Association between multiple comorbidities and self-rated health status in middle-aged and elderly Chinese: The China Kadoorie Biobank study

China Kadoorie Biobank (CKB) collaborative group

doi:10.1186/s12889-018-5632-1

Association between multiple comorbidities and self-rated health status in middle-aged and elderly Chinese: The China Kadoorie Biobank study

China Kadoorie Biobank (CKB) collaborative group

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Abstract

Background: Understanding the correlates of self-rated health (SRH) can help public health professionals prioritize health-promotion and disease-prevention interventions. This study aimed to investigate the association between multiple comorbidities and global SRH and age-comparative SRH. Methods: A total of 512,891 participants aged 30-79 years old were recruited into the China Kadoorie Biobank study from ten regions between 2004 and 2008. Multivariate logistic regression models were used to estimate the odds ratios (ORs) for the associations between comorbidities (including diabetes, hypertension, coronary heart disease, rheumatic heart disease, stroke, tuberculosis, emphysema/bronchitis, asthma, cirrhosis/chronic hepatitis, peptic ulcer, gallbladder disease, kidney disease, fracture, rheumatic arthritis, psychiatric disorders, depressive symptoms, neurasthenia, head injury and cancer) and SRH. Population attributable risks (PARs) were used to estimate the contribution of multiple comorbidities to poor global SRH and worse age-comparative SRH. Results: After adjusting for covariates, suffering from various diseases increased the chance of reporting a poor global SRH [OR (95% CI) ranged from 1.10 (1.07, 1.13) for fracture to 3.21 (2.68, 3.83) for rheumatic heart disease] and a worse age-comparative SRH [OR (95% CI) ranged from 1.18 (1.13, 1.23) for fracture to 7.56 (6.93, 8.25) for stroke]. From the population perspective, 20.23% of poor global SRH and 45.12% of worse age-comparative SRH could attributed to the cardiometabolic diseases, with hypertension (7.84% for poor global SRH and 13.79% for worse age-comparative SRH), diabetes (4.35% for poor global SRH and 10.71% for worse age-comparative SRH), coronary heart disease (4.44% for poor global SRH and 9.51% for worse age-comparative SRH) and stroke (3.20% for poor global SRH and 10.19% for worse age-comparative SRH) making the largest contribution. Conclusions: Various diseases were major determinants of global and age-comparative SRH, and cardiometabolic diseases had the strongest impact on both global SRH and age-comparative SRH at the population level. Prevention measures concentrated on these conditions would greatly reduce the total burden of poor SRH and its consequences such as poor quality of life and use of health care services.

Original language	English
Article number	744
Number of pages	24
Journal	BMC Public Health
Volume	18
Issue number	1
DOIs	https://doi.org/10.1186/s12889-018-5632-1
Publication status	Published - 15 Jun 2018

Bibliographical note

© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Funder

This work was supported by the National Key Research and Development Program of China (2016YFC0900500, 2016YFC0900501, 2016YFC0900504, 2017YFC0907500 and 2017YFC0907504) and the National Natural Science Foundation of China (81390540, 81390541, and 81202266). The CKB baseline survey and the first re-survey were supported by a grant from the Kadoorie Charitable Foundation in Hong Kong. The long-term follow-up is supported by grants from the UK Wellcome Trust (202922/Z/16/Z, 088158/Z/09/Z, 104085/Z/14/Z) and Chinese Ministry of Science and Technology (2011BAI09B01). The funders had no role in the study design, data collection, data analysis and interpretation, writing of the report, or the decision to submit the article for publication.

Keywords

Chinese population
Comorbidity
Cross-sectional study
Self-rated health status

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s12889-018-5632-1

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Cite this

@article{da1a045cd1cc46f8be411571fda8262f,

title = "Association between multiple comorbidities and self-rated health status in middle-aged and elderly Chinese: The China Kadoorie Biobank study",

