Background Non-communicable disease (NCD) risk factors can co-exist with disability and cause a greater burden on the health status of adults with disabilities. A lack of egalitarian social policies in China may result in gender disparities in the NCD risk factors of adults with disabilities. However, little is known about the gender disparities in the association between socio-demographics and NCD risk factors among adults with disabilities in China; consequently, we examined this association among adults with disabilities in Shanghai, China. Methods We used the health examination data of 44,896 adults with disabilities in Shanghai in 2014. Descriptive analyses and logistic regression models were conducted to estimate gender disparities in the association between socio-demographics, disability characteristics, and four selected NCD risk factors among adults with disabilities—including high blood pressure, high blood glucose, high blood lipids, and being overweight. We estimated marginal effects (MEs) on NCD risk factors between gender and other confounders. Results Women with disabilities were about 11.6 percentage points more likely to suffer from high blood lipids and less likely to develop the other three risk factors than men were. The association of age group, residence permit, education level, marital status, and disability type with health outcomes varied by gender among adults with disabilities. The difference in age effects between men and women was more pronounced in older age groups. Urban residence was associated with less risk of high blood pressure risk among women (ΔME = − 0.035, p < 0.01), but no significant difference in other NCD risk factors. Education remained a major protective factor against high blood pressure, high blood glucose and being overweight among women with disabilities (MEs < 0, p < 0.05); however, this did not hold for men. The difference in marriage effects between men and women was observed in high blood lipids (ΔME = − 0.048 for the married group and −0.054 for the divorced or widowed group) and overweight individuals (ΔME = − 0.091 for the married group and −0.114 for the divorced or widowed group). Women with intellectual disabilities or mental disabilities reported worse health conditions than men did. Discussion Preventive strategies and interventions on NCD risk factors for adults with disabilities should take into account gender disparities in these socio-demographic effects. Rural women or poorly educated women with disabilities can be a vulnerable population that requires more health education and promotion strategies. Health education for caregivers of women with intellectual or mental disabilities may also play a vital role in preventing their NCD risk factors.

本文以了解上海市残疾人的抑郁水平及相关影响因素为目的,采用抑郁自评量表(SDS)对683名残疾人进行问卷调查,运用SPSS22.0对各项比较的人员结构差异进行χ2检验和Fisher精确概率检验.结果显示金山卫镇抑郁检出率为51.40%,抑郁人数在男性、女性中的检出率分别为49.20%和55.59%;中重度抑郁在小学及以下、初中、高中和大专及以上的检出率分别为28.14%、19.66%、16.67%和40.00%;轻度抑郁在未婚、已婚、离婚和丧偶残疾人中的检出率分别为31.88%、27.18%、27.78%和27.27%,中重度抑郁在这四种婚姻状况的检出率分别为26.09%、21.67%、27.78%和51.52%;抑郁在农业和非农业残疾人中检出率分别为62.50%和42.48%.这提示上海市金山卫镇残疾人群抑郁发生率处于较低水平,非在婚、文化程度高及户籍为农业的三类残疾人为重点关注人群.

本文采用自设问卷入户调查了解金山卫镇15岁及以上残疾人的吸烟、饮酒、体育锻炼和高血压测量等情况.结果显示,金山卫镇15岁及以上残疾人的吸烟率和饮酒率分别为21.43%和7.66%;每周参加体育锻炼的残疾人为58.93%;70.61%的残疾人近一年内至少1次测量过血压.不同残疾类型残疾人的吸烟、饮酒、血压测量情况均有统计学差异.金山卫镇15岁及以上残疾人健康行为状况较好,但仍需积极采取有针对性的健康管理措施以继续改善残疾人的健康行为.

本文通过分析上海市金山区金山卫镇残疾人健康现状及慢性病发病风险,探索以残疾人健康状况为导向的个性化健康管理服务,从而实现精准服务.以金山卫镇1443名持证残疾人为研究对象,从上海市康复综合信息平台和上海市金山区卫生事务中心数据平台分别收集到了2011至2015年金山卫镇858名残疾人的健康体检记录和1301名残疾人的健康档案,并采用入户调查的方式收集了1392名残疾人的健康行为数据.运用一般描述性分析方法对健康体检资料进行分析,并运用Framingham风险评估工具分别评估金山卫镇残疾人患心血管病和高血压的风险.结果显示,残疾人健康体检异常项前5位分别为高血压(41.96%)、高血脂(40.68%)、肥胖(36.36%)、心电图异常(34.73%)和脂肪肝(28.44%),478名30~74岁的残疾人中有89人(18.62%)心血管疾病10年发病风险达到30%以上,435名20~69岁的残疾人中分别有1人、79人和186人1年、2年、4年高血压发病风险达15%以上.卫生部门应以不同健康状况的残疾人群的健康需求为导向,针对残疾人群健康状况特点,为残疾人群提供有针对性的健康管理服务.

