Integrating Point-of-Care Hemoglobin A1c Screening into China's Rural Community-based Health Check-up for the Older Population

Older adults (defined as those aged ≥60 years) are disproportionately affected by diabetes in China according to the latest national survey. Among adults aged 60 to 70 and older than 70 years, the prevalence of diabetes is estimated to be 28.8% and 31.8%, respectively, and one-half of those individuals are not aware of their condition. Moreover, prediabetes is present in almost half of older adults. 1 Li Y. Teng D. Shi X. et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. BMJ. 2020; 369: m997 Crossref PubMed Scopus (923) Google Scholar A previous study indicated that the rural‒urban care gap for patients with chronic disease shrank since the implementation of the central government's health reform effort in 2002, but inequities still persist. 2 Jian W. Chan K.Y. Reidpath D.D. Xu L. China's rural-urban care gap shrank for chronic disease patients, but inequities persist. Health Aff. 2010; 29: 2189-2196 Crossref PubMed Scopus (80) Google Scholar Faultiness of basic infrastructure might mean that rural residents of China have less access to primary care, especially for older individuals. Successful and sustainable chronic disease management often requires strategies tailored to unique local conditions, especially when targeted at remote communities. In the current study, we evaluated a novel strategy to integrate point-of-care A1c testing into an established rural community-based routine health check-up for older individuals.