Effects of Community Health Movements on Disabilities Free Life Years and Compression of Morbidity

为了评估社区老年人护理的负担，使用开发的N-life计算机软件计算残疾生命年（DLY），使用大岛町、大岛之子和露岛町3个岛屿社区40岁及以上居民的日常生活活动（ADL）数据。大岛町和楼岛町是日本厚生省健康促进规划的示范社区。ADL数据由社区公共卫生护士收集。轻度残疾的男女比例在大岛町分别为4.1%（61/1495）和5.9%（114/1927），在大岛山分别为8.0%（40/500）和7.0%（44/626），在鹿岛町分别为16.2%（45/278）和18.5%（73/394）。需要重症监护的比例（每1 000人）分别为7.6、18.2、20.0、12.8、68.3、63.5，其平均护理年数分别为3.1、6.5、7.6、7.1、14.9、15.4。在所有社区，妇女的无残疾寿命年和残疾期都长于男子。尽管他们努力促进社区健康，但Ioujima町的老年人护理负担最大。在Ioujima-cho，导致残疾的基本疾病是心血管疾病、老年损伤和精神障碍。虽然评估社区健康促进活动对降低发病率的效果需要较长的时间，但在明确活动目的的情况下，本研究方法是合适的。

To evaluate the burden of elder care in communities, the disabilities life years (DLY) were calculated by N-life computer software developed, with the data of activities of daily living (ADL) for residents aged 40 years and over in three island communities, Oshima-cho, Oshima-son, and loujima-cho. Oshima-cho and loujima-cho are model communities of health promotion planning of Ministry of Health and Welfare, Japan. The ADL data were collected by public health nurses in the communities. Proportions of person with mild disabilities for men and women were 4.1% (61/1495) and 5.9%(114/1927) in Oshima-cho, 8.0%(40/500) and 7.0%(44/626) in Oshima-son, and 16.2%(45/278) and 18.5%(73/394) in loujima-cho, respectively. Proportions of those who need intensive care (per 1,000) were 7.6, 18.2, 20.0, 12.8, 68.3, 63.5, respectively, and their average years for care were calculated as 3.1, 6.5, 7.6, 7.1, 14.9, 15.4, respectively. Both disabilities free life years and periods with disabilities were longer for women than men in all the communities. Ioujima-cho showed the largest burden of elder care, despite their efforts of community health promotion. Basic disease causing disabilities in Ioujima-cho were cardiovascular diseases, impairment with ageing, and psychiatric disorders. Although it takes longer time to evaluate the effects of community health promotion activities on compression of morbidity, the present research method was found to be suitable to do it with making clear the aim of the activities.