【摘要】 目的 从健康不平等的视角全面分析慢性病与残疾之间的关系，为有效应对人口老龄化提供依据。方法 基于中国健康与养老追踪调查（China Health and Retirement Longitudinal Study, CHARLS）4轮的调查数据，分析不同慢性病群体的残疾流行情况，采用多重累积风险模型对残疾发生风险进行分解，探讨慢性病贡献率反映的不平等现象。结果 2011—2018年，调查对象的残疾总体发生率从16.48%上升至18.83%，差异具有统计学意义（χ~2=47.44,P <0.001）。女性、农村地区和低社会经济地位个体在各年龄组中均表现出更高的特定疾病的残疾发生率，且具有更高的慢性病贡献度。在低年龄组群体（45～64岁）中，相对贡献率最大的是背景因素（41.31%～58.57%），其次为关节炎（18.85%～31.28%）；在高年龄组群体（65岁及以上）中，相对贡献率最大的为关节炎（29.77%～40.80%）。结论 残疾流行情况呈现出不平等现象，受教育程度不同的群体和城乡个体之间差异尤为明显。降低背景因素和关节炎发生风险，或将有助于缓解残疾负担和促进健康老龄化。更多还原

【Abstract】 Objective To comprehensively analyze the relationship between chronic diseases and disability from the perspective of health inequalities, providing evidence to support effective responses to population ageing. Methods This study utilized data from four waves of the China Health and Retirement Longitudinal Study(CHARLS) to examine the prevalence of disability across different chronic disease groups. A multiple cumulative risk model was employed to decompose the risk of disability. Additionally, health inequalities in chronic disease contributions were explored. Results From 2011 to 2018, the overall disability prevalence rate among the participants increased from 16.48% to 18.83%, and the difference was statistically significant(χ~2 = 47.44, P < 0.001). Higher disease-specific disability rate and greater contributions of chronic diseases were identified among women, rural residents, and individuals with low socioeconomic status across all age groups. Among younger populations(aged 45 ～ 64), the largest relative contribution was from background factors(41.31% ～ 58.57%), followed by arthritis(18.85% ～ 31.28%). For populations aged 65 and above,arthritis accounted for the highest relative contribution(29.77% ～ 40.80%). Conclusions The prevalence of disability shows inequality, particularly evident across different educational levels and between urban and rural areas. Reducing the risks associated with background factors and arthritis will help alleviate the burden of disability and promote healthy aging.更多还原