Rethinking morbidity compression and morbidity expansion: Differential developments of morbidity and social inequalities in terms of health impairments and chronic diseases.

重新思考发病率压缩和发病率扩张：健康损害和慢性病方面发病率和社会不平等的差异发展。

• 批准号: 471338999
• 负责人: Professor Dr. Siegfried Geyer
• 金额: --
• 依托单位: Forschungs- und Lehreinheit Medizinische Soziologie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 资助国家: 德国
• 项目状态: 未结题
• 来源: https://gepris.dfg.de/gepris/projekt/471338999?language=en
• 关键词: Rethinking; morbidity; compression; expansion; Differential

The proposed project builds on the findings of a previous one where it was examined whether the long-term developments of myocardial infarction, stroke and functional impairments can be described as morbidity compression, morbidity expansion or as a dynamic equilibrium. The second main topic was related to the development of related social inequalities in health over time. Unexpectedly it turned out that in myocardial infarction and in other health-related endpoints compression occurred in the higher age groups, while we found expansion in the younger ones.Based in these findings it will be examined how chronic obstructive pulmonary disease (COPD) as an important determinant of population health develops over time and whether the related social gradients are narrowing or broadening. In addition, it will be considered whether the disease is developing differently according to the age groups considered, i.e., whether compression and expansion are occurring in the same disease. COPD-related analyses are performed both using claims data and surveys, thus making it possible to replicate findings derived from different types of data. This also makes it possible to perform supplementary analyses that may be possible with one of the datasets, but not with the other. According to present knowledge, the longitudinal developments of myocardial infarctions and stroke in higher age groups can be described as morbidity compression, and it has to be examined to what extent this can be attributed to increasing preventive medications over time. Morbidity compression and expansion are concepts describing developments at population level, i.e., numbers of morbidity or mortality may not necessarily be derived from the same individuals. The third part of the project leaves this perspective by considering the longitudinal development of comorbidities of individuals with stroke, myocardial infarction and COPD. This implies that time periods spent in states of disease and disability may increase, while morbidity compression may occur at population level. In the final part of the project the findings on the three concepts and diseases describing morbidity development will be integrated into a unified concept of morbidity development in the population.

拟议的项目建立在前一个项目的调查结果的基础上，该项目审查了心肌梗塞、中风和功能障碍的长期发展是否可以被描述为发病率压缩、发病率扩大或动态平衡。第二个主要议题是，随着时间的推移，健康方面的相关社会不平等现象有所发展。出乎意料的是，在心肌梗死和其他健康相关终点中，压缩发生在较高的年龄组，而我们发现在年轻组中扩大。基于这些发现，我们将研究慢性阻塞性肺疾病（COPD）作为人口健康的重要决定因素如何随着时间的推移而发展，以及相关的社会梯度是缩小还是扩大。此外，还将考虑疾病的发展是否因所考虑的年龄组而异，即，压迫和扩张是否发生在同一种疾病中。与COPD相关的分析是使用索赔数据和调查进行的，因此可以重复从不同类型的数据得出的调查结果。这也使得有可能执行补充分析，这可能是可能的数据集之一，但不与其他。根据目前的知识，心肌梗死和中风在较高年龄组的纵向发展可以被描述为发病率压缩，必须检查这在多大程度上可以归因于随着时间的推移预防药物的增加。Moreover压缩和膨胀是描述人口水平发展的概念，即，发病率或死亡率的数字不一定来自同一个人。该项目的第三部分通过考虑患有中风、心肌梗死和COPD的个体的合并症的纵向发展来离开这个视角。这意味着处于疾病和残疾状态的时间可能会增加，而在人口一级，发病率可能会压缩。 在该项目的最后部分，关于三个概念和描述发病率发展的疾病的调查结果将被纳入人口发病率发展的统一概念。