abstract = "Background: Understanding the correlates of self-rated health (SRH) can help public health professionals prioritize health-promotion and disease-prevention interventions. This study aimed to investigate the association between multiple comorbidities and global SRH and age-comparative SRH. Methods: A total of 512,891 participants aged 30-79 years old were recruited into the China Kadoorie Biobank study from ten regions between 2004 and 2008. Multivariate logistic regression models were used to estimate the odds ratios (ORs) for the associations between comorbidities (including diabetes, hypertension, coronary heart disease, rheumatic heart disease, stroke, tuberculosis, emphysema/bronchitis, asthma, cirrhosis/chronic hepatitis, peptic ulcer, gallbladder disease, kidney disease, fracture, rheumatic arthritis, psychiatric disorders, depressive symptoms, neurasthenia, head injury and cancer) and SRH. Population attributable risks (PARs) were used to estimate the contribution of multiple comorbidities to poor global SRH and worse age-comparative SRH. Results: After adjusting for covariates, suffering from various diseases increased the chance of reporting a poor global SRH [OR (95% CI) ranged from 1.10 (1.07, 1.13) for fracture to 3.21 (2.68, 3.83) for rheumatic heart disease] and a worse age-comparative SRH [OR (95% CI) ranged from 1.18 (1.13, 1.23) for fracture to 7.56 (6.93, 8.25) for stroke]. From the population perspective, 20.23% of poor global SRH and 45.12% of worse age-comparative SRH could attributed to the cardiometabolic diseases, with hypertension (7.84% for poor global SRH and 13.79% for worse age-comparative SRH), diabetes (4.35% for poor global SRH and 10.71% for worse age-comparative SRH), coronary heart disease (4.44% for poor global SRH and 9.51% for worse age-comparative SRH) and stroke (3.20% for poor global SRH and 10.19% for worse age-comparative SRH) making the largest contribution. Conclusions: Various diseases were major determinants of global and age-comparative SRH, and cardiometabolic diseases had the strongest impact on both global SRH and age-comparative SRH at the population level. Prevention measures concentrated on these conditions would greatly reduce the total burden of poor SRH and its consequences such as poor quality of life and use of health care services.",

keywords = "Chinese population, Comorbidity, Cross-sectional study, Self-rated health status",

author = "{China Kadoorie Biobank (CKB) collaborative group} and Xingyue Song and Jing Wu and Canqing Yu and Wenhong Dong and Jun Lv and Yu Guo and Zheng Bian and Ling Yang and Yiping Chen and Zhengming Chen and An Pan and Liming Li and Junshi Chen and Rory Collins and Richard Peto and Daniel Avery and Ruth Boxall and Derrick Bennett and Yumei Chang and Robert Clarke and Huaidong Du and Simon Gilbert and Alex Hacker and Mike Hill and Michael Holmes and Andri Iona and Christiana Kartsonaki and Rene Kerosi and Ling Kong and Om Kurmi and Garry Lancaster and Sarah Lewington and Kuang Lin and John McDonnell and Iona Millwood and Qunhua Nie and Jayakrishnan Radhakrishnan and Sajjad Rafiq and Paul Ryder and Sam Sansome and Dan Schmidt and Paul Sherliker and Rajani Sohoni and Becky Stevens and Iain Turnbull and Robin Walters and Jenny Wang and Lin Wang and Neil Wright and Xiaoming Yang",

note = "{\textcopyright} The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.",

year = "2018",

month = jun,

day = "15",

doi = "10.1186/s12889-018-5632-1",

language = "English",

volume = "18",

journal = "BMC Public Health",

issn = "1471-2458",

publisher = "BioMed Central",

number = "1",

}

TY - JOUR

T1 - Association between multiple comorbidities and self-rated health status in middle-aged and elderly Chinese

