中国儿童健康不平等的演化和影响因素分析

Evolution of Children's Health Inequality and Related Social Economic Factors in China

本文使用1993年至2009年的中国健康与营养调查(CHNS)数据,分析经济社会因素对中国儿童健康不平等的影响。文章发现:首先,中国儿童存在健康不平等现象。其次,各因素在不同时间截面对儿童健康不平等的相对贡献存在差异。户口和医疗保险对儿童健康不平等的贡献呈现递减的趋势。家庭人均收入和地区固定效应二者的作用相互补充。家庭人均收入的贡献较小时,地区固定效应的贡献相对较大。此外,儿童健康不平等很大程度上受到健康资本代际传递的影响;同时,父母及家庭对儿童的照顾影响也比较大。跨时期看,儿童健康不平等程度存在波动性发展但总体扩大的趋势,即1993年至2004年持续扩大,2004年到2006年有所缩小,2006年后进一步扩大。分析表明医疗保险增加和家庭人均收入增长在一定程度上起到了缩小不平等的作用,但是地区发展不平衡等长期客观存在的问题仍然有待解决。

This paper analyzes the social economic factors behind the health inequality of Chinese children. We find that, first, health inequality is quite significant in China. Second, the contributions of different factors vary, and the importance of Hukou and health insurance is diminishing. The effects of family income and region fixed effect are complementary. Smaller contribution of family income associates with larger contribution of regional fixed effect,and vice versa. Furthermore, inter-generational transmission of health capital significantly affects health inequality. Children＇s care from parents and family also has large impact. The health inequality fluctuates over time but shows increasing trend. From 1993 to 2009,the health inequality increased,but showed different trends for different periods. The inequality increased from 1993 to 2004 while decreased from 2004 to 2006,and widened again since 2006. Overall,the expansion of health insurance coverage and the growth of family income are helpful to reduce inequality,however,the inequality stemming from regional disparity persists.