Key Social Determinants to Narrow the Gap between Health-adjusted Life Expectancy and Life Expectancy in Megacities  

作　　者：XI Jun Yan CHEN Yuan Yuan ZHANG Yu Qin LUO Ao DU Zhi Cheng LIANG Bo Heng DONG Hang LIN Xiao QIN Peng Zhe HAO Yuan Tao 

机构地区：[1]Department of Medical Statistics,School of Public Health,Sun Yat-sen University,Guangzhou 510080,Guangdong,China [2]Department of Chronic Non-communicable Disease Control and Prevention,Guangzhou Center for Disease Control and Prevention,Guangzhou 510440,Guangdong,China [3]Institute for Infectious Disease Control and Prevention,Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511430,Guangdong,China [4]Peking University Center for Public Health and Epidemic Preparedness&Response,Peking University,Beijing 100191,China [5]Sun Yat-sen Global Health Institute,Sun Yat-sen University,Guangzhou 510080,Guangdong,China [6]Center for Health Information Research,Sun Yat-sen University,Guangzhou 510080,Guangdong,China

出　　处：《Biomedical and Environmental Sciences》2022年第9期773-781,共9页生物医学与环境科学（英文版）

基　　金：supported by the Guangdong Basic and Applied Basic Research Foundation[grant 2020A1515011294,2020A1515110230,and 2021A1515011765];the China Postdoctoral Science Foundation[grant 2021M693594];the Guangzhou Municipal Health Commission[grant No.2021-2023-12,No.20201A011054];Guangzhou Municipal Science and Technology Bureau[grant 2021BRP004]。

摘　　要：Objective Improvement in the quality of life is reflected in the narrowing of the gap between healthadjusted life expectancy(HALE)and life expectancy(LE).The effect of megacity expansion on narrowing the gap is rarely reported.This study aimed to disclose this potential relationship.Methods Annual life tables were constructed from identified death records and population counts from multiple administrative sources in Guangzhou,China,from 2010 to 2020.Joinpoint regression was used to evaluate the temporal trend.Generalized principal component analysis and multilevel models were applied to examine the county-level association between the gap and social determinants.Results Although LE and HALE in megacities are increasing steadily,their gap is widening.Socioeconomic and health services are guaranteed to narrow this gap.Increasing personal wealth,a growing number of newborns and healthy immigrants,high urbanization,and healthy aging have helped in narrowing this gap.Conclusion In megacities,parallel LE and HALE growth should be highly considered to narrow their gap.Multiple social determinants need to be integrated as a whole to formulate public health plans.

关 键 词：Generalized principal component analysis Health-adjusted life expectancy MEGACITIES Quality of life Social determinants Temporal trend Urban expansion 

分 类 号：R195.3[医药卫生—卫生统计学]