摘要
目的了解中国中老年人群多维健康贫困指数的时空分布格局,为中老年人群多维健康贫困的精准消除提供循证依据。方法收集2011、2013、2015和2018年中国健康与养老追踪调查(CHARLS)中37296户中国家庭≥45岁中老年人群的个人基本信息、家庭结构和经济支持、健康状况、医疗服务利用和医疗保险、收入和消费等相关数据,采用课题组构建的健康贫困评价指标体系及多维健康贫困测度指数创新性地以健康权利、健康能力和健康风险三大维度测算2011—2018年中国中老年人群多维健康贫困指数并进行地区分解测度,分析中老年人群多维健康贫困指数的时空分布格局。结果中国中老年人群2011、2013、2015、2018年的健康贫困指数和发生率分别为0.320和69.7%、0.326和69.0%、0.349和71.9%、0.291和63.0%,2011—2018年中老年人群健康权利、健康能力和健康风险的贡献度均值分别为0.143、0.450和0.416;基于多维健康贫困指数地区分解测度结果显示,2011年健康贫困最严重的地区为贵州(0.365)、甘肃(0.364)、新疆(0.395)、四川(0.377)、安徽(0.402)和吉林(0.413)6个省(自治区),2013年健康贫困最严重的地区为云南(0.359)、青海(0.361)、内蒙古(0.381)、四川(0.378)、安徽(0.389)和贵州(0.402)6个省(自治区),2015年健康贫困最严重的地区为云南(0.395)、新疆(0.388)、青海(0.448)、四川(0.406)、内蒙古(0.390)、安徽(0.388)、重庆(0.391)、贵州(0.373)、天津(0.370)、黑龙江(0.366)、广西(0.362)、山东(0.362)、江西(0.359)、吉林(0.355)、福建(0.351)和辽宁(0.350)16个省(自治区、直辖市),2018年健康贫困最严重的地区为四川(0.352)、贵州(0.352)和云南(0.351)3个省份。结论中国中老年人群2011—2018年的健康贫困指数和发生率总体上均有所下降,西南地区始终是多维健康贫困最为严重的地区,已陷入整体性的多维健康贫困。
Objective To examine spatial and temporal distribution patterns of household-based multidimensional health poverty(MHP)indexes among middle-aged and elderly populations in China,and to provide evidence to precise elimination of MHP in the populations.Methods The data of the analysis were extracted from four rounds of China Health and Retirement Longitudinal Survey(CHARLS)conducted in 2011,2013,2015,and 2018 across China,which collected the information of residents aged≥45 years in 37296 households on demographics,income and consumption,family structure,economic support,health status,health service utilization and medical insurance.The MHP was assessed and deconstructed with self-established health poverty evaluation index system and multidimensional health poverty measurement index(MHPI)covering three dimensional components(health right,health capability and health risk)of MHP.The year-and region-specific distribution of MHPI were described.Results For all the middle-aged and elderly residents surveyed in 2011,2013,2015,and 2018,the health MHPI were 0.320,0.326,0.349,and 0.29 and the MHP prevalence were 69.7%,69.0%,71.9%,and 63.0%,respectively.The mean values of index measuring the contribution of health right,health capacity and health risk to MHP were 0.143,0.450 and 0.416 for all the residents surveyed in the four rounds of CHARLS study.The results of regional decomposition analysis on MHPI showed that following six provinciallevel administrative divisions(PLADs)could be assessed as with severe prevalence of health poverty in 2011:Guizhou,Gansu,Xinjiang Uygur Autonomous Region(Xinjiang),Sichuan,Anhui,and Jilin,with the mean MHPI of 0.365,0.364,0.395,0.377,0.402,and 0.413,respectively;in 2013,the six PLADs assessed as having severe prevalence of health poverty were Yunnan,Qinghai,Inner Mongolia Autonomous Region(Inner Mongolia),Sichuan,Anhui,and Guizhou and the mean MHPI for those PLADs were 0.359,0.361,0.381,0.378,0.389,and 0.402;while in 2015 the number of PLADs with severe prevalence of health poverty incr
作者
赖勇强
李叶
吴群红
田雨露
刘馨蔚
张曦宇
张晨溪
李红雨
LAI Yongqiang;LI Ye;WU Qunhong;TIAN Yulu;LIU Xinwei;ZHANG Xiyu;ZHANG Chenxi;LI Hongyu(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707-712,共6页
Chinese Journal of Public Health
基金
国家自然科学基金(72174047,71874045)。
关键词
多维健康贫困指数
时空分布格局
中老年人群
中国
multidimensional health poverty index
spatio-temporal distribution pattern
middle-aged and elderly people
China