T2 - The China Kadoorie Biobank study

AU - China Kadoorie Biobank (CKB) collaborative group

AU - Song, Xingyue

AU - Wu, Jing

AU - Yu, Canqing

AU - Dong, Wenhong

AU - Lv, Jun

AU - Guo, Yu

AU - Bian, Zheng

AU - Yang, Ling

AU - Chen, Yiping

AU - Chen, Zhengming

AU - Pan, An

AU - Li, Liming

AU - Chen, Junshi

AU - Collins, Rory

AU - Peto, Richard

AU - Avery, Daniel

AU - Boxall, Ruth

AU - Bennett, Derrick

AU - Chang, Yumei

AU - Clarke, Robert

AU - Du, Huaidong

AU - Gilbert, Simon

AU - Hacker, Alex

AU - Hill, Mike

AU - Holmes, Michael

AU - Iona, Andri

AU - Kartsonaki, Christiana

AU - Kerosi, Rene

AU - Kong, Ling

AU - Kurmi, Om

AU - Lancaster, Garry

AU - Lewington, Sarah

AU - Lin, Kuang

AU - McDonnell, John

AU - Millwood, Iona

AU - Nie, Qunhua

AU - Radhakrishnan, Jayakrishnan

AU - Rafiq, Sajjad

AU - Ryder, Paul

AU - Sansome, Sam

AU - Schmidt, Dan

AU - Sherliker, Paul

AU - Sohoni, Rajani

AU - Stevens, Becky

AU - Turnbull, Iain

AU - Walters, Robin

AU - Wang, Jenny

AU - Wang, Lin

AU - Wright, Neil

AU - Yang, Xiaoming

N1 - © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

PY - 2018/6/15

Y1 - 2018/6/15

N2 - Background: Understanding the correlates of self-rated health (SRH) can help public health professionals prioritize health-promotion and disease-prevention interventions. This study aimed to investigate the association between multiple comorbidities and global SRH and age-comparative SRH. Methods: A total of 512,891 participants aged 30-79 years old were recruited into the China Kadoorie Biobank study from ten regions between 2004 and 2008. Multivariate logistic regression models were used to estimate the odds ratios (ORs) for the associations between comorbidities (including diabetes, hypertension, coronary heart disease, rheumatic heart disease, stroke, tuberculosis, emphysema/bronchitis, asthma, cirrhosis/chronic hepatitis, peptic ulcer, gallbladder disease, kidney disease, fracture, rheumatic arthritis, psychiatric disorders, depressive symptoms, neurasthenia, head injury and cancer) and SRH. Population attributable risks (PARs) were used to estimate the contribution of multiple comorbidities to poor global SRH and worse age-comparative SRH. Results: After adjusting for covariates, suffering from various diseases increased the chance of reporting a poor global SRH [OR (95% CI) ranged from 1.10 (1.07, 1.13) for fracture to 3.21 (2.68, 3.83) for rheumatic heart disease] and a worse age-comparative SRH [OR (95% CI) ranged from 1.18 (1.13, 1.23) for fracture to 7.56 (6.93, 8.25) for stroke]. From the population perspective, 20.23% of poor global SRH and 45.12% of worse age-comparative SRH could attributed to the cardiometabolic diseases, with hypertension (7.84% for poor global SRH and 13.79% for worse age-comparative SRH), diabetes (4.35% for poor global SRH and 10.71% for worse age-comparative SRH), coronary heart disease (4.44% for poor global SRH and 9.51% for worse age-comparative SRH) and stroke (3.20% for poor global SRH and 10.19% for worse age-comparative SRH) making the largest contribution. Conclusions: Various diseases were major determinants of global and age-comparative SRH, and cardiometabolic diseases had the strongest impact on both global SRH and age-comparative SRH at the population level. Prevention measures concentrated on these conditions would greatly reduce the total burden of poor SRH and its consequences such as poor quality of life and use of health care services.

AB - Background: Understanding the correlates of self-rated health (SRH) can help public health professionals prioritize health-promotion and disease-prevention interventions. This study aimed to investigate the association between multiple comorbidities and global SRH and age-comparative SRH. Methods: A total of 512,891 participants aged 30-79 years old were recruited into the China Kadoorie Biobank study from ten regions between 2004 and 2008. Multivariate logistic regression models were used to estimate the odds ratios (ORs) for the associations between comorbidities (including diabetes, hypertension, coronary heart disease, rheumatic heart disease, stroke, tuberculosis, emphysema/bronchitis, asthma, cirrhosis/chronic hepatitis, peptic ulcer, gallbladder disease, kidney disease, fracture, rheumatic arthritis, psychiatric disorders, depressive symptoms, neurasthenia, head injury and cancer) and SRH. Population attributable risks (PARs) were used to estimate the contribution of multiple comorbidities to poor global SRH and worse age-comparative SRH. Results: After adjusting for covariates, suffering from various diseases increased the chance of reporting a poor global SRH [OR (95% CI) ranged from 1.10 (1.07, 1.13) for fracture to 3.21 (2.68, 3.83) for rheumatic heart disease] and a worse age-comparative SRH [OR (95% CI) ranged from 1.18 (1.13, 1.23) for fracture to 7.56 (6.93, 8.25) for stroke]. From the population perspective, 20.23% of poor global SRH and 45.12% of worse age-comparative SRH could attributed to the cardiometabolic diseases, with hypertension (7.84% for poor global SRH and 13.79% for worse age-comparative SRH), diabetes (4.35% for poor global SRH and 10.71% for worse age-comparative SRH), coronary heart disease (4.44% for poor global SRH and 9.51% for worse age-comparative SRH) and stroke (3.20% for poor global SRH and 10.19% for worse age-comparative SRH) making the largest contribution. Conclusions: Various diseases were major determinants of global and age-comparative SRH, and cardiometabolic diseases had the strongest impact on both global SRH and age-comparative SRH at the population level. Prevention measures concentrated on these conditions would greatly reduce the total burden of poor SRH and its consequences such as poor quality of life and use of health care services.

KW - Chinese population

KW - Comorbidity

KW - Cross-sectional study

KW - Self-rated health status

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U2 - 10.1186/s12889-018-5632-1

DO - 10.1186/s12889-018-5632-1

M3 - Article

C2 - 29907132

AN - SCOPUS:85048685206

SN - 1471-2458

VL - 18

JO - BMC Public Health

JF - BMC Public Health

IS - 1

M1 - 744

ER -

Association between multiple comorbidities and self-rated health status in middle-aged and elderly Chinese: The China Kadoorie Biobank study

Abstract

Bibliographical note

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Keywords

ASJC Scopus subject areas

UN SDGs

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