慢性病管理中的社会经济与人口学挑战分析

doi:10.12114/j.issn.1007-9572.2025.0485

中国全科医学 ›› 2026, Vol. 29 ›› Issue (20): 2800-2807.DOI: 10.12114/j.issn.1007-9572.2025.0485

• 论著·慢性病共病专题研究 • 上一篇下一篇

慢性病管理中的社会经济与人口学挑战分析

程玉¹^,²^,³, 韩士尧⁴, 孙平⁴, 向娟¹^,²^,³, 杨辉⁵, 李东泽⁶^,⁷^,^*(), 郑莉⁴^,^*(), 廖晓阳¹^,²^,³^,^*()

1．610041　四川省成都市，四川大学华西医院全科医学中心全科特需病房
2．610041　四川省成都市，四川大学华西医院全科医学中心全科医学教研室
3．610041　四川省成都市，四川大学华西医院全科医学中心全科医学研究室
4．610041　四川省成都市，四川大学公共管理学院社会学与心理学系
5．3168澳大利亚墨尔本市，蒙纳士大学医学部公共卫生和预防医学学院全科医学系
6．610041　四川省成都市，四川大学华西医院急诊科　急诊医学研究室
7．610041　四川省成都市，四川大学灾难医学中心

收稿日期:2025-11-13 修回日期:2026-03-25 出版日期:2026-07-15 发布日期:2026-06-05
通讯作者: 李东泽, 郑莉, 廖晓阳
程玉和韩士尧为共同第一作者

作者贡献：
程玉、韩士尧负责研究资料的收集与整理；程玉、韩士尧、孙平、向娟负责论文撰写；杨辉负责对论文的监督管理与指导；李东泽负责论文修订；郑莉、廖晓阳负责文章的构思与设计、文章的质量控制及审校；李东泽、郑莉、廖晓阳对文章整体质量负责。
基金资助:
国家社科基金项目(22BSH053); 国家自然科学基金资助项目(62506248); 国家科技重大专项(2024ZD0524700，2024ZD0523904); 四川省科技厅项目(2025YFHZ0150); 四川省自然科学基金项目(2024NSFSC1534)

Analysis of Socioeconomic and Demographic Challenges in Chronic Disease Management

CHENG Yu¹^,²^,³, HAN Shiyao⁴, SUN Ping⁴, XIANG Juan¹^,²^,³, YANG Hui⁵, LI Dongze⁶^,⁷^,^*(), ZHENG Li⁴^,^*(), LIAO Xiaoyang¹^,²^,³^,^*()

1. General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, China
2. Teaching & Research Section, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, China
3. General Practice Medical Center and General Practice Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
4. Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu 610041, China
5. Department of General Practice, Faculty of Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria 3168, Australia
6. Department of Emergency Medicine, Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
7. Disaster Medical Center, West China Hospital, Sichuan University, Chengdu 610041, China

Received:2025-11-13 Revised:2026-03-25 Published:2026-07-15 Online:2026-06-05
Contact: LI Dongze, ZHENG Li, LIAO Xiaoyang
About author:
CHENG Yu and HAN Shiyao are co-first authors

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摘要/Abstract

摘要： 慢性病已成为我国居民的主要疾病负担。慢性病的管理不仅是医学问题，也深受社会结构因素的影响。本文采用叙述性综述方法，以根本原因理论（FCT）为分析框架，围绕社会经济地位（SES）、性别与年龄3个核心维度，梳理国内外相关研究，探讨不同社会群体在慢性病管理中的差异表现及其形成机制。低SES群体在健康信息获取、自我效能感与资源可及性方面普遍处于不利地位；性别差异不仅体现在女性特定疾病负担上，更受社会性别分工与制度性偏见的影响；老年人因生理衰退、技术适应能力不足及社会支持网络减弱，在多病共管的慢性病管理中面临更大挑战。上述差异并未因技术进步而自动弥合，反而可能因资源动员能力的差异而持续扩大。本文提出"三级干预"思路，倡导引入"社会处方"机制，强调从结构公平、服务优化与数字普惠等层面协同推进，促进慢性病管理中的健康公平。

关键词: 慢性病管理, 健康不平等, 社会经济地位, 性别, 老年人, 根本原因理论, 叙述性综述

Abstract:

Chronic diseases have become a major health burden in China. The management of chronic diseases extends beyond clinical care and is profoundly shaped by structural social determinants. This research adopts a narrative review approach and applies Fundamental Cause Theory (FCT) to analyze disparities in chronic disease management across three key dimensions: socioeconomic status (SES), gender, and age. Individuals with lower SES face systemic disadvantages in accessing health information, exercising self-efficacy, and securing necessary health resources. Gender disparities are shaped not only by female-specific disease burdens but also by socially constructed roles and institutional biases. Older adults encounter additional challenges in managing multiple chronic conditions due to physiological decline, digital exclusion, and weakening social support networks. Rather than narrowing these gaps, technological advancements may inadvertently exacerbate inequalities due to unequal capacity to mobilize resources. This paper proposes a three-tiered intervention framework and advocates the integration of 'social prescribing' into chronic care models. It calls for coordinated action across structural equity, service delivery, and digital inclusion to advance health equity in chronic disease management.

Key words: Chronic disease management, Health disparities, Socioeconomic status, Gender, Older adults, Fundamental cause theory, Narrative review

中图分类号:

R 197

程玉,韩士尧,孙平,等. 慢性病管理中的社会经济与人口学挑战分析[J]. 中国全科医学, 2026, 29(20): 2800-2807. DOI: 10.12114/j.issn.1007-9572.2025.0485.
CHENG Yu,HAN Shiyao,SUN Ping, et al. Analysis of Socioeconomic and Demographic Challenges in Chronic Disease Management[J]. Chinese General Practice, 2026, 29(20): 2800-2807. DOI: 10.12114/j.issn.1007-9572.2025.0485.

图/表 1

参考文献 54

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慢性病管理中的社会经济与人口学挑战分析

Analysis of Socioeconomic and Demographic Challenges in Chronic Disease Management

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