疼、高血压、胃炎、心脏病和气管炎。外迁移民慢性病患病率、两周患病率和两周就诊率均高于内迁移民(均有P < 0.05)。多因素分析结果显示，影响内迁移民慢性病患病的因素有：≥ 60岁(OR=59.928，P < 0.001)、家庭收入不满意(OR=0.377，P=0.002)和经济状况差(OR=0.519，P=0.028)；影响外迁移民慢性病患病的因素有：≥ 60岁(OR=26.190，P < 0.001)、吸烟(OR=1.856，P=0.004)、家庭收入不满意(OR=0.598，P=0.029)和经济状况差(OR=0.460，P < 0.001)。 结论 南水北调中线工程水源区内外迁移民慢性病患病率较高，切实提高移民收入有利于提高移民的健康状况。 Abstract:Objective To understand the prevalence and disease distribution of migrants within the water source area of the Middle Route Project of South-to-North Water Diversion Project and analyze the influencing factors. Methods By multi-stage stratified cluster sampling method, 307 immigrants and 676 immigrants were selected from Danjiangkou reservoir area, Shiyan city, Hubei Province. Results The prevalence of chronic diseases among in-migration was 51.8%. The prevalence rates of the top five chronic diseases were waist and leg pain, hypertension, gastritis, heart disease and diabetes. The prevalence of chronic diseases among out-migration was 65.1%. The prevalence rates of the top five chronic diseases were waist and leg pain, hypertension, gastritis, heart disease and bronchitis. The rate of chronic disease, the rate of two weeks and the rate of two weeks' visit were higher than that of emigration(all P < 0.05). The results of multivariate analysis showed that the factors influencing the chronic diseases of immigrants were 60 years old (OR=59.928, P < 0.001), unsatisfied family income (OR=0.377, P=0.002) and poor economic status (OR=0.517, P=0.028). The factors influencing the chronic diseases of immigrants were 60 years old (OR=26.190, P < 0.001), smoking (OR=1.856, P=0.004), unsatisfactory family income (OR=0.598, P=0.029) and poor economic status (OR=0.460, P < 0.001). Conclusions The prevalence of migrants within a high level is at a high level. Actually raising the income of immigrants is conducive to improving the health condition of immigrants. -
Key words:
- South-to-North Water Transfer Project /
- Immigrants /
- Disease spectrum /
- Factors
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表 1 内迁移民与外迁移民基本情况构成比较[n(%)]
Table 1. Comparison of basic situation of internal migration and external migration[n(%)]
项目 内迁移民(n=307) 外迁移民(n=676) χ2值 P值 性别 0.566 0.491 男性 151(49.2) 350(51.8) 女性 156(50.8) 326(48.2) 年龄(岁) 18.497 ＜0.001 15~ 31(10.1) 64(9.5) 30~ 66(21.5) 114(16.9) 45~ 126(41.0) 218(32.2) ≥60 84(27.4) 280(41.4) 婚姻状况 9.960 0.007 未婚 25(8.1) 43(6.4) 已婚 275(89.6) 585(86.5) 离婚或丧偶 7(2.3) 48(7.1) 文化程度 14.350 0.002 文盲半文盲 56(18.2) 186(27.5) 小学 72(23.5) 170(25.1) 初中 116(37.8) 225(33.3) 高中及以上 63(20.5) 95(14.1) 职业 46.277 ＜0.001 农业 159(51.8) 499(73.8) 非农业 148(48.2) 177(26.2) 吸烟状况 4.816 0.032 不吸烟 251(81.8) 510(75.4) 吸烟 56(18.2) 166(24.6) 饮酒状况 0.383 0.568 不饮酒 232(75.6) 523(77.4) 饮酒 75(24.4) 153(22.6) 交通状况 7.737 0.021 好 180(58.6) 357(52.8) 一般 83(27.0) 171(25.3) 差 44(14.3) 148(21.9) 家庭收入满意度 10.281 0.006 满意 32(10.4) 54(8.0) 一般 96(31.3) 157(23.2) 不满意 179(58.3) 465(68.8) 家族疾病史情况 6.307 0.013 无 231(75.2) 455(64.3) 有 76(24.8) 221(32.7) 医疗保障情况 1.049 0.401 无 6(2.0) 21(3.1) 有 301(98.0) 655(96.9) 经济状况 7.178 0.028 好 30(9.8) 49(7.2) 一般 165(53.7) 321(47.5) 差 112(36.5) 306(45.3) 风俗适应状况 172.797 ＜0.001 能 285(92.8) 332(49.1) 不好说 19(6.2) 278(41.1) 不能 3(1.0) 66(9.8) 慢性病患病种数(种) 28.323 ＜0.001 0 148(48.2) 236(34.9) 1 113(36.8) 253(37.4) 2 34(11.1) 101(14.9) ≥3 12(3.9) 86(12.7) 
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表 2 内外迁移民患病率比较[n(%)]
Table 2. Comparison of the prevalence of internal and external migration [n(%)]
项目 内迁移民(n=307) 外迁移民(n=676) χ2值 P值 慢性病患病率 159(51.8) 440(65.1) 15.682 ＜0.001 两周患病率 121(39.4) 329(48.7) 7.285 0.007 两周就诊率 44(14.3) 139(20.6) 5.408 0.021 过去一年住院率 86(28.0) 161(23.8) 1.976 0.177
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表 3 内迁移民慢性病患病影响因素多因素非条件Logistic回归分析结果
Table 3. Results of multivariate non-conditional Logistic regression analysis on influential factors of chronic diseases in migrant workers
变量 β sx Wald值 P值 OR(95% CI)值 年龄(岁) 15~ 1.000 30~ 2.186 0.896 5.953 0.015 8.901(1.537~51.533) 45~ 3.215 0.881 13.319 < 0.001 24.907(4.430~140.027) ≥60 4.093 0.942 18.889 < 0.001 59.928(9.462~379.563) 家庭收入满意度 不满意 1.000 一般 -0.219 0.472 0.216 0.642 0.803(0.319~2.024) 满意 -0.976 0.313 9.734 0.002 0.377(0.204~0.696) 经济状况 差 1.000 一般 -0.715 0.306 4.693 0.038 0.489(0.181~1.320) 好 -0.656 0.298 4.852 0.028 0.519(0.290~0.930) 常量 -2.812 2.029 1.921 0.166 0.060
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表 4 外迁移民慢性病患病影响因素多因素非条件Logistic回归分析结果
Table 4. Results of multivariate non-conditional Logistic regression analysis on influencing factors of chronic diseases in migrant workers
变量 β sx Wald值 P值 OR(95% CI)值 吸烟 是 0.619 0.216 8.169 0.004 1.856(1.215~2.837) 否 1.000 年龄(岁) 15~ 1.000 30~ 1.104 0.512 4.647 0.031 3.015 (1.105~8.223) 45~ 2.665 0.513 26.981 < 0.001 14.363(5.255~39.255) ≥60 3.265 0.543 36.179 < 0.001 26.190(9.037~75.899) 家庭收入满意度 不满意 1.000 一般 -1.102 0.378 8.510 0.004 0.332(0.158~0.697) 满意 -0.514 0.235 4.780 0.029 0.598(0.377~0.948) 经济状况 差 1.000 一般 -0.591 0.201 8.463 0.003 0.554(0.249~1.229) 好 -0.777 0.211 13.542 < 0.001 0.460(0.304~0.695) 常量 -1.779 0.737 5.833 0.016 0.169
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