摘要
目的了解中国社会区域多维健康贫困的空间分异格局及叠加耦合驱动特征,为下一阶段精准扶贫和健康贫困空间治理提供科学依据。方法收集2011、2013、2015和2018年中国健康与养老追踪调查(CHARLS),2012、2014、2016、2019年《中国统计年鉴》、《中国卫生和计划生育统计年鉴》和2019年全球疾病负担网络中的相关数据,以课题组构建的“能力-权利-风险”多维健康贫困理论模型为框架,最终纳入了健康能力、健康权利、健康风险3个维度的13个指标作为多维健康贫困的驱动因子,采用地理探测器实现单一及耦合驱动作用特征的捕捉,分析驱动因子的空间差异。结果与2011、2013和2015年比较,2018年健康能力维度的人均国内生产总值、城镇化率、居民年住院率的排位均有所上升,而健康权利维度的人均社会保障和就业支出、公众健康教育活动次数的排位均有所下降,权利赋能对于抵御健康贫困发生的效应增强。驱动因子空间差异研究结果显示,2011—2018年东部地区的风险驱动因子主要为城镇失业率,中部地区的风险驱动因子主要为调查前3年PM2.5浓度,而西部地区的多维健康贫困则是健康能力、健康权利和健康风险3个维度联合驱动的结果。从交互作用探测结果显示,健康能力维度的人均国内生产总值、城镇化率与健康权利维度的政府卫生支出占比、人均社会保障和就业支出、每千人口医疗卫生机构床位数的交互作用类型始终为双因子增强,健康能力与健康权利的联合作用会改善多维健康贫困的发生;调查前3年PM2.5浓度这一健康风险指标与居民年住院率、老年抚养比2011年、2013年、2018年的交互作用类型亦为双因子增强。结论多维健康贫困在中国社会区域空间存在时空分异格局,是多维因素耦合驱动的结果,而多维因素耦合对多维健康贫困发生的复杂机制则要求多领域、�
Objective To examine social region-specific characteristics and transition-differentiation of driving factors for multidimensional health poverty(MHP)in China for providing a reference to precise poverty alleviation and effective governance of health poverty.Methods We collected nationwide data from four rounds of the China Health and Retirement Longitudinal Survey(CHARLS)conducted in 2011,2013,2015,and 2018 and other relevant data from the China Statistical Yearbook and the China Health and Family Planning Statistical Yearbook of 2012,2014,2016,and 2019 and from the Global Burden of Disease Network in 2019.Based on a self-established theoretical framework of MHP associated with three dimensional components of health capability-right-risk,we selected 13 indicators covering the three dimensional components as the driving factors of MHP and used geographic detectors to explore the characteristics of independent and coupled effect of the driving factors and analyze differences in spatial distribution of the driving factors.Results Compared with those in 2011,2013,and 2015,the ranking of three health capability dimension factors(gross domestic production[GDP]per capita,urbanization rate,and annual hospitalization rate of residents)increased in 2018;while the ranking of three health right dimension factors(per capita expenditure on both social security and employment and the number of public health education programs)decreased;the effect of health right empowerment on preventing the occurrence of health poverty increased.The analysis on differences in spatial distribution of driving factors during 2011-2018 showed that urban unemployment rate was a main driving factor for MHP in eastern region;while,the main driving factor for MHP in central region was the concentration of particulate matter less than 2.5μm in aerodynamic diameter(PM2.5)three years ago and the MHP was driven jointly by multiple factors with regard to health capability-right-risk.The analyses on interactive effect of the driving factors revealed bivar
作者
吴冰
李叶
吴群红
赖勇强
郝艳华
宁宁
张曦宇
田雨露
WU Bing;LI Ye;WU Qunhong;LAI Yongqiang;HAO Yanhua;NING Ning;ZHANG Xiyu;TIAN Yulu(Research Center of Public Policy and Management,School of Health Management,Harbin Medical University,Harbin 150076,China;Department of Social Medicine,Harbin Medical University,Harbin 150076,China)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2023年第6期695-701,共7页
Chinese Journal of Public Health
基金
国家自然科学基金(72174047,71874045)。
关键词
多维健康贫困
空间分异格局
耦合驱动特征
社会区域
中国
multidimensional health poverty
spatial differentiation pattern
coupled driving characteristics
social region
China
