北京地区的健康差异和公平性问题研究

Health Disparity and Equity Analysis in Beijing Municipality, China

目的:分析当前北京地区健康差异和公平性现状,探讨其成因及改善健康不公平性的措施,为进一步改善北京地区健康公平性的卫生工作提供一定的依据和对策。方法:综合运用文献分析,健康公平性指标测算等方法分析北京地区居民的健康差异和健康公平性。结果:洛伦兹曲线、基尼系数、差异指数等健康公平性指标测算的结果表明,总体上北京地区健康公平性较好。但在在城乡对比中,2005年北京远郊区县居民期望寿命为77.46岁,比城区居民低3.98岁;值得关注的是,2003—2006年北京市新生儿死亡率以及婴儿死亡率整体下降,但在城乡之间的差距反而有所增加,表明城乡之间的相对公平性没有得到改善。结论:北京地区健康公平性总体较好,存在一定的健康差异,但此差异远小于全国,该差异突出表现在城乡之间、不同社会经济水平之间以及流动人口和户籍人口之间。建议完善社会医疗保障制度、加强农村卫生投入、加强基础卫生建设、关注弱势群体的健康状况,进一步促进健康公平性的提高。

Objective： With the high speed development of the social economic in China, it made a remarkable progress in public health and a obvious enhancement in the people＇s health level. But the health level of the residents in China has a visible disparity between the different areas, the urban and rural, and the different crowd. The objective of the paper is to analyze the status quo and problems of the health disparity and equity in Beijing area, to explore the solutions to this problem for giving the basis and countermeasures to the ＇further work in health equity in Beijing. Method： The indices of equity calculated, descriptive statistics, and literature analysis was carried out to analyze the health disparity and equity in Beijing area. Results： The results of Lorenz＇ curve, Gini coefficient, PAR% and Index of dissimilarity （ID） indicated that it was better on the whole level of the health equity in Beijing. But compared with urban and rural, the life expectancy of the population in the suburban and counties of Beijing was 77.46 in 2005, and it was 3.98 years lower than that in the urban. It＇s worth noting that the disparity of the infant and neonatal mortality were increasing between urban and rural during the year 2003--2006, with whole level in Beijing descending. It showed that the relative equity in Beijing wasn＇t improved between urban and rural. Conclusion： As a whole, the health equity in Beijing area was better. It exited some disparity. The disparity is less than its in the whole country. It was obviously reflected in urban and rural, different social economic levels and between floating population and inhabitant. Suggestion： We should pay more attention to the health of rural and floating population, enhance the improve reform of social security system, and increase the coverage of proper health scheme so as to promote the equity of people＇s health in Beijing.