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

为评价社区养老负担，采用开发的N-life计算机软件，利用大岛町、大岛子、鹿岛町3个海岛社区40岁及以上居民的日常生活活动（ADL）数据，计算出社区养老负担的残疾生命年（DLY）。大岛町和鹿岛町是日本厚生劳动省健康促进规划示范社区。ADL数据由社区公共卫生护士收集。大岛町男性和女性轻度残疾人比例分别为4.1%（61/1495）和5.9%(114/1927)，大岛子为8.0%（40/500）和7.0%(44/626)，鹿岛町为16.2%（45/278）和18.5%（73/394）。需要重症监护的比例（每千人）分别为7.6、18.2、20.0、12.8、68.3、63.5，平均护理年数分别为3.1、6.5、7.6、7.1、14.9、15.4。在所有社区中，妇女的无残疾寿命年数和残疾时间都比男子长。Ioujima-cho的老年人护理负担最大，尽管他们努力促进社区健康。在硫磺岛町造成残疾的基本疾病是心血管疾病、老化损害和精神疾病。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，本研究方法是适合的。

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.