Objective To know the health status of the disabled in Shanghai and to provide scientific basis for health intervention and management of disabled persons. Methods Through the ” Comprehensive Information Platform for Rehabilitation” of Shanghai Disabled Persons' Federation,93 267 health examination data of the disabled were collected from Shanghai Sunshine Rehabilitation Center from January 2011 to August 2014,and from Shanghai Training Center of Vocation and Rehabilitation from January 2013 to June 2014 ( 61 969 in the former institution and 31 298 in the latter) . The basic demographic information,disability type,and physical examination data were primarily collected,and the detection status of disease,positive signs and abnormal indicators in laboratory of the disabled were calculated and analyzed. Results Among the 93 267 disabled persons,the top 3 types of disability were limbs disability(49. 71% ,46 361 / 93 267),visual disability (21. 09% ,19 672 / 93 267),and mental disability(12. 89% ,12 021 / 93 267). The top 3 detection rate of diseases were fatty liver(38. 22% ,21 877 / 57 243 ),fundus atherosclerosis( 37. 37% ,28 153 / 75 336 ) and pharyngitis( 31. 90% , 14 716 / 46 126);the top 3 detection rate of positive signs were high blood pressure(44. 23% ,40 853 / 92 364),increased and thickened lung markings(43. 04% ,33 539 / 77 928)and overweight(35. 43% ,32 276 / 91 097)respectively;the top 3 detection rate of abnormal indexes in laboratory were urine specific gravity(34. 83% ,27 007 / 77 524),red cell distribution width( 31. 32% , 28 939 / 92 389 ), and the amount of basophilic granulocyte ( 30. 53% , 24 710 / 80 941 ) respectively. Conclusion The health status of the disabled in Shanghai is poor and complex. It is suggested that the relevant departments should pay more attention to the status of the disabled so as to achieve the standardization health information collection of the disabled.

Objective To know ophthalmic testing status of the disabled in Shanghai and provide information of prevention,treatment and health guidance of eye disease for the disabled. Methods Through the ” Comprehensive Information Platform for Rehabilitation” of Shanghai Disabled Persons' Federation,75 336 ophthalmic examination data of the disabled were collected from Shanghai Sunshine Rehabilitation Center from January 2011 to August 2014,and from Shanghai Training Center of Vocation and Rehabilitation from January 2013 to June 2014(45 084 in the former institution and 30 252 in the latter). The basic demographic situation of the disabled, disabled characteristics and ophthalmologic examination data were mainly collected. The detection results of ophthalmological abnormalities of the disabled with different genders,ages and disease characteristics were compared and analyzed. Results 145 kinds of ophthalmologic abnormalities were detected,and the top three detection rate of ophthalmologic abnormalities were fundus arteriosclerosis(37. 37% ,28 153 / 75 336),ametropia(16. 47% , 12 406 / 75 336),and cataract(15. 77% ,11 879 / 75 336) respectively. ( 1 ) There were significant differences in the detection rate of fundus arteriosclerosis,ametropia,cataract,pterygium,vitreous opacity,macular degeneration,retinopathy and fundus lesions of the disabled with different genders(P < 0. 05);there was no significant difference in the detection rate of blindness and strabismus(P > 0. 05). (2)There were significant differences in the detection rate of fundus arteriosclerosis, ametroia ametropia,cataract,pterygium,vitreous opacity, blindness, macular degeneration, retinopathy, strabismus and fundus lesions among the disabled with different ages(P < 0. 05). (3)There were significant differences in the detection rate of fundus arteriosclerosis,ametropia,cataract,pterygium,vitreous opacity,blindness,macular degeneration,retinopathy, strabismus and fundus lesions among the disabled with different disability types( P < 0. 05). (4) There were significant differences in the detection rate of fundus arteriosclerosis,ametropia,cataract,pterygium,macular degeneration and strabismus among the disabled with different levels of limbs disability(P < 0. 05);there were significant differences in the detection rate of fundus arteriosclerosis, ametropia, cataract, pterygium, vitreous opacity, blindness, macular degeneration, retinopathy, strabismus and fundus lesions in the disabled with different levels of vision disability( P < 0. 05 );there were significant differences in the detection rate of fundus arteriosclerosis,cataract,pterygium and strabismus among the disabled with different levels of intellectual disability( P < 0. 05);there were significant differences in the detection rate of fundus arteriosclerosis, cataract,ametropia,pterygium,vitreous opacity and macular degeneration among the disabled with different levels of hearing disability(P < 0. 05);there were significant differences in the detection rate of fundus arteriosclerosis and ametropia among the disabled with different levels of mental disability( P < 0. 05 );there were significant differences in the detection rate of ametropia,vitreous opacity,macular degeneration,retinopathy and fundus lesions among the disabled with different levels of multiple disability(P < 0. 05). Conclusion The detection rate of ophthalmic abnormalities of the disabled in Shanghai is high, and there are differences in the detection rate of ophthalmologic abnormalities among the disabled with different demographic characteristics. It is suggested that ophthalmological health examination should be carried out to help the disabled to form good living habits.

Objective To define the problems in the field of health supervision and classify them according to the Mac?ro-Model of Health System, and then to define key issues according to the result consultation. Methods Literature review is done to collect issues of health supervision, and the Macro Model of Health System is used to classify issues. And intention investigation is used to define the focus of issues. Results The key problems of Health Supervision system include:Inade?quate number of personnel, the law enforcement agency is incompatible with the institution nature, the weakening of health supervision function resulted from functional adjustments, lack of financial investment, Health Supervision system reform lags behind the economic reform, which Problem 1, Problem 17 and Problem 34 are also among the problems that are diffi?cult to solve. Conclusion In order to solve the key issues in the field of health supervision, top-level design is very essen?tial, and multi-sectoral cooperation is also very important. Specifically, the nature of institutions and institutional functions should be defined clearly. And personnel building and financial investment should also be strengthened.