Peigang Wang

Age-period-cohort analysis on the cancer mortality in rural China: 1990–2010

BackgroundCancer has become a global health problem. China still suffers continuous increasing cancer mortality. To study the trend of cancer mortality in rural China, this paper established an Age-Period-Cohort model to discuss the age effect, period effect and cohort effect on cancer mortality in rural China.MethodsThe data were collected from the “China Health Statistical Yearbook” from 1990 to 2010. Collected data were analyzed by Age-Period-Cohort model and Intrinsic Estimation method.ResultsThe age effect on the total cancer mortality represented a V trend. Compared with Group 0–4, Group 5–9 showed 71.87% lower cancer mortality risk. Compared with Group 5–9, Group 75–79 showed 38 times higher cancer mortality risk. The period effect on the total cancer mortality risk weakened firstly but then increased. It increased by 35.70% from 1990 to 2010, showing an annual average growth of 1.79%. The cohort effect on the total cancer mortality risk weakened by totally 84.94% from 1906–1910 to 2005–2010. Three “deterioration periods” and three “improvement periods” were witnessed during this period. The malignant cancer mortality varied similarly with the total cancer mortality, while benign cancer mortality and other cancer mortality represented different variation laws.ConclusionsAlthough the total cancer mortality risk is increasing at an accelerated rate, cancer mortality risk in recent born year is decreasing, indicating very important impact of social change on the cancer mortality in rural China.

Relationship of body fat and cardiorespiratory fitness with cardiovascular risk in Chinese children.

Backgrounds/Objectives Cardiorespiratory fitness (CRF) and body fat play an important role in elevated risk for cardiovascular disease (CVD). However, the combined effects of CRF and obesity on metabolic health in Chinese children are unclear. The purpose of this study was to investigate the independent and combined associations between body fat, CRF, and CVD risk in Chinese schoolchildren. Methods The study subjects comprised 676 schoolchildren (392 boys and 284 girls, aged 9.6±0.7 yrs old) in Wuhan, China. Their body mass index (BMI), waist circumference (WC), CRF, blood pressure (BP), lipids, glucose, and pubertal status were assessed. Children were categorized into different groups based on their BMI, WC, and CRF using Chinese obesity cut-off points and CRF sex-specific median points. Metabolic Risk Score (MRS) was computed based on the standardized scores of BP, lipids, and glucose. Results Multiple linear regression models showed that, in the separate models, body fat was positively associated with MRS while CRF was inversely associated with MRS (p<0.001). However, when assessed simultaneously, only body fat had a significant association with MRS (p<0.001). In general, low-fit children had a lower MRS compared to their counterparts, and a significant difference between the two extreme groups was observed (low CRF and high fat vs. high CRF and low fat, p<0.001). Conclusions These findings suggest that both body fat and CRF should be considered when interpreting CVD risk in Chinese children, while body fat may be correlated with CVD risk more than CRF.

Dietary total flavonoids intake and risk of mortality from all causes and cardiovascular disease in the general population: a systematic review and meta-analysis of cohort studies.

SCOPE Epidemiologic studies assessing the association between dietary total flavonoids intake and the risk of mortality from cardiovascular disease (CVD) and all causes have yielded inconsistent results. Therefore, we conducted a dose-response meta-analysis to investigate this association. METHOD AND RESULTS We searched PubMed and Embase databases from January 1966 through May 2016 and examined the references of retrieved articles to identify relevant prospective cohort studies. The random-effect model was used to calculate the summary risk estimates and dose-response analysis was performed. Ten studies were included in the present meta-analysis. The relative risk (RR) of all-cause mortality for the highest versus lowest category of total flavonoids intake was 0.82 (95% confidence interval (CI): 0.72-0.92). Dose-response analysis showed that those consuming 200 mg/day of total flavonoids had the lowest risk of all-cause mortality. Furthermore, a marginally significant association was found between dietary total flavonoids consumption and risk of death from CVD (summary RR: 0.85; 95% CI: 0.70-1.03; P = 0.099) and coronary heart diseases (summary RR: 0.74; 95% CI: 0.54-1.02; P = 0.069), respectively. CONCLUSION The meta-analysis provides strong evidence for the recommendation of consuming flavonoids-rich food to reduce risks of mortality from all causes as part of a healthy diet among general adults.

Age-period-cohort analysis of infectious disease mortality in urban-rural China, 1990-2010.

BackgroundAlthough a number of studies on infectious disease trends in China exist, these studies have not distinguished the age, period, and cohort effects simultaneously. Here, we analyze infectious disease mortality trends among urban and rural residents in China and distinguish the age, period, and cohort effects simultaneously.MethodsInfectious disease mortality rates (1990–2010) of urban and rural residents (5–84 years old) were obtained from the China Health Statistical Yearbook and analyzed with an age-period-cohort (APC) model based on Intrinsic Estimator (IE).ResultsInfectious disease mortality is relatively high at age group 5–9, reaches a minimum in adolescence (age group 10–19), then rises with age, with the growth rate gradually slowing down from approximately age 75. From 1990 to 2010, except for a slight rise among urban residents from 2000 to 2005, the mortality of Chinese residents experienced a substantial decline, though at a slower pace from 2005 to 2010. In contrast to the urban residents, rural residents experienced a rapid decline in mortality during 2000 to 2005. The mortality gap between urban and rural residents substantially narrowed during this period. Overall, later birth cohorts experienced lower infectious disease mortality risk. From the 1906–1910 to the 1941–1945 birth cohorts, the decrease of mortality among urban residents was significantly faster than that of subsequent birth cohorts and rural counterparts.ConclusionsWith the rapid aging of the Chinese population, the prevention and control of infectious disease in elderly people will present greater challenges. From 1990 to 2010, the infectious disease mortality of Chinese residents and the urban-rural disparity have experienced substantial declines. However, the re-emergence of previously prevalent diseases and the emergence of new infectious diseases created new challenges. It is necessary to further strengthen screening, immunization, and treatment for the elderly and for older cohorts at high risk.

Associations between multiple health risk behaviors and mental health among Chinese college students

Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95%CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.

Lung Cancer Mortality Trends in China from 1988 to 2013: New Challenges and Opportunities for the Government

Background: As lung cancer has shown a continuously increasing trend in many countries, it is essential to stay abreast of lung cancer mortality information and take informed actions with a theoretical basis derived from appropriate and practical statistical methods. Methods: Age-specific rates were collected by gender and region (urban/rural) and analysed with descriptive methods and age-period-cohort models to estimate the trends in lung cancer mortality in China from 1988 to 2013. Results: Descriptive analysis revealed that the age-specific mortality rates of lung cancer in rural residents increased markedly over the last three decades, and there was no obvious increase in urban residents. APC analysis showed that the lung cancer mortality rates significantly increased with age (20–84), rose slightly with the time period, and decreased with the cohort, except for the rural cohorts born during the early years (1909–1928). The trends in the patterns of the period and cohort effects showed marked disparities between the urban and rural residents. Conclusions: Lung cancer mortality remains serious and is likely to continue to rise in China. Some known measures are suggested to be decisive factors in mitigating lung cancer, such as environmental conservation, medical security, and tobacco control, which should be implemented more vigorously over the long term in China, especially in rural areas.

Psychometric evaluation of health related quality of life among rural-to-urban migrants in China.

ObjectivesOur study discusses health related quality of life (HRQOL) as measured by 36-item Short Form (SF-36) for rural-to-urban migrants in China, and assesses the validity and reliability of the SF-36 for this group.MethodsIn 2012,765 rural-to-urban migrant respondents chosen by probability and the non-probability sampling methods have completed the survey in Wuhan, Mid-China. The reliability of SF-36 is analyzed by Cronbachs alpha (α) coefficient, split-half coefficient, theta (θ) and omega (Ω) coefficient, the validity is calculated by confirmatory factor analysis (CFA) and known-group methods.ResultSplit-half reliability coefficient is 0.717. Cronbachs alpha coefficient is 0.776. Theta and omega coefficient are 0.862 and 0.903 respectively. CFA statistical analysis results are shown as follows: GFI = 0.926, Chi-Square/Df = 2.059, RMSEA = 0.037, CFI = 0.939. Physical and mental component summary (PCS/MCS) scores are tabulated by known-group variables and show a statistical significance.ConclusionIn general, SF-36 is a reliable and valid instrument for measuring HRQOL of rural-to-urban migrants in China. Furthermore, Chinese migrants have lived and worked in a hard environment, their salaries are much lower than that of the counterparts, HRQOL of this group is also a little lower and deserves much attention from society.

Urban-Rural Differences in Cardiovascular Disease Risk Factors: A Cross-Sectional Study of Schoolchildren in Wuhan, China

Background China’s rapid population growth and urban migration has developed healthcare inequity across the urban-rural divide. Past studies comparing cardiovascular disease (CVD) risk factor prevalence amongst urban-rural Chinese children are sparse and conflicting. We examined the association between urban-rural residence and risk of offspring CVD in Chinese children. Methods A cross-sectional study was conducted in Wuhan, China, during May and June 2010. CVD risk factors include; waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), triglycerides (TG), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, body mass index (BMI), cardiorespiratory fitness (CRF), metabolic syndrome (MetS), and metabolic risk score (MRS). Analysis of covariance and multivariable logistic regression were used to estimate associations between urban-rural residence and offspring CVD risks. Findings A total of 579 Chinese children (338 boys and 241 girls) aged 9.6 (0.7) years participated in this study. Rural boys had significantly lower CRF and higher FBG, TG, and MRS, while urban boys had significantly higher LDL and DBP. Rural girls had significantly higher BMI, FBG, and TG, as well as lower CRF. Rural children were at increased risks for decreased CRF, elevated MRS, and TG, (OR:2.04, 95%CI:1.29–3.25), (OR:2.33, 95%CI:1.50–3.62), and (OR:2.40, 95%CI:1.62–3.57), respectively. Rural girls and mothers were at increased risks for overweight(OR:7.19, 95%CI:1.64–31.6)/obesity (OR:1.683, 95%CI:1.01–2.82). However, rural boys and fathers were less likely to have overweight(OR:0.62, 95%CI:0.34–1.12)/obesity (OR:0.68, 95%CI:0.48–0.97). Conclusions Rural residence was significantly associated with increased CVD risks amongst Chinese children. It is important to provide interventions aiming at China’s urban-rural healthcare inequity and community-based approaches that reduce familial CVD risk.

Factors influencing the decision to participate in medical premarital examinations in Hubei Province, Mid-China

BackgroundTo investigate the attitudes of premarital couples towards the premarital screening program after the abolition of compulsory screening in China and to study the factors influencing participation.MethodsBetween July 1st 2010 to August 31st 2010, 650 people who registered for marriage at the civil affairs bureau of Wuhan, Suizhou, Zaoyang in Hubei province were studied using questionnaires. Logistic regression was used to examine the factors influencing participation in the premarital screening program.ResultsThe premarital screening rate was 34.8% (95% Confidence Interval: 31.0% to 38.5%). Several demographic factors (age, residence, profession), awareness, knowledge, and attitudes towards premarital screening all had significant influence on participation in the premarital screening program.ConclusionsPromotion activities and health education to improve knowledge and attitudes to premarital screening will help increase the rate of voluntary premarital screening.

Social Capital Associated with Quality of Life Mediated by Employment Experiences: Evidence from a Random Sample of Rural-to-Urban Migrants in China

Working-age migrants need to possess adequate social capital in order to secure a stable and satisfactory job so that they can pursue a better quality of life (QOL). The positive relationship between social capital and vocational experiences, including successful employment, has been well established. In this study we focused on testing a multi-step mediation model linking social capital with employment experiences, and further to QOL. Survey data from rural-to-urban migrants randomly selected from Wuhan, China were analyzed. Social capital, including bonding and bridging capital, was measured using the Personal Social Capital Scale; employment experiences were measured using five job-related items; and QOL was measured using the Brief Symptoms Inventory. Structural equation modeling analysis indicated that job security and job satisfaction were positively and significantly associated with QOL, and social capital measures were significantly associated with higher QOL (primarily for males). Furthermore, job security and job satisfaction fully mediated the relationship between social capital and QOL after controlling for covariates. Findings of this study suggest the significance of social capital, job security and satisfaction in improving migrants’ QOL, implying the importance of vocational experiences in mediating the effect from social capital to QOL. If the findings can be confirmed with longitudinal data, these factors should be considered in decision making to improve rural-to-urban migrants’ QOL in China.