Effects of Chronic Disease Prevalence and Comorbidity Patterns on SRH Status in Middle-aged and Elderly Populations in Rural Areas

Background With the acceleration of China's aging population, the prevalence of chronic diseases and comorbidity patterns pose significant challenges to global health. There is a close relationship between the prevalence of chronic diseases and individuals' self-related health (SRH) status. However, there is limited research on the prevalence of chronic diseases and comorbidity patterns among middle-aged and elderly populations in rural areas of Xinjiang, China, and their impact on SRH status. Objective To understand the prevalence of chronic diseases and comorbidity patterns among middle-aged and elderly populations in rural areas of Xinjiang and to explore the impact of chronic diseases and comorbidity patterns on SRH status, providing effective reference for improving the health level of this population. Methods The data for this study were derived from the survey database of the National Social Science Foundation project (17BRK030) from 2016 to 2019. A questionnaire survey was conducted on the demographic characteristics, chronic disease status, and self-rated health status of male and female heads of households. Ordered logistics regression analysis was used to screen the influencing factors of SRH status. SOM network training analysis and partial least squares method were employed to evaluate the interrelationships among 14 chronic diseases and the degree of their impact on SRH status. Results A total of 3 400 middle-aged and elderly individuals were surveyed. Residents' SRH status varied significantly by geographical distribution, gender, age, education level, occupation, marital status, illness or disability, and chronic disease status (P<0.05). Geographical region as southern Xinjiang, education level of primary school below, and presence of chronic diseases were identified as risk factors for SRH status (P<0.05). Being male, aged 45-59 years, occupation as pastoralists, staff of government or public institutions, or technical workers, being divorced, and having illness or disability were identified as protective factors for SRH status. The prevalence of chronic diseases among middle-aged and elderly populations in rural areas of Xinjiang was 36.47%. The top three diseases were hypertension (17.47%), arthritis or rheumatism (8.62%), and heart disease (5.68%). The comorbidity rate of chronic diseases was 8.09%, with hypertension (6.12%), arthritis or rheumatism (5.18%), and heart disease (4.71%) being the top three comorbid diseases. The predominant comorbidity pattern was the co-occurrence of two chronic diseases (78.18%). The most common comorbidity pattern among individuals with two chronic diseases was hypertension combined with heart disease, and among those with three chronic diseases was hypertension combined with heart disease and arthritis or rheumatism. The impact of chronic disease status on SRH status revealed that individuals with chronic diseases had significantly lower SRH status than those without chronic diseases, and individuals with two or more chronic diseases had lower SRH status than those with one chronic disease. Conclusion The prevalence of chronic diseases and comorbidity among middle-aged and elderly populations in rural areas of Xinjiang is high. Chronic respiratory diseases, arthritis or rheumatism, heart disease, anemia, and other chronic diseases have a significant impact on SRH status. Therefore, it is necessary to further strengthen the construction of chronic disease service systems, improve the health records of middle-aged and elderly individuals, establish specialized clinics for chronic disease comorbidity to detect and control the comorbidity of chronic diseases among middle-aged and elderly populations. Additionally, efforts should be made to enhance health education for middle-aged and elderly groups, increase awareness of chronic diseases, and promote active and healthy lifestyles to improve the health level and quality of life of middle-aged and elderly populations.