贫困人口因贫致病和因病致贫影响因素分析

Influencing factors of poverty-related disease and illness-related poverty among poverty stricken population in China

目的通过实证研究的方式,了解我国城乡二元结构下健康与贫困的关联程度,分析健康贫困风险的关键影响因素,为摆脱健康贫困问题找到路径。方法以2012年CFPS成人数据库中35 719个访问对象作为样本,以国家贫困线作为判断低收入的标准,以自评健康状况作为健康标准,用logistic回归分析法了解健康贫困风险的社会因素和疾病因素。结果在调查的≥16岁成年人口中,自评不健康的人群占18%,存在健康贫困风险的人群占13%;不健康与低收入之间存在明显相关关系(P <0.01),在城乡二元结构下,农村地区不健康与低收入的关联程度更高;性别、年龄和受教育程度均是导致健康贫困风险的关键社会因素(P <0.01);导致疾病产生的贫困因素,并不在于贫困本身,而在于与贫困有关的低下的教育水平和有待改善的居住环境(P <0.01);恶性肿瘤、血液疾病和生殖系统疾病因病致贫的效应更为显著(P <0.01)。结论中国健康贫困问题是脱贫的关键,健康贫困与教育贫困和环境贫困之间存在密切的关联。由于城乡社会人口结构的差异,健康贫困问题表现出不同的程度和特点,在精准扶贫的背景下,需要根据社会特征和疾病特征采取有针对性的扶贫策略。

Objective To examine the correlation between poverty and disease and major impact factors of health poverty under urban-rural dual structure condition for exploring pathway to eliminate health poverty in China. Methods We extracted data on 35 719 adult residents(≥ 16 years old) from the dataset of the China Family Panel Studies(CFPS)conducted in 2012. National poverty line was used as the criteria of low income and self-rated health was adopted for health assessment. Logistic regression analysis was used to analyze associations of social and disease factors with health poverty among the participants. Results Of the adults surveyed, 18% were in poor health condition and 13% were at the risk of health poverty. There was a significant correlation between poor health and low income(P < 0.01) and the correlation was much more strong among the rural adults. Gender, age, and education level were major factors related to health poverty(all P <0.01). Low education and poor living condition were significant impact factors for incidence of poverty-related disease(both P < 0.01). Malignant tumor and diseases of hematologic and reproductive system had a stronger influence on illness-related poverty. Conclusion Health poverty is a key determinant for poverty elimination and low education and poor living condition are closely associated with health poverty in China. Specific poverty relief strategies should be developed according to prevalence characteristics in impact factors of health poverty.