童年期家庭经济状况对个体健康的长期影响研究——以医疗保险为视域

The Long-term Effect of Childhood Family Economic Status on Middle Age and Old Age Health:From the Perspective of Medical Insurance

探析长期影响个体健康状况的因素,对构建全生命周期的健康保障进而推进健康中国战略至关重要。本文基于生命历程理论,利用中国健康与养老追踪调查(CHARLS)数据,探讨童年期家庭经济状况对个体健康的长期影响。通过"受访者母亲是否是文盲、受访者父母当中是否有党员"这两个工具变量处理内生性后发现,童年期家庭经济状况较差个体的中老年期ADL能力和IADL能力较好。引入医疗保险做进一步研究的结果表明:(1)首份工作参保类型为老农合的受访者,中老年期ADL和IADL能力皆较差,而受访者目前参加的社会医疗保险对其中老年期的ADL和IADL能力暂无影响;(2)参加社会医疗保险时年龄越大的个体,现阶段的IADL能力越差,而ADL能力无明显差异。因此,健康中国战略的发展须关注低收入家庭的儿童;医疗保障政策的实施要重视老农合、新农合参保者的长期健康;应加强医疗保险政策与公共卫生政策联动,减缓较大年龄时加入社会医疗保险群体认知能力的衰退。

To explore the factors which have effects on people health,has great importance to construct a life cycle health protection and carry out Healthy China strategy.This paper is basd on life course theory and used the data of CHARLS to explore the long-term effect of childhood family economic status on middle age and old age people′s health.While useing the instruments variable of“Whether the respondent′s mother was illiterate,Whether the respondent′s parents was party members”to solve endogenous problem,it finds that people who had low childhood family economic status had better ADL and IADL status now.And then,a further analysis is made considering the factors of medical insurance,it finds:①respondents who had first medical insurance of cooperative medical insurance had bad ADL and IADL status now,however,the current social medical insurance had no impact on people′s current ADL and IADL status;②participants who joined the social medical insurance order and now had bad IADL status,while there was no significant difference in ADL status.So,at first,the implementation of Healthy China strategy should focus on the children born and grow in low-income families.And then,the implementation of medical insurance policy should pay attention to the long-term health of those old rural cooperative medical insurance and the new rural cooperative medical insurance participants.Finally,government should strengthen the linkage between medical insurance policy and public health policy to slow down the decline of cognitive ability about people who participated social medical insurance were order.