中国老年人口健康状态变动的辨识及影响因素的评估分析——基于SSAPUR 2015-2016年面板数据

Study on Identification and Determinants of Transition in Health Status of Aging Population in China——Based on Panel Data SSAPUR 2015-2016

老年人的健康问题不仅关系老年人自身的生存质量,而且会对整个社会经济产生深远影响,因此亟须基于大样本数据对老年人口健康状态变动及影响因素进行深入研究。本文基于中国城乡老年人生活状况抽样调查2015-2016年面板数据,在生物-心理-社会医学模式的分析框架下研究影响老年人口健康状态变动的因素。本研究分别采用固定效应的多元Logistic回归模型以及混合的多元Logistic回归模型进行分析。结果表明固定效应模型能够更好地识别老年人口从健康到失能或半失能变动的影响因素。老年人口的健康状况及其变动的影响因素都符合生物-心理-社会医学模式。健康老年人口半失能变动和失能变动的影响因素具有显著不同的分布,从健康到半失能变动主要受社会维度的变量影响,从健康到失能变动主要受生物维度的变量影响。失能变动比半失能变动受更多因素的影响,年龄、参加公益活动、自评经济状况、单独居住和孤独感仅对失能变动有显著影响,居住地和听力障碍仅对半失能变动有显著影响。建议对面临不同风险的老年人进行健康干预,有针对性地采取不同措施。同时注重预防和控制老年人慢性病发生发展,关注老年人听力减退状况,消除老年人贫困,关注老年人心理健康,开展多种适合老年人的活动,推动健康老龄化的实现。

The health problems of the elderly are not only related to the quality of life of the elderly,but also have a profound impact on the entire social economy.An in-depth study of the transition in the health status of the elderly population and influencing factors based on large sample data is urgently needed.Based on panel data SSAPUR 2015-2016,this paper study the determinants of transition in individual health status of the elderly in China in the framework of biopsychosocial model.In this paper,multinomial logistic regression with fixed effects model and mixed multinomial logistic regression model are used.The results show that the multinomial logistic regression with fixed effects model can better identify the determi⁃nants of transition in elderly population from health to disability or semi-disability.The health status of the elderly population and the determinants of transition are in line with the biopsychosocial model.There are significant differences in the distribution of the determinants of the transition of semi-disability and dis⁃ability in elderly.The transition of semi-disability is mainly affected by the variables of social dimension,and the transition of disability is mainly affected by the variables of biological dimension.The transition of disability is influenced by more factors than the transition of semi-disability.Age,participation in public welfare activities,self-assessment of economic status,living alone and loneliness have a significant impact on the transition of disability,while residence and hearing impairment have a significant impact on the transition of semi-disability.It is suggested that different measures should be taken to intervene the elderly with different risks.At the same time,we should pay attention to the prevention and control of the devel⁃opment of chronic diseases of the elderly,also the hearing loss of the elderly,eliminate the poverty of the elderly,pay attention to the mental health of the elderly,carry out various activities suitable for the elderly,and promote the realization of healthy aging.