农村地区经济状况相关的健康不平等演变研究——基于济南市的实证研究

The Analysis on Evolution of Health Inequality Related to the Economic Status in Rural Areas:An Empirical Study of Jinan

目的了解农村地区居民经济状况相关的健康不平等及其来源和变化。方法采用济南市三县、区2009年和2012年的面板数据,利用集中指数及Oaxaca分解法分析居民健康状况与水平公平目标的差距和不平等产生的因素及其演变。结果2009年和2012年居民不良健康得分的集中指数分别为-0.017和-0.022;收入对不平等的贡献率分别为21.88%和63.98%,60岁以上年龄组、受教育程度、职业以及自来水供应的贡献率也较大;在健康不平等的变动中收入对健康不平等增大的贡献最大,为225.97%,主要归因于弹性变化;受教育程度和职业对健康不平等扩大的贡献为负,主要归因于集中指数的变化。结论济南市三县、区存在健康不平等现象,健康水平较差人群较多的集中在低收入人群中,并且在2009年至2012年期间是扩大的。建议增加收入分配的公平性,关注老年人口的保障水平,提高低收入者受教育、就业机会,改善公共服务的提供和社会福利水平,扩大医疗保险覆盖面和保障水平。

OBJECTIVE To study the sources and changes of the health inequality related to the economic status in rural areas. METH- ODS The panel data of three counties in Jinan in 2009 and 2012 were selected as the sample. The study used concentration index （CI） and Oaxaca decomposition method to analyze the inequality and its contributors. RESULTS The CI of ill-health score in 2009 and 2012 were -0.017and -0.022 respectively; the contribution rates of income to the inequality were 21.88% and 63.98% respective- ly; the education, occupation and supply of tap water also has large contribution to inequality of health status. The income has larg- est contribution to the increase of inequality, reaching to 225.97%, and mainly attributed to the change of elasticity; the contribu- tions of education and occupation were negative, and mainly attributed to the change of CI. CONCLUTION There existed health in- equality in three counties of Jinan. The poor health status concentrated in the low-income group, and the inequality was expanded in the period 2009 to 2012. Policies needed to increase the equity of income, pay more attention to old people, improve the low-in- come group from education,promote employment opportunities,improre the support for public services and social profit level and broad- en the coverage of health insurance and reimbursement ability.