The Frontiers of Applied Demography
The Frontiers of Applied Demography
复制标题
应用人口统计学的前沿
DOI：
10.1007/978-3-319-43329-5_2
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Clark S
中科院分区：
文献类型：
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作者：
Clark S
人口老龄化通常被认为是卫生保健系统压力增加的主要驱动因素之一，因为越来越多的慢性病患者活到老年。本章通过估计以下因素对健康的连续影响来深入探讨这种假定的关系：总人口变化、人口老龄化、人口种族构成的变化以及特定年龄疾病发病率的趋势。一组健康预测的分解是使用微观模拟模型。这些预测是根据英格兰50岁及以上的人口，按地方居住当局分类。该模型预测了2011年以后20年心血管疾病、糖尿病和呼吸道疾病的流行情况。对于糖尿病，研究发现，到2031年，仅人口增长就导致患病率增加24%，而性别、种族和年龄构成的变化共同导致另外24%。考虑到所有潜在的贡献，总体糖尿病患病率增加了57%。对于心血管疾病（CVD），人口增长贡献了23%的增长;人口构成进一步增加了30%;而CVD患病率的下降使患病率降低了60%，导致到2031年CVD患者总体下降35%。对于呼吸系统疾病，人口增长占23%;人口构成变化占13%;而患病率下降29%意味着疾病负担适度减少1%。这些结果强调了成功的健康干预的潜力（如心血管疾病），预防的迫切需要（如糖尿病）和继续关心健康的激励非常老的年龄（如呼吸系统疾病）。这些标题结果是指英格兰作为一个整体，但我们也显示了他们如何不同的地方当局的地区类型，指出在发病率控制的良好做法的模型。
Population ageing is commonly cited as one of the main drivers of increasing pressures on health care systems, as more people with chronic morbidities live to older ages. This chapter digs deeper into this presumed relationship by estimating the successive health impacts of: total population change, population ageing, changing ethnic mix of the population and trends in the age-specific incidence of disease. The decomposition of a set of health projections is developed using a micro-simulation model. These projections are based on the population of England aged 50 and over, classified by local authority of residence. The model projects forward, for the 20 years beyond 2011, the prevalence of cardiovascular disease, diabetes and respiratory illness. For diabetes the finding is that population increase alone contributes to a 24 % increase in prevalence by 2031, while the changes in gender, ethnicity and age composition together contribute another 24 %. Taking account of all potential contributions, the overall diabetes prevalence count increases by 57 %. For cardio-vascular disease (CVD), population increase contributes a 23 % increase; demographic composition processes a further 30 %; while decreases in CVD prevalence rates reduce prevalence by 60 %, resulting in an overall decrease of 35 % in those with CVD by 2031. For respiratory illness, population increase contributes 23 %; demographic composition changes 13 %; while a decrease in prevalence rates of 29 % means that the burden of the disease reduces by a modest 1 %. These results underline the potential for successful health intervention (as in CVD), the urgent need for prevention (as in diabetes) and the incentive to continue to care about health to very old ages (as in respiratory illness). These headline results refer to England as a whole but we also show how they vary across local authorities by area type, pointing to models of good practice in morbidity control.