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Research article
Wei Zhang
West China Biomedical Big Data Center, Sichuan University
Corresponding Author
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View the published article at BMC Public Health.
Background Neighborhood factors have gained increasing attention, while the association between the neighborhood's characteristics and multimorbidity has not been clarified. In this study, we aim to depict variations in the number of non-communicable chronic diseases (NCDs) as a function of urban vs. rural settings and road types.
Methods The present cross-sectional study derived data from the China Health and Retirement Longitudinal Study 2011 National Baseline Survey. Negative binomial regression with clustered robust standard errors was performed to analyze variations in the number of NCDs among 13,414 Chinese middle-aged and older adults. Logistic regression models were employed to investigate the association between neighborhood-level characteristics and each NCD, respectively.
Results First, over 65% of subjects had at least one NCDs, and over 35% had multimorbidity. Arthritis (33.08%), hypertension (24.54%), and digestive disease (21.98%) were the most prevalent NCDs. Urban vs. rural differences in multimorbidity were fully explained by neighborhood clustering variations (IRR = 1.02, 95% CI, 0.95 - 1.10). Living with paved roads was associated with a smaller number of NCDs relative to living with unpaved roads (IRR = 0.86, 95% CI, 0.78 - 0.95). Results from subgroup analyses suggested that in comparison with those living with unpaved roads, individuals living with paved roads respectively had lower odds of chronic lung disease (OR = 0.76, 95% CI, 0.63 - 0.93), chronic liver disease (OR = 0.74, 95% CI, 0.55 - 0.99), chronic kidney disease (OR = 0.68, 95% CI, 0.51 - 0.89), digestive disease (OR = 0.82, 95% CI, 0.69 - 0.97), arthritis or rheumatism (OR = 0.69, 95% CI, 0.55 - 0.87), and asthma (OR = 0.67, 95% CI, 0.51 - 0.88).
Conclusions Urban vs. rural disparities in multimorbidity appeared to result from within-neighborhoods characteristics. The improvement in neighborhood-level characteristics, such as road pavement, holds promise to alleviate the increasing disease burden of chronic diseases.
Keywords
non-communicable chronic disease, multimorbidity, neighborhood, walkability, urban-rural disparities, middle-aged, older adults
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CURRENT STATUS: Published
Version 4
Posted 04 Nov, 2020
No comments provided
Review #1 received
Received 14 Oct, 2020
Reviewer #1 agreed
On 11 Oct, 2020
Reviewers invited
Invitations sent on 04 Oct, 2020
Editor assigned
On 20 Sep, 2020
Submission checks complete
On 19 Sep, 2020
Editor invited
On 19 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 13 Sep, 2020
Review #1 received
Received 17 Aug, 2020
Review #2 received
Received 17 Aug, 2020
Reviewer #2 agreed
On 30 Jul, 2020
Reviewer #1 agreed
On 26 Jul, 2020
Reviewers invited
Invitations sent on 23 Jul, 2020
Editor assigned
On 09 Jul, 2020
Submission checks complete
On 08 Jul, 2020
Editor invited
On 08 Jul, 2020
No comments provided
Editorial decision: Major revision
On 14 Jun, 2020
Review #2 received
Received 12 Jun, 2020
Reviewer #2 agreed
On 16 Apr, 2020
Review #1 received
Received 19 Feb, 2020
Reviewer #1 agreed
On 03 Dec, 2019
Editor assigned
On 13 Nov, 2019
Reviewers invited
Invitations sent on 13 Nov, 2019
Submission checks complete
On 12 Nov, 2019
Editor invited
On 12 Nov, 2019
First submitted
On 06 Nov, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Epidemiology
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Wei Zhang
West China Biomedical Big Data Center, Sichuan University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 04 Nov, 2020
No comments provided
Review #1 received
Received 14 Oct, 2020
Reviewer #1 agreed
On 11 Oct, 2020
Reviewers invited
Invitations sent on 04 Oct, 2020
Editor assigned
On 20 Sep, 2020
Submission checks complete
On 19 Sep, 2020
Editor invited
On 19 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 13 Sep, 2020
Review #1 received
Received 17 Aug, 2020
Review #2 received
Received 17 Aug, 2020
Reviewer #2 agreed
On 30 Jul, 2020
Reviewer #1 agreed
On 26 Jul, 2020
Reviewers invited
Invitations sent on 23 Jul, 2020
Editor assigned
On 09 Jul, 2020
Submission checks complete
On 08 Jul, 2020
Editor invited
On 08 Jul, 2020
No comments provided
Editorial decision: Major revision
On 14 Jun, 2020
Review #2 received
Received 12 Jun, 2020
Reviewer #2 agreed
On 16 Apr, 2020
Review #1 received
Received 19 Feb, 2020
Reviewer #1 agreed
On 03 Dec, 2019
Editor assigned
On 13 Nov, 2019
Reviewers invited
Invitations sent on 13 Nov, 2019
Submission checks complete
On 12 Nov, 2019
Editor invited
On 12 Nov, 2019
First submitted
On 06 Nov, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Epidemiology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background Neighborhood factors have gained increasing attention, while the association between the neighborhood's characteristics and multimorbidity has not been clarified. In this study, we aim to depict variations in the number of non-communicable chronic diseases (NCDs) as a function of urban vs. rural settings and road types.
Methods The present cross-sectional study derived data from the China Health and Retirement Longitudinal Study 2011 National Baseline Survey. Negative binomial regression with clustered robust standard errors was performed to analyze variations in the number of NCDs among 13,414 Chinese middle-aged and older adults. Logistic regression models were employed to investigate the association between neighborhood-level characteristics and each NCD, respectively.
Results First, over 65% of subjects had at least one NCDs, and over 35% had multimorbidity. Arthritis (33.08%), hypertension (24.54%), and digestive disease (21.98%) were the most prevalent NCDs. Urban vs. rural differences in multimorbidity were fully explained by neighborhood clustering variations (IRR = 1.02, 95% CI, 0.95 - 1.10). Living with paved roads was associated with a smaller number of NCDs relative to living with unpaved roads (IRR = 0.86, 95% CI, 0.78 - 0.95). Results from subgroup analyses suggested that in comparison with those living with unpaved roads, individuals living with paved roads respectively had lower odds of chronic lung disease (OR = 0.76, 95% CI, 0.63 - 0.93), chronic liver disease (OR = 0.74, 95% CI, 0.55 - 0.99), chronic kidney disease (OR = 0.68, 95% CI, 0.51 - 0.89), digestive disease (OR = 0.82, 95% CI, 0.69 - 0.97), arthritis or rheumatism (OR = 0.69, 95% CI, 0.55 - 0.87), and asthma (OR = 0.67, 95% CI, 0.51 - 0.88).
Conclusions Urban vs. rural disparities in multimorbidity appeared to result from within-neighborhoods characteristics. The improvement in neighborhood-level characteristics, such as road pavement, holds promise to alleviate the increasing disease burden of chronic diseases.
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