Decomposing the causes of socioeconomic-related health inequality among urban and rural populations in China: a new decomposition approach.
Decomposing the causes of socioeconomic-related health inequality among urban and rural populations in China: a new decomposition approach.
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DOI：
10.1186/s12939-017-0624-9
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发表时间：
2017-07-18
影响因子：
4.8
通讯作者：
Zhao H
中科院分区：
文献类型：
--
作者：
Cai J;Coyte PC;Zhao H
近几十年来，中国经历了巨大的经济增长，但也见证了与社会经济相关的健康不平等日益加剧。该研究旨在探讨过去二十年来中国城乡地区与社会经济相关的健康不平等的潜在原因。本研究使用1991年至2006年的六波中国健康与营养调查（CHNS）。采用近期影响函数（RIF）回归分解方法来分解中国与社会经济相关的健康不平等。健康状况源自自评健康 (SRH) 分数。分析分别针对城市和农村样本进行。我们发现，从1989年到2006年，城市和农村人口的平均健康状况水平均有所下降。与城市人口相比，农村人口的平均健康得分更高。我们还发现，中国存在有利于富人的健康不平等。虽然收入和中等教育是减少健康不平等的主要因素，但老年人、不健康的生活方式和恶劣的家庭环境加剧了不平等。医疗保险对城乡人口的健康不平等产生相反的影响，导致城市人口的不平等程度较低，而农村人口的不平等程度较高。这些发现表明，减少与社会经济相关的健康不平等的有效方法不仅是增加收入和改善获得医疗保健服务的机会，而且还要注重改善生活方式和家庭环境。具体来说，对于农村人口来说，完善医疗保险设计，实施更加全面、有效针对农村贫困人口的保险方案显得尤为重要。而且，要在农村全面推广抽水马桶和自来水。对于城市人口来说，除了促进普及中等教育外，还应提倡健康的生活方式，包括控制酒精等措施。本文的在线版本 (doi:10.1186/s12939-017-0624-9) 包含补充材料，可供授权用户使用。
In recent decades, China has experienced tremendous economic growth and also witnessed growing socioeconomic-related health inequality. The study aims to explore the potential causes of socioeconomic-related health inequality in urban and rural areas of China over the past two decades. This study used six waves of the China Health and Nutrition Survey (CHNS) from 1991 to 2006. The recentered influence function (RIF) regression decomposition method was employed to decompose socioeconomic-related health inequality in China. Health status was derived from self-rated health (SRH) scores. The analyses were conducted on urban and rural samples separately. We found that the average level of health status declined from 1989 to 2006 for both urban and rural populations. Average health scores were greater for the rural population compared with those for the urban population. We also found that there exists pro-rich health inequality in China. While income and secondary education were the main factors to reduce health inequality, older people, unhealthy lifestyles and a poor home environment increased inequality. Health insurance had the opposite effects on health inequality for urban and rural populations, resulting in lower inequality for urban populations and higher inequality for their rural counterparts. These findings suggest that an effective way to reduce socioeconomic-related health inequality is not only to increase income and improve access to health care services, but also to focus on improvements in the lifestyles and the home environment. Specifically, for rural populations, it is particularly important to improve the design of health insurance and implement a more comprehensive insurance package that can effectively target the rural poor. Moreover, it is necessary to comprehensively promote the flush toilets and tap water in rural areas. For urban populations, in addition to promoting universal secondary education, healthy lifestyles should be promoted, including measures such as alcohol control. The online version of this article (doi:10.1186/s12939-017-0624-9) contains supplementary material, which is available to authorized users.
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DOI：
10.1016/j.healthpol.2003.07.005
发表时间：
2004-03
期刊：
Health policy (Amsterdam, Netherlands)
影响因子：
--
作者：
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影响因子：
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10.1097/ede.0000000000000319
发表时间：
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期刊：
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影响因子：
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