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Chinese suicide rates have been reported in various studies in the past two decades, but few of them were based on national data. The most recent mortality data (2002-2011) provided by the China Ministry of Health and the detailed census data provided by the National Population Census were used in this study. We calculated the age-, gender-, and region-specific suicide rates and their trends in the past 10 years between 2002 and 2011. The overall suicide rates in China decreased during the study period. The rural/urban ratio of the suicide rates has been significantly reduced from the ratio in the 1990s, and male suicide rates have exceeded those of females. Age was positively associated with suicide rates without the two peaks found in the suicide rates over 20 years ago. The Chinese suicide rates have significantly declined in the past decade, with withering of the unique suicide rate patterns previously found in Chinese suicides about 20 years ago.

Objectives: To examine the prevalence of loneliness and to explore the association between loneliness and health service utilization among the rural elderly in Shandong Province, China. Methods: A total of 5514 rural people aged 60 and above from Shandong Province, China, were enrolled in this study. Loneliness was used as a binary variable based on a single-item question. Health service utilization was measured by recent two-week physician visits and annual hospitalizations rates. Multiple logistic regression analysis was performed to examine the association between loneliness and health service utilization. Results: The prevalence of loneliness among the rural elderly in Shandong, China, was 25.0%. Loneliness was associated with higher rates of recent two-week physician visits (OR = 1.260, p < 0.01) and annual hospitalizations (OR = 1.183, p < 0.05). The regression results also showed that self-rated health status and chronic conditions were significant and positively associated with both physician visits and hospitalizations rates. Conclusions: Loneliness had a significant association with higher odds of health service utilization among the elderly. The independent contribution of loneliness on health service utilization was smaller than self-rated health status and chronic conditions. Thus, healthcare policies need to shift from an emphasis on controlling health utilization and cost to a greater focus on enabling lonely older people to get more social support.

ObjectivesWhether the association between obesity-related anthropometric indices and multimorbidity differs by age among Chinese older adults (aged 65+) is unclear. We aimed to investigate the association between body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) with multimorbidity among the young-old (aged 65–79) and old-old (aged 80+) adults.DesignCross-sectional population-based study.SettingShandong province on the eastern coast of China.Participants5493 subjects aged 65 years or above.MeasurementsDetails on sociodemographics, lifestyle characteristics and chronic conditions were collected using a structured questionnaire. The respondents were assessed with anthropometric measurements including height, weight, WC, hip circumference.ResultsThe overall prevalence of multimorbidity in older adults (aged 65+) was 35.2%. The BMI-obesity, WC-obesity and WHR-obesity rates were 7.4%, 57.5% and 80.4%, respectively. In the young-old adults (aged 65–79), the likelihood of multimorbidity was more than two times higher among the BMI-obese than the BMI-normal population (OR 2.08, 95% CI 1.66 to 2.60). Similar but less strong associations were found for the WC-obese and WHR-obese young-old population (OR 1.60, 95% CI 1.42 to 1.81; OR 1.31, 95% CI 1.10 to 1.56, respectively). For the old-old group (aged 80+), the BMI-obese, WC-obese and WHR-obese had a higher likelihood of having multimorbidity compared with the normal weight category (OR 2.10, 95% CI 0.96 to 4.57; OR 1.75, 95% CI 1.21 to 2.54; OR 2.15, 95% CI 1.18 to 3.93, respectively).ConclusionBMI-obesity, WC-obesity and WHR-obesity were associated with a greater risk of multimorbidity, and the associations were different between the young-old and the old-old adults. These age differences need to be considered in assessing healthy body weight in old age. These findings may be vital for public health surveillance, prevention and management strategies for multimorbidity in older adults.

IntroductionInstitutional care has been strongly promoted in China to meet seniors’ long-term care needs. Empty-nest elderly, in comparison with their counterparts, have less social support and fewer caring networks. This study aimed to compare the utilisation willingness for institutional care and its predictors between empty-nest and non-empty-nest seniors.MethodsA total of 3923 seniors were included in the analysis. Binary logistic regression models were used to understand the association between the living arrangements of the elderly households and willingness for institutional care and to identify the predictors of the utilisation willingness for institutional care among empty nesters and non-empty nesters.ResultsOur study found that approximately 8.5% of the seniors had a willingness for institutional care in Shandong, China. Empty-nest singles (OR 5.301; 95% CI 2.838 to 9.904) and empty-nest couples (OR 1.547; 95% CI 1.135 to 2.107) were found to be more willing to receive institutional care. Our results also showed that residence was a key determinant for institutionalisation willingness in empty-nest and non-empty-nest elderly. Among empty-nest singles, psychological stress was a positive determinant for institutional care. Factors, including education attainment, relationship with adult children, household income and per capita living space, were determinants for empty-nest couple willingness for institutionalisation. Age, number of children and self-reported health status were found to be associated factors for willingness among non-empty nesters.ConclusionsThe government should pay more attention to institutional care in rural areas where there is still a gap in elder care compared with that in urban areas. Targeted policies should be made for different types of seniors to offer appropriate institutional care.

Type 2 diabetes mellitus has a significantly catastrophic effect on patients and their households in China. Early screening for type 2 diabetes mellitus patients among the high-risk groups and effective management of the detected cases should be priorities to reduce the overall healthcare expenditure for type 2 diabetes mellitus.

Background This study aims to assess the association between body mass index (BMI) and health-related quality of life (HRQOL), and to further explore gender differences in BMI-HRQOL association among adults. Methods We used data from the fifth Health Service Survey of Shandong Province, which was part of China’s National Health Service Survey (NHSS), a total of 27,257 adults aged 18 and over were interviewed. The HRQOL was measured using the EuroQOL-5 Dimensions (EQ-5D) instrument. One-way ANOVA and Post hoc tests were used to compare EQ-5D utility values and visual analogue scale (VAS) scores between BMI categories. Tobit regression models were used to identify the association between BMI and HRQOL for male and female separately after controlling for influential confounders, and to assess gender differences on the relationship between BMI and HRQOL. Results The prevalence of underweight in men and women were 3.2 and 5.3%, respectively, while the prevalence of overweight/obesity in men and women were 35.7 and 34.6%, respectively. Men had higher EQ-5D utility values and VAS scores than women. The mean EQ-5D utility value and VAS score was highest in obese men and normal-weight women, respectively. After controlling potential confounders, being underweight was significantly and negatively associated with lower HRQOL among adults. The relationship between obesity and gender was that in women obesity was negatively and significantly associated with HRQOL, whereas in men this association was positive but not statistically significant. Results of gender by BMI interaction in regression model showed that this difference between men and women in this respect was significant. Conclusions The association between BMI and HRQOL differed by gender and the so-called “obesity-HRQOL paradox” phenomenon was verified in male adults . Gender difference should be considered when implementing targeted weight control programs and appropriate interventions to improve HRQOL.

BackgroundWith the implementation of Chinese economic reform and rapid urbanization, policies and values surrounding migration have changed and given rise to unprecedented population mobility. This study is designed to examine the effect of Hukou origin on establishment of health records among internal migrants in China.MethodsThe data used for this study are from the 2015 National Internal Migrant Population Dynamic Monitoring Survey, covering 112,782 migrants nationwide. For continuous variables, the p value is calculated using Student t test; for categorical variables, the p value is calculated using chi-square test. Binary logistic regression with an enter method is employed to assess the association of establishment of health records with origin residence.ResultsAbout 35.1% of the migrant population has established health records in their inflow communities, with 37.4% established among those of urban origin and 34.8% established among those of rural origin. The establishment of health records is significantly higher among migrants of urban origin than among migrants of rural origin (OR = 1.057; 1.017–1.098). Our results also show that among populations of both rural and urban origin, inter-province migrants, along with migrants who are employers, have no plans for long-term residence, have no insurance, and have more family income less likely to establish health records.ConclusionsThis study demonstrates that residence is associated with establishment of health records among the migrant population in China. Targeted policies should be made to improve the establishment of health records among migrants of both rural and urban origins.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3519-6) contains supplementary material, which is available to authorized